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Sample records for hospitalized schizophrenia patients

  1. Effects of medication adherence on hospitalizations and healthcare costs in patients with schizophrenia in Thailand

    PubMed Central

    Dilokthornsakul, Piyameth; Thoopputra, Thitaporn; Patanaprateep, Oraluck; Kongsakon, Ronnachai; Chaiyakunapruk, Nathorn

    2016-01-01

    Background: This study was conducted to determine the impacts of medication adherence on hospitalization and direct healthcare cost in patients with schizophrenia in Thailand. Methods: A retrospective study was undertaken. Patients with schizophrenia aged 18–65 years who visited a University hospital and received antipsychotics from April 2011 to October 2011 were included. Propensity score–adjusted logistic regression was used to determine the impacts of medication adherence on schizophrenia-related and all-cause hospitalizations. Results: A total of 582 patients were included. Three out of 224 patients (1.3%) were hospitalized with schizophrenia in optimal adherence group, while 10 of 140 (7.1%) were hospitalized in under-adherence group, and 7 of 218 (3.2%) were hospitalized in over-adherence group. Based on propensity score–adjusted multivariate logistic regression, the adjusted odds ratio was 5.86 (95% confidence interval = 1.53–22.50) for schizophrenia-related hospitalization and 8.04 (95% confidence interval = 2.20–29.40) for all-cause hospitalization. The average annual direct healthcare costs in patients with optimal adherence, under-adherence, and over-adherence were US$371 ± US$836, US$386 ± US$734, and US$508 ± US$2168, respectively. Conclusion: An initiation of interventions to maintain optimal adherence in patients with schizophrenia would significantly impact the healthcare system. PMID:27026801

  2. Hospitalization and cost after switching from atypical to typical antipsychotics in schizophrenia patients in Thailand

    PubMed Central

    Boonlue, Tuanthon; Subongkot, Suphat; Dilokthornsakul, Piyameth; Kongsakon, Ronnachai; Pattanaprateep, Oraluck; Suanchang, Orabhorn; Chaiyakunapruk, Nathorn

    2016-01-01

    Background Several clinical practice guidelines suggest using atypical over typical antipsychotics in patients diagnosed with schizophrenia. Nevertheless, cost-containment policy urged restricting usage of atypical antipsychotics and switching from atypical to typical antipsychotics. Objective This study aimed to evaluate clinical and economic impacts of switching from atypical to typical antipsychotics in schizophrenia patients in Thailand. Methods From October 2010 through September 2013, a retrospective cohort study was performed utilizing electronic database of two tertiary hospitals. Schizophrenia patients aged 18 years or older and being treated with atypical antipsychotics were included. Patients were classified as atypical antipsychotic switching group if they switched to typical antipsychotics after 180 days of continual atypical antipsychotics therapy. Outcomes were schizophrenia-related hospitalization and total health care cost. Logistic and Poisson regression were used to evaluate the risk of hospitalization, and generalized linear model with gamma distribution was used to determine the health care cost. All analyses were adjusted by employing propensity score and multivariable analyses. All cost estimates were adjusted according to 2013 consumer price index and converted to US$ at an exchange rate of 32.85 Thai bahts/US$. Results A total of 2,354 patients were included. Of them, 166 (7.1%) patients switched to typical antipsychotics. The adjusted odds ratio for schizophrenia-related hospitalization in atypical antipsychotic switching group was 1.87 (95% confidence interval [CI] 1.23–2.83). The adjusted incidence rate ratio was 2.44 (95% CI 1.57–3.79) for schizophrenia-related hospitalizations. The average total health care cost was lower in patients with antipsychotic switching (−$64; 95% CI −$459 to $332). Conclusion Switching from atypical to typical antipsychotics is associated with an increased risk of schizophrenia-related hospitalization

  3. Cognitive Adaptation Training Provided to Chronically Hospitalized Patients with Schizophrenia in The Netherlands: Two Case Reports

    PubMed Central

    Quee, Piotr J.; Schneider, Harald; van Slogteren, Saskia; Wiersma, Durk; Bruggeman, Richard; Velligan, Dawn I.

    2012-01-01

    Cognitive adaptation training (CAT) improves functional outcome in outpatients with schizophrenia living in the United States of America. The efficacy of CAT has never been demonstrated for patients living in a residential facility. We describe how CAT was delivered to two chronically hospitalized patients with schizophrenia living in The Netherlands. CAT was delivered for 8 months, and consisted of weekly home visits by a psychiatric nurse. Both patients improved on measures of functional outcome used in the US studies. These results indicate that CAT may improve outcomes, even in patients that have been hospitalized for several years. PMID:23082269

  4. Prevalence of Metabolic Syndrome in Patients with Schizophrenia Referred to Farabi Hospital, Kermanshah, Iran

    PubMed Central

    Shakeri, Jalal; Karimi, Kamyar; Farnia, Vahid; Golshani, Senobar; Alikhani, Mostafa

    2016-01-01

    Objectives Our study was conducted to determine the prevalence of metabolic syndrome in patients with schizophrenia. Methods The study population included all patients with schizophrenia who were referred to Farabi Hospital, Kermanshah, Iran, between March 2014 and March 2015. A total of 280 subjects who met the study criteria were selected according to the census sampling method. Results The prevalence of metabolic syndrome was 30.4% (20.7% in men and 51.5% in women). The prevalence of metabolic syndrome was greater in patients > 40 years than patients aged 20–40 years. There was a significant relationship between marital status and number of hospitalizations with the prevalence of metabolic syndrome. Conclusions Given the high prevalence of metabolic syndrome in patients with schizophrenia, healthcare professionals should take measures to identify the risk factors and timely treatment of affected patients, thereby improving the patient’s quality of life and reducing health costs. PMID:27403239

  5. Previous hospital admissions and disease severity predict the use of antipsychotic combination treatment in patients with schizophrenia

    PubMed Central

    2011-01-01

    Background Although not recommended in treatment guidelines, previous studies have shown a frequent use of more than one antipsychotic agent among patients with schizophrenia. The main aims of the present study were to explore the antipsychotic treatment regimen among patients with schizophrenia in a catchment area-based sample and to investigate clinical characteristics associated with antipsychotic combination treatment. Methods The study included 329 patients diagnosed with schizophrenia using antipsychotic medication. Patients were recruited from all psychiatric hospitals in Oslo. Diagnoses were obtained by use of the Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I). Additionally, Global Assessment of Functioning (GAF), Positive and Negative Syndrome Scale (PANSS) and number of hospitalisations and pharmacological treatment were assessed. Results Multiple hospital admissions, low GAF scores and high PANSS scores, were significantly associated with the prescription of combination treatment with two or more antipsychotics. The use of combination treatment increased significantly from the second hospital admission. Combination therapy was not significantly associated with age or gender. Regression models confirmed that an increasing number of hospital admission was the strongest predictor of the use of two or more antipsychotics. Conclusions Previous hospital admissions and disease severity measured by high PANSS scores and low GAF scores, predict the use of antipsychotic combination treatment in patients with schizophrenia. Future studies should further explore the use of antipsychotic drug treatment in clinical practice and partly based on such data establish more robust treatment guidelines for patients with persistently high symptom load. PMID:21812996

  6. A population-based longitudinal study of suicide risk in male schizophrenia patients: Proximity to hospital discharge and the moderating effect of premorbid IQ.

    PubMed

    Weiser, Mark; Kapara, Ori; Werbeloff, Nomi; Goldberg, Shira; Fenchel, Daphna; Reichenberg, Abraham; Yoffe, Rinat; Ginat, Keren; Fruchter, Eyal; Davidson, Michael

    2015-12-01

    Suicide is a major cause of death in schizophrenia. Identifying factors which increase the risk of suicide among schizophrenia patients might help focus prevention efforts. This study examined risk of suicide in male schizophrenia patients using population-based data, examining the timing of suicide in relation to the last hospital discharge, and the effect of premorbid IQ on risk of suicide. Data on 930,000 male adolescents from the Israeli military draft board were linked with data from the Israeli Psychiatric Hospitalization Case Registry and vital statistics from the Israeli Ministry of Health. The relationship between premorbid IQ and risk for suicide was examined among 2881 males hospitalized with schizophrenia and compared to a control group of 566,726 males from the same cohort, who were not hospitalized for a psychiatric disorder, using survival analysis methods. Over a mean follow-up period of 9.9 years (SD=5.8, range: 0-22 years), 77/3806 males with schizophrenia died by suicide (a suicide rate of 204.4 per 100,000 person-years). Approximately 48% of the suicides occurred within a year of discharge from the last hospital admission for schizophrenia. Risk of suicide was higher in male schizophrenia patients with high premorbid IQ (HR=4.45, 95% CI=1.37-14.43) compared to those with normal premorbid IQ. These data indicate that male schizophrenia patients with high premorbid IQ are at particularly high risk of suicide, and the time of peak risk is during the first year after the last hospitalization discharge. PMID:26490295

  7. [The long road home: a discussion of the autonomy of schizophrenia patients after their discharge from the hospital].

    PubMed

    Chuang, Li-Yu; Huang, Mei-Chih

    2014-10-01

    Every adult has the right to self-determination and to have his or her autonomy respected. While schizophrenia patients have the right to be discharged from the hospital, their needs subject their caregivers to high care loadings. This situation presents a dilemma for the medical team. The authors justify the patient's autonomy to request and to be granted a discharge. Then, present the decision-making process related to discharge for the reference of medical teams. Capacity is necessary to autonomy. There is currently no standard for assessing the capacity of patients that clearly defines their competence. A sliding scale approach to decision making distinguishes between decisions involving significant potential risk and, therefore, involving higher level of capacity requirements and decisions on minimal potential risk. In order to protect the interests of patients, the sliding scale approach takes into account different decisions. Cases in which schizophrenia patients choose to self-discharge involve a high-level of risk. Poor preparations for follow-up care lead to poor-quality patient care and may cause harm to the patients. In a share decision model, the medical team plays the role of negotiator between the patient and the family and respects the autonomy of the patient while supporting the family through the hospital discharge process. Medical team must have a discharge planning for the patient and family, follow-up care system, and support network. During hospitalization, the discharge plan aims to facilitate the life adaptation and disease recovery for patients with the goal of restoring their normal home life. PMID:25271036

  8. mHealth for Schizophrenia: Patient Engagement With a Mobile Phone Intervention Following Hospital Discharge

    PubMed Central

    Scherer, Emily A; Gottlieb, Jennifer D; Rotondi, Armando J; Brunette, Mary F; Achtyes, Eric D; Mueser, Kim T; Gingerich, Susan; Brenner, Christopher J; Begale, Mark; Mohr, David C; Schooler, Nina; Marcy, Patricia; Robinson, Delbert G; Kane, John M

    2016-01-01

    Background mHealth interventions that use mobile phones as instruments for illness management are gaining popularity. Research examining mobile phone‒based mHealth programs for people with psychosis has shown that these approaches are feasible, acceptable, and clinically promising. However, most mHealth initiatives involving people with schizophrenia have spanned periods ranging from a few days to several weeks and have typically involved participants who were clinically stable. Objective Our aim was to evaluate the viability of extended mHealth interventions for people with schizophrenia-spectrum disorders following hospital discharge. Specifically, we set out to examine the following: (1) Can individuals be engaged with a mobile phone intervention program during this high-risk period?, (2) Are age, gender, racial background, or hospitalization history associated with their engagement or persistence in using a mobile phone intervention over time?, and (3) Does engagement differ by characteristics of the mHealth intervention itself (ie, pre-programmed vs on-demand functions)? Methods We examined mHealth intervention use and demographic and clinical predictors of engagement in 342 individuals with schizophrenia-spectrum disorders who were given the FOCUS mobile phone intervention as part of a technology-assisted relapse prevention program during the 6-month high-risk period following hospitalization. Results On average, participants engaged with FOCUS for 82% of the weeks they had the mobile phone. People who used FOCUS more often continued using it over longer periods: 44% used the intervention over 5-6 months, on average 4.3 days a week. Gender, race, age, and number of past psychiatric hospitalizations were associated with engagement. Females used FOCUS on average 0.4 more days a week than males. White participants engaged on average 0.7 days more a week than African-Americans and responded to prompts on 0.7 days more a week than Hispanic participants. Younger

  9. Concurrent Oral Antipsychotic Drug Use Among Schizophrenia Patients Initiated on Long-Acting Injectable Antipsychotics Post-Hospital Discharge.

    PubMed

    Doshi, Jalpa A; Pettit, Amy R; Stoddard, Jeffrey J; Zummo, Jacqueline; Marcus, Steven C

    2015-08-01

    Pharmacological treatment is central to effective management of schizophrenia. Prescribing clinicians have an increasing array of options from which to choose, and oral antipsychotic polypharmacy is common in routine clinical practice. Practice guidelines recommend long-acting injectable (LAI) formulations, typically viewed as monotherapeutic alternatives, for patients with established nonadherence. Yet there are limited data on the prevalence and nature of concurrent oral antipsychotic prescriptions in patients receiving LAIs. Our observational, claims-based study examined the frequency and duration of concurrent oral prescriptions in 340 Medicaid patients receiving LAI therapy. Specifically, we examined patients with a recent history of nonadherence and hospitalization for schizophrenia and included both first-generation antipsychotic depot medications (fluphenazine decanoate, haloperidol decanoate) and more recently available second-generation injectables (LAI risperidone, paliperidone palmitate). Of all patients initiated on LAIs, 75.9% had a concurrent oral antipsychotic prescription in the 6 months post-hospital discharge. Patients receiving concurrent prescriptions were frequently prescribed an oral formulation of their LAI agent, but many first-generation LAI users received a concurrent second-generation oral medication. The lowest rate of concurrent prescribing (58.8%) was found with paliperidone palmitate, whereas the highest rate was with LAI risperidone (88.9%). Overlap in oral and LAI prescriptions typically occurred for a substantial period of time (ie, >30 days) and for a notable percentage of the days covered by LAIs (often 50% or more). Our findings highlight the need to further examine such prescribing patterns, to probe the reasons for them, and to clarify the optimal roles of different antipsychotic treatments in clinical practice. PMID:26075492

  10. Electroencephalographic characteristics of Iranian schizophrenia patients.

    PubMed

    Chaychi, Irman; Foroughipour, Mohsen; Haghir, Hossein; Talaei, Ali; Chaichi, Ashkan

    2015-12-01

    Schizophrenia is a prevalent psychiatric disease with heterogeneous causes that is diagnosed based on history and mental status examination. Applied electrophysiology is a non-invasive method to investigate the function of the involved brain areas. In a previously understudied population, we examined acute phase electroencephalography (EEG) records along with pertinent Positive and Negative Syndrome Scale (PANSS) and Mini Mental State Examination (MMSE) scores for each patient. Sixty-four hospitalized patients diagnosed to have schizophrenia in Ebn-e-Sina Hospital were included in this study. PANSS and MMSE were completed and EEG tracings for every patient were recorded. Also, EEG tracings were recorded for 64 matched individuals of the control group. Although the predominant wave pattern in both patients and controls was alpha, theta waves were almost exclusively found in eight (12.5 %) patients with schizophrenia. Pathological waves in schizophrenia patients were exclusively found in the frontal brain region, while identified pathological waves in controls were limited to the temporal region. No specific EEG finding supported laterality in schizophrenia patients. PANSS and MMSE scores were significantly correlated with specific EEG parameters (all P values <0.04). Patients with schizophrenia demonstrate specific EEG patterns and show a clear correlation between EEG parameters and PANSS and MMSE scores. These characteristics are not observed in all patients, which imply that despite an acceptable specificity, they are not applicable for the majority of schizophrenia patients. Any deduction drawn based on EEG and scoring systems is in need of larger studies incorporating more patients and using better functional imaging techniques for the brain. PMID:25651947

  11. Clinical characteristics of synthetic cannabinoid-induced psychosis in relation to schizophrenia: a single-center cross-sectional analysis of concurrently hospitalized patients

    PubMed Central

    Altintas, Merih; Inanc, Leman; Oruc, Gamze Akcay; Arpacioglu, Selim; Gulec, Huseyin

    2016-01-01

    Background This study aimed to evaluate synthetic cannabinoid (SC)-induced psychosis in terms of patient profile and clinical characteristics with reference to concurrently hospitalized schizophrenic patients. Methods A total of 81 male patients diagnosed with psychotic disorder induced by the use of SCs (n=50; mean (standard deviation [SD]) age: 25.9 (5.5) years) or with schizophrenia (n=31, mean (SD) age: 42.9 (11.6) years) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis criteria who were concurrently hospitalized at Erenköy Mental and Neurological Diseases Training and Research Hospital were included in this cross-sectional study. Data on sociodemographic characteristics, Brief Psychiatric Rating Scale (BPRS), Positive and Negative Syndrome Scale (PANSS), Frontal Assessment Battery (FAB), Hamilton Rating Scale for Depression (HRSD), and Hamilton Anxiety Rating Scale (HAM-A) were recorded in all the patients. Results Mean (SD) age at disease onset in SC-induced psychosis patients was 22.3 (5.6) years; 26.0% had suicidal ideation and 58.4% were hospitalized involuntarily. Marijuana was the most common first used substance (72.0%), and solitary use of SC was noted in 38.0% of patients. SC-induced psychosis patients had similar PANSS positive, BPRS, HRSD, and FAB scores and significantly lower PANSS negative scores (18.0 [6.5] vs 22.3 [6.0], P=0.004) than patients with schizophrenia, while they had similar HAM-A scores (17.8 [10.3] vs 21.6 [5.5], P=0.085) as young schizophrenics. Age at onset for SC (r=0.364, P=0.05) or substance (r=0.395, P=0.01) use was correlated positively with total FAB scores. Conclusion In conclusion, our findings revealed SC-induced psychosis to influence young individuals and be associated with remarkable rates of suicidal ideation and involuntary hospitalization as well as similar clinical picture with schizophrenia in terms of PANSS positive, BPRS, HRSD, HAM-A, and FAB scores. Younger age at

  12. Efficacy and safety of once-monthly injection of paliperidone palmitate in hospitalized Asian patients with acute exacerbated schizophrenia: an open-label, prospective, noncomparative study

    PubMed Central

    Li, HuaFang; Turkoz, Ibrahim; Zhang, Fan

    2016-01-01

    Introduction This single-group, open-label, prospective, noncomparative, multicenter, Phase IV study explored the efficacy and tolerability of paliperidone palmitate (PP) in hospitalized patients with acute exacerbation of schizophrenia. Methods Asian patients of either sex, between 18 and 65 years of age, diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) with acute exacerbations within the previous 4 weeks, were enrolled. Intramuscular PP was initiated at doses of 150 milligram equivalent (mg eq) (day 1) and 100 mg eq (day 8), followed by a monthly maintenance dose between 75 mg eq and 150 mg eq (days 36 and 64). Primary efficacy endpoint was the change from baseline in the Positive and Negative Syndrome Scale (PANSS) total score (last-observation-carried-forward) at week 13. Results Of the 212 enrolled patients, 152 (71.7%) completed the 13-week treatment; withdrawal of consent (24 [11.3%] patients) was the most common reason for study discontinuation. Mean (standard deviation) PANSS total score from baseline (90.0 [17.41]) improved significantly at day 4 (−6.1 [9.27]; 95% confidence interval: −7.38, −4.85; P<0.001) and week 13 endpoint (−23.9 [23.24]; 95% confidence interval: −27.10, −20.78; P<0.001). Similarly, the secondary endpoints (Clinical Global Impression-Severity, Physical and Social Performance, each PANSS subscale, and Marder factor scores) improved significantly from baseline to week 13 endpoint (P<0.001 for all). At week 13, 112/210 (53.3%) patients had a 40% improvement in the PANSS total score (responder rate), and 133/212 (62.7%) patients were ready for hospital discharge. Overall, 139 (65.6%) patients experienced at least one treatment-emergent adverse event (TEAE). Most common (>5%) TEAEs were hyperprolactinemia, constipation, nasopharyngitis, insomnia, increased weight, and tremor. Worsening of schizophrenia (3.3%) and sinus bradycardia (2.0%) were serious TEAEs; no deaths were

  13. Sulfotransferase 4A1 Haplotype 1 (SULT4A1-1) Is Associated With Decreased Hospitalization Events in Antipsychotic-Treated Patients With Schizophrenia

    PubMed Central

    Liu, Qian; Ramsey, Timothy L.; Meltzer, Herbert Y.; Massey, Bill W.; Padmanabhan, Saranya

    2012-01-01

    Objective: To evaluate a common genetic variant, sulfotransferase 4A1 haplotype 1 (SULT4A1-1), as a predictor of hospitalization events due to the exacerbation of schizophrenia for patients treated with antipsychotic medications. Haplotypes were determined using single nucleotide polymorphism data. Method: The study included 417 white subjects from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study with a DSM-IV diagnosis of schizophrenia. Patients were assigned to 1 of 4 atypical antipsychotics (olanzapine, quetiapine, risperidone, or ziprasidone) or to the first-generation antipsychotic perphenazine. Kaplan-Meier survival analysis and Cox proportional hazards regression models were used to measure if haplotype status impacted hospitalization events for these 5 treatments. Haplotype status was evaluated for its relationship to hospitalization events regardless of treatment and for the individual treatments, with or without previous exacerbation. Data for the CATIE study were collected from January 2001 to December 2004. The current post hoc analysis was performed between May 2011 and August 2011. Results: In phase 1 of the trial, considering only the first hospitalization events, the haplotype had a significant impact on hospitalization events, with a hazard ratio for SULT4A1-1(−) versus SULT4A1-1(+) of 2.54 (P = .048). When prior exacerbation was included in the model for phase 1, the hazard ratio was 2.34 (P = .072) considering only the first hospitalization event and 2.71 (P = .039) considering all hospitalization events in the phase. When data for all phases were evaluated, SULT4A1-1(−) status was associated with increased hospitalization risk for subjects treated with olanzapine, with a hazard ratio of 8.26 (P = .041), and possibly for subjects treated with quetiapine, with a hazard ratio of 6.80 (P = .070). Conclusions: The SULT4A1-1 haplotype may be an important predictor of risk of hospitalization. SULT4A1-1(+) status was

  14. The impact of the Chi-Chi earthquake on the incidence of hospitalizations for schizophrenia and on concomitant hospital choice.

    PubMed

    Tseng, Kuan-Chiao; Hemenway, David; Kawachi, Ichiro; Subramanian, S V; Chen, Wei J

    2010-02-01

    This study aimed to evaluate the impact of a catastrophic earthquake on the incidence of hospitalizations for schizophrenia, and on the choice of hospitals for patients thus hospitalized, using a quasi-experimental design. Results demonstrated post-catastrophe increases in the incidence of hospitalizations for schizophrenia by 11.0 and 21.6% in the first and second year after the disaster, respectively. Among index hospitalizations for schizophrenia, the earthquake was associated with decreases in the use of teaching and public hospitals. For patients with schizophrenia, aggravation of symptoms and the likelihood of being crowded out of the use of health care services by those with other physical or mental illnesses after a catastrophe warrant our attention. PMID:19898984

  15. Outpatient Follow-Up Visit after Hospital Discharge Lowers Risk of Rehospitalization in Patients with Schizophrenia: A Nationwide Population-Based Study

    PubMed Central

    Lee, Seung Yup; Kim, Kyoung Hoon; Kim, Tae; Kim, Sun Min; Kim, Jong-Woo; Han, Changsu; Song, Ji Young

    2015-01-01

    Objective Non-adherence to medication is a recognized problem in psychiatric patients and may be one of the most challenging aspects of treatment for patients with schizophrenia. Failure of follow-up care after discharge greatly increases non-adherence to prescribed medications, relapse and rehospitalization. However, it is still unknown whether and how much outpatient follow-up visits can mitigate the risk of rehospitalization. Therefore we sought to investigate the continuity and effectiveness of outpatient care after inpatient discharge and its effect on rehospitalization of patients with schizophrenia. Methods Data were extracted from National Health Insurance Claim Database covering the period from 2007 through 2010. We identified 10,246 patients aged 18 years or older who were admitted in psychiatric facilities with the diagnosis of schizophrenia between January 1 and December 31 in 2007. The number of outpatient visits within 60 days after discharge from index admission was defined as the indicator for the continuous care and rehospitalization was inspected during the following 36-month period. Cox's proportional hazard model was used to examine the factors affecting the risk of rehospitalization including the number of outpatient visits, age, sex, comorbidities, antipsychotics, and characteristics of medical institution. Results We found that 12.7% (n=1,327) of the patients visited psychiatric outpatient department once within 60 days after hospital discharge, 34.8% (n=3,626) twice, and 27.8% (n=2,900) more than three times. Patients taking atypical antipsychotics showed higher proportion in 2 or more outpatient visits, whereas patients taking typical antipsychotics showed higher proportion in one or no outpatient visits. Cox hazard ratios of rehospitalization for the factor of 3 or more outpatient visits referenced to that of no follow-up visit were 0.567 (0.428-0.750, 95% confidence interval) within 90 days, 0.673 (0.574-0.789) within 180 days, 0.800 (0

  16. Differences between patients with schizophrenia with and without co-occurring methamphetamine use disorders in a Taiwanese public psychiatric hospital.

    PubMed

    Lin, Ching-Hua; Huang, Yu-Hui; Wu, Hung-Chi; Chen, Cheng-Chung

    2014-11-01

    This study aimed to examine the factors related to and the outcomes of schizophrenic patients with co-occurring methamphetamine use disorders (MUDs). All schizophrenic patients discharged from a psychiatric hospital between January 1, 2006, and December 31, 2006, were monitored. This study compared the important demographic and clinical variables between patients with co-occurring MUDs and those without, and postdischarge measured time to rehospitalization during a 1-year period. Seven hundred fifty-six patients were included in this study. Of these patients, 88 (11.6%) reported the use of methamphetamine. Univariate analyses indicated that male sex, low educational level, discharge against medical advice, missed first appointment after discharge, co-occurring other illicit substance use disorder, age (younger), diazepam equivalents prescribed at discharge (higher), number of previous admissions within the past 5 years (higher), and length of hospital stay (longer) were predictive of patients with co-occurring MUDs. There were also significant differences in time to rehospitalization between these two groups during the follow-up periods. Many factors can be identified in schizophrenic patients with co-occurring MUDs. Furthermore, schizophrenic patients with co-occurring MUDs were more likely to be rehospitalized. Future studies in many different mental health systems are needed before these findings can be generalized. PMID:25268153

  17. Corneal temperature in schizophrenia patients.

    PubMed

    Shiloh, Roni; Munitz, Hanan; Portuguese, Shirley; Gross-Isseroff, Ruth; Sigler, Mayanit; Bodinger, Liron; Katz, Nachum; Stryjer, Rafael; Hermesh, Haggai; Weizman, Abraham

    2005-12-01

    Most data imply that dopaminergic transmission is essential for proper hypothalamic-mediated core temperature regulation. Altered central dopaminergic transmission is suggested to be involved in the pathophysiology of schizophrenia. Thus, hypothetically, schizophrenia patients might be at increased risk of developing thermoregulatory dysregulation manifested by alterations in core temperature, as well as in peripheral tissue, the temperature of which has been shown to correlate with core temperature (e.g. cornea). Previous small pilot studies of ours showed that schizophrenia patients may exhibit corneal temperature abnormalities. Hence, we assessed corneal temperature in a controlled sample of drug-free ( n =11) and medicated ( n =28) schizophrenia patients compared to healthy comparison subjects ( n =9), using a FLIR thermal imaging camera. Drug-free schizophrenia patients exhibited significantly higher corneal temperature compared to healthy subjects, typical antipsychotic drug (APD)-treated patients ( n =16) and atypical APD-treated patients ( n =12) (37.08+/-1.46 degrees C vs. 33.37+/-2.51 degrees C, 31.08+/-1.43 degrees C and 31.67+/-0.44 degrees C respectively, p <0.0001; p <0.001 vs. each group separately). The healthy comparison subjects and the atypical APD-treated patients exhibited comparable corneal temperatures and these two groups exhibited higher corneal temperatures compared to the typical APD-treated patients ( p <0.01 and p =0.051 respectively). In conclusion, this study indicates that drug-free schizophrenia patients exhibit substantially higher corneal temperature compared to healthy comparison subjects or medicated patients, and that APDs may decrease corneal temperature either to normal (atypical APD) or to subnormal (typical APD) values. The relevance of these phenomena to the pathophysiology of schizophrenia, the biological mechanism underlying drug-induced corneal temperature alterations, the possible role of temperature-lowering drugs

  18. Factors Affecting Well-being and Socio-occupational Functioning in Schizophrenia Patients Following an Acute Exacerbation: A Hospital Based Observational Study

    PubMed Central

    Gopalakrishnan, Roopa; Behere, Rishikesh V.; Sharma, P.S.V.N.

    2015-01-01

    Background: Improving functioning levels are an important goal of treatment in schizophrenia. Most studies have described long-term course and outcome in schizophrenia. However, understanding factors influencing functioning in the immediate recovery period following an acute exacerbation may be of important clinical relevance. Aim: The aim of this study is to assess the factors that influence well-being and socio-occupational functioning following an acute exacerbation in schizophrenia patients. Materials and Methods: The study included 40 patients during the period from June 2013 to June 2014. The possible effect of gender, duration of illness, duration of untreated psychosis, premorbid adjustment, cognitive impairment, facial affect perception and treatment compliance on well-being, and socio-occupational functioning was examined. Results: About 45% of the individuals experienced below average well-being. On logistic regression analysis poor compliance with medication and poorer cognitive functioning significantly differentiated the patient group with below average well-being from those with an above average well-being. Male gender, poor premorbid adjustment, poor compliance to treatment, poor cognitive functioning, and greater duration of untreated psychosis were found to be associated with a poorer socio-occupational functioning. Conclusion: Clinical interventions focusing on improving cognitive impairment and compliance to treatment could play a role in improving well-being, and socio-occupational functioning in schizophrenia patients following an acute exacerbation. PMID:26702175

  19. Do patients think cannabis causes schizophrenia? - A qualitative study on the causal beliefs of cannabis using patients with schizophrenia

    PubMed Central

    2010-01-01

    Background There has been a considerable amount of debate among the research community whether cannabis use may cause schizophrenia and whether cannabis use of patients with schizophrenia is associated with earlier and more frequent relapses. Considering that studies exploring patients' view on controversial topics have contributed to our understanding of important clinical issues, it is surprising how little these views have been explored to add to our understanding of the link between cannabis and psychosis. The present study was designed to elucidate whether patients with schizophrenia who use cannabis believe that its use has caused their schizophrenia and to explore these patients other beliefs and perceptions about the effects of the drug. Methods We recruited ten consecutive patients fulfilling criteria for paranoid schizophrenia and for a harmful use of/dependence from cannabis (ICD-10 F20.0 + F12.1 or F12.2) from the in- and outpatient clinic of the Psychiatric University Hospital Zurich. They were interviewed using qualitative methodology. Furthermore, information on amount, frequency, and effects of use was obtained. A grounded theory approach to data analysis was taken to evaluate findings. Results None of the patients described a causal link between the use of cannabis and their schizophrenia. Disease models included upbringing under difficult circumstances (5) or use of substances other than cannabis (e. g. hallucinogens, 3). Two patients gave other reasons. Four patients considered cannabis a therapeutic aid and reported that positive effects (reduction of anxiety and tension) prevailed over its possible disadvantages (exacerbation of positive symptoms). Conclusions Patients with schizophrenia did not establish a causal link between schizophrenia and the use of cannabis. We suggest that clinicians consider our findings in their work with patients suffering from these co-occurring disorders. Withholding treatment or excluding patients from certain

  20. Approaches to improve adherence to pharmacotherapy in patients with schizophrenia

    PubMed Central

    Shuler, Kimberly M

    2014-01-01

    Purpose In patients with schizophrenia, nonadherence to prescribed medications increases the risk of patient relapse and hospitalization, key contributors to the costs associated with treatment. The objectives of this review were to evaluate the impact of nonadherence to pharmacotherapy in patients with schizophrenia as it relates to health care professionals, particularly social workers, and to identify effective team approaches to supporting patients based on studies assessing implementation of assertive community treatment teams. Materials and methods A systematic review of the medical literature was conducted by searching the Scopus database to identify articles associated with treatment adherence in patients with schizophrenia. Articles included were published from January 1, 2003, through July 15, 2013, were written in English, and reported findings concerning any and all aspects of nonadherence to prescribed treatment in patients with schizophrenia. Results Of 92 unique articles identified and formally screened, 47 met the inclusion criteria for the systematic review. The burden of nonadherence in schizophrenia is significant. Factors with the potential to affect adherence include antipsychotic drug class and formulation, patient-specific factors, and family/social support system. There is inconclusive evidence suggesting superior adherence with an atypical versus typical antipsychotic or with a long-acting injectable versus an oral formulation. Patient-specific factors that contribute to adherence include awareness/denial of illness, cognitive issues, stigma associated with taking medication, substance abuse, access to health care, employment/poverty, and insurance status. Lack of social or family support may adversely affect adherence, necessitating the assistance of health care professionals, such as social workers. Evidence supports the concept that an enhanced team-oriented approach to managing patients with schizophrenia improves adherence and supports

  1. Long-term hospitalizations for schizophrenia in the Czech Republic 1998-2012.

    PubMed

    Winkler, Petr; Mladá, Karolína; Krupchanka, Dzmitry; Agius, Mark; Ray, Manaan Kar; Höschl, Cyril

    2016-08-01

    Deinstitutionalization has not been pursued in the post-communist Europe until recently. The population of psychiatric patients institutionalized in the regional mental hospitals is, however, largely understudied. The aim of this study is to assess discharges of long-term inpatients with schizophrenia from Czech psychiatric hospitals and to analyse re-hospitalizations within this group. The nationwide register of all-cause inpatient hospitalizations was merged with the nationwide register of all-cause deaths on an individual level basis. Descriptive statistics, survival analysis and logistic regression were performed. 3601 patients with schizophrenia previously hospitalized for more than a year were discharged from Czech mental hospitals between 1998 and 2012. This included 260 patients hospitalized for >20years. Nearly one fifth (n=707) of the long-term patients died during the hospitalization; and discharges of 19.36% (n=697) were only administrative in their nature. Out of 2197 truly discharged patients, 14.88% (n=327) were re-hospitalized within 2weeks after the discharge. The highest odds of rehospitalization were associated with being discharged against medical advice (OR 5.27, CI: 3.77-7.35, p<0.001). These data are important for the ongoing mental health care reforms in the Czech Republic and other countries in the Central and Eastern Europe. PMID:27094718

  2. Brain Morphometry using MRI in Schizophrenia Patients

    NASA Astrophysics Data System (ADS)

    Abanshina, I.; Pirogov, Yu.; Kupriyanov, D.; Orlova, V.

    2010-01-01

    Schizophrenia has been the focus of intense neuroimaging research. Although its fundamental pathobiology remains elusive, neuroimaging studies provide evidence of abnormalities of cerebral structure and function in patients with schizophrenia. We used morphometry as a quantitative method for estimation of volume of brain structures. Seventy eight right-handed subjects aged 18-45 years were exposed to MRI-examination. Patients were divided into 3 groups: patients with schizophrenia, their relatives and healthy controls. The volumes of interested structures (caudate nucleus, putamen, ventricles, frontal and temporal lobe) were measured using T2-weighted MR-images. Correlations between structural differences and functional deficit were evaluated.

  3. Medical illness in patients with schizophrenia.

    PubMed

    Goldman, L S

    1999-01-01

    Research into the relationship between physical illness and schizophrenia has revealed that patients with schizophrenia may be at decreased risk for certain disorders, such as rheumatoid arthritis and allergies, but at increased risk for others, including substance abuse and polydipsia. Although such knowledge may ultimately help determine the underlying causes of schizophrenia, the principal concern of practicing clinicians should be to diagnose and treat medical comorbidity in individual patients. Nearly 50% of patients with schizophrenia have a comorbid medical condition, but many of these illnesses are misdiagnosed or undiagnosed. A fragmented health care system, lack of access to care, patient inability to clearly appreciate or describe a medical problem, and patient reluctance to discuss such problems all contribute to the lack of attention to medical problems in patients with schizophrenia. Psychiatrists and primary care practitioners who treat patients with schizophrenia should make an effort to uncover medical illnesses by using a structured interview or routine physical examination whenever a patient is seen for care. PMID:10548136

  4. Gender differences in coerced patients with schizophrenia

    PubMed Central

    2013-01-01

    Background Despite the recent increase of research interest in involuntary treatment and the use of coercive measures, gender differences among coerced schizophrenia patients still remain understudied. It is well recognized that there are gender differences both in biological correlates and clinical presentations in schizophrenia, which is one of the most common diagnoses among patients who are treated against their will. The extent to which these differences may result in a difference in the use of coercive measures for men and women during the acute phase of the disease has not been studied. Methods 291 male and 231 female coerced patients with schizophrenia were included in this study, which utilized data gathered by the EUNOMIA project (European Evaluation of Coercion in Psychiatry and Harmonization of Best Clinical Practice) and was carried out as a multi-centre prospective cohort study at 13 centers in 12 European countries. Sociodemographic and clinical characteristics, social functioning and aggressive behavior in patients who received any form of coercive measure (seclusion and/or forced medication and/or physical restraint) during their hospital stay were assessed. Results When compared to the non-coerced inpatient population, there was no difference in sociodemographic or clinical characteristics across either gender. However coerced female patients did show a worse social functioning than their coerced male counterparts, a finding which contrasts with the non-coerced inpatient population. Moreover, patterns of aggressive behavior were different between men and women, such that women exhibited aggressive behavior more frequently, but men committed severe aggressive acts more frequently. Staff used forced medication in women more frequently and physical restraint and seclusion more frequently with men. Conclusions Results of this study point towards a higher threshold of aggressive behavior the treatment of women with coercive measures. This may be

  5. Phonetic Measures of Reduced Tongue Movement Correlate with Negative Symptom Severity in Hospitalized Patients with First-Episode Schizophrenia-Spectrum Disorders

    PubMed Central

    Covington, Michael A.; Lunden, S.L. Anya; Cristofaro, Sarah L.; Wan, Claire Ramsay; Bailey, C. Thomas; Broussard, Beth; Fogarty, Robert; Johnson, Stephanie; Zhang, Shayi; Compton, Michael T.

    2012-01-01

    Background Aprosody, or flattened speech intonation, is a recognized negative symptom of schizophrenia, though it has rarely been studied from a linguistic/phonological perspective. To bring the latest advances in computational linguistics to the phenomenology of schizophrenia and related psychotic disorders, a clinical first-episode psychosis research team joined with a phonetics/computational linguistics team to conduct a preliminary, proof-of-concept study. Methods Video recordings from a semi-structured clinical research interview were available from 47 first-episode psychosis patients. Audio tracks of the video recordings were extracted, and after review of quality, 25 recordings were available for phonetic analysis. These files were de-noised and a trained phonologist extracted a 1-minute sample of each patient’s speech. WaveSurfer 1.8.5 was used to create, from each speech sample, a file of formant values (F0, F1, F2, where F0 is the fundamental frequency and F1 and F2 are resonance bands indicating the moment-by-moment shape of the oral cavity). Variability in these phonetic indices was correlated with severity of Positive and Negative Syndrome Scale negative symptom scores using Pearson correlations. Results A measure of variability of tongue front-to-back position—the standard deviation of F2—was statistically significantly correlated with the severity of negative symptoms (r=−0.446, p=0.03). Conclusion This study demonstrates a statistically significant and meaningful correlation between negative symptom severity and phonetically measured reductions in tongue movements during speech in a sample of first-episode patients just initiating treatment. Further studies of negative symptoms, applying computational linguistics methods, are warranted. PMID:23102940

  6. Counterfactual Reasoning Deficits in Schizophrenia Patients

    PubMed Central

    Castellví, Pere; Caño, Agnès; Benejam, Bessy

    2016-01-01

    Background Counterfactual thinking is a specific type of conditional reasoning that enables the generation of mental simulations of alternatives to past factual events. Although it has been broadly studied in the general population, research on schizophrenia is still scarce. The aim of the current study was to further examine counterfactual reasoning in this illness. Methods Forty schizophrenia patients and 40 controls completed a series of tests that assessed the influence of the “causal order effect” on counterfactual thinking, and the ability to generate counterfactual thoughts and counterfactually derive inferences from a hypothetical situation. Socio-demographic and clinical characteristics, as well as neurocognitive variables, were also examined. Results Compared to controls, the schizophrenia patients generated fewer counterfactual thoughts when faced with a simulated scenario. The pattern of response when assessing the causality effect of the order was also different between the groups, with the patients being more frequently unable to attribute any ordering of events than the control subjects. Additionally, the schizophrenia patients showed more difficulties when deriving normative counterfactual inferences from hypothetical social situations. None of the counterfactual reasoning measures was associated to any of the cognitive functions or clinical and socio-demographic variables assessed. Conclusions A global impairment in counterfactual thinking characterizes schizophrenia patients. Because of the potential impact of such deficits on psychosocial functioning, targeting counterfactual reasoning for improvement might be considered in future treatment approaches. PMID:26828931

  7. Predictors of vocational status in schizophrenia patients – Results from the Polish nationwide survey

    PubMed Central

    Kiejna, Andrzej; Piotrowski, Patryk; Misiak, Błażej; Adamowski, Tomasz; Schubert, Agata; Skrzekowska-Baran, Iwona; Frydecka, Dorota

    2015-01-01

    Background: Steady employment constitutes one of most important aspects of functional recovery in schizophrenia. Therefore, there is a need for understanding clinical and demographic factors predicting vocational status in schizophrenia. Methods: Clinical and demographic data of 1,010 schizophrenia patients were gathered from public outpatient clinics. We compared patients who maintained employment between the diagnosis time point and the day of assessment, with the patients who were employed in the diagnosis time point but were unemployed on the day of assessment with respect to clinical and demographic variables. Results: Lower educational attainment, lower-income region of residence, medical comorbidities (obesity, diabetes and hypertension), first hospitalization at inpatient unit in comparison with the day hospital, higher total number of hospitalizations and the number of inpatient hospitalizations were found to serve as predictors of unemployment throughout the course of schizophrenia. After application of Bonferroni correction and logistic binary regression analysis, lower educational attainment, higher number of inpatient hospitalizations and obesity predicted unemployment. Conclusion: Education, obesity and the number of inpatient hospitalizations seem to predict vocational outcome in schizophrenia. This study warrants further investigation of medical comorbidities in schizophrenia in terms of social consequences in order to indicate the direction of this relationship. PMID:25838338

  8. A mentally retarded patient with schizophrenia.

    PubMed

    Rabia, K; Khoo, Em

    2008-01-01

    Schizophrenia is one of the most incapacitating forms of mental disorder that runs a chronic and relapsing course. It typically starts in adolescence or early adulthood and can be life-long. It is more common in people with learning disabilities than in the general population. Its prodromal features include depression, anxiety, suspiciousness, social isolation and bizarre behaviour. It may result in significant functional, social and economic impairments. The care of patients with schizophrenia places a considerable burden on all carers including patient's family, health and social services. Treatment includes pharmacotherapy and psychosocial interventions. In this case report we describe a thirteen-year-old patient with schizophrenia who has a background history of mental retardation. PMID:25606140

  9. An Integrated Care Initiative to Improve Patient Outcome in Schizophrenia

    PubMed Central

    Mayer-Amberg, Norbert; Woltmann, Rainer; Walther, Stefanie

    2016-01-01

    The optimal treatment of schizophrenia patients requires integration of medical and psychosocial inputs. In Germany, various health-care service providers and institutions are involved in the treatment process. Early and continuous treatment is important but often not possible because of the fragmented medical care system in Germany. The Integrated Care Initiative Schizophrenia has implemented a networked care concept in the German federal state of Lower Saxony that integrates various stakeholders of the health care system. In this initiative, office-based psychiatrists, specialized nursing staff, psychologists, social workers, hospitals, psychiatric institutional outpatient’s departments, and other community-based mental health services work together in an interdisciplinary approach. Much emphasis is placed on psychoeducation. Additional efforts cover socio-therapy, visiting care, and family support. During the period from October 2010 (start of the initiative) to December 2012, first experiences and results of quality indicators were collected of 713 registered patients and summarized in a quality monitoring report. In addition, standardized patient interviews were conducted, and duration of hospital days was recorded in 2013. By the end of 2012, patients had been enrolled for an average of 18.7 months. The overall patient satisfaction measured in a patient survey in June 2013 was high and the duration of hospital days measured in a pre–post analysis in July 2013 was reduced by 44%. Two years earlier than planned, the insurance fund will continue the successfully implemented Integrated Care Initiative and adopt it in the regular care setting. This initiative can serve as a learning case for how to set up and measure integrated care systems that may improve outcomes for patients suffering from schizophrenia. PMID:26779043

  10. Multimodal based classification of schizophrenia patients.

    PubMed

    Cetin, Mustafa S; Houck, Jon M; Vergara, Victor M; Miller, Robyn L; Calhoun, Vince

    2015-01-01

    Schizophrenia is currently diagnosed by physicians through clinical assessment and their evaluation of patient's self-reported experiences over the longitudinal course of the illness. There is great interest in identifying biologically based markers at the onset of illness, rather than relying on the evolution of symptoms across time. Functional network connectivity shows promise in providing individual subject predictive power. The majority of previous studies considered the analysis of functional connectivity during resting-state using only fMRI. However, exclusive reliance on fMRI to generate such networks, may limit inference on dysfunctional connectivity, which is hypothesized to underlie patient symptoms. In this work, we propose a framework for classification of schizophrenia patients and healthy control subjects based on using both fMRI and band limited envelope correlation metrics in MEG to interrogate functional network components in the resting state. Our results show that the combination of these two methods provide valuable information that captures fundamental characteristics of brain network connectivity in schizophrenia. Such information is useful for prediction of schizophrenia patients. Classification accuracy performance was improved significantly (up to ≈ 7%) relative to only the fMRI method and (up to ≈ 21%) relative to only the MEG method. PMID:26736831

  11. Psychiatrists' Attitudes toward Metabolic Adverse Events in Patients with Schizophrenia

    PubMed Central

    Sugawara, Norio; Yasui-Furukori, Norio; Yamazaki, Manabu; Shimoda, Kazutaka; Mori, Takao; Sugai, Takuro; Suzuki, Yutaro; Someya, Toshiyuki

    2014-01-01

    Background There is growing concern about the metabolic abnormalities in patients with schizophrenia. Aims The aim of this study was to assess the attitudes of psychiatrists toward metabolic adverse events in patients with schizophrenia. Method A brief questionnaire was constructed to cover the following broad areas: the psychiatrists' recognition of the metabolic risk of antipsychotic therapy, pattern of monitoring patients for physical risks, practice pattern for physical risks, and knowledge of metabolic disturbance. In March 2012, the questionnaire was mailed to 8,482 psychiatrists who were working at hospitals belonging to the Japan Psychiatric Hospitals Association. Results The overall response rate was 2,583/8,482 (30.5%). Of the respondents, 85.2% (2,200/2,581) reported that they were concerned about prescribing antipsychotics that have a risk of elevating blood sugar; 47.6% (1,201/2,524) stated that their frequency of monitoring patients under antipsychotic treatment was based on their own experiences; and only 20.6% (5,22/2,534) of respondents answered that the frequency with which they monitored their patients was sufficient to reduce the metabolic risks. Conclusions Psychiatrists practicing in Japan were generally aware and concerned about the metabolic risks for patients being treated with antipsychotics. Although psychiatrists should monitor their patients for metabolic abnormalities to balance these risks, a limited number of psychiatrists answered that the frequency with which they monitored patients to reduce the metabolic risks was sufficient. Promotion of the best practices of pharmacotherapy and monitoring is needed for psychiatrists treating patients with schizophrenia. PMID:24466260

  12. Rapid Clozapine Titration in Patients with Treatment Refractory Schizophrenia.

    PubMed

    Poyraz, Cana Aksoy; Özdemir, Armağan; Sağlam, Nazife Gamze Usta; Turan, Şenol; Poyraz, Burç Çağrı; Tomruk, Nesrin; Duran, Alaattin

    2016-06-01

    The aim of this study is to evaluate the safety and effectiveness of rapid clozapine titration in patients with schizophrenia in hospital settings. We conducted a retrospective two-center cohort study to compare the safety and effectiveness of clozapine with different titration rates in treatment-refractory patients with schizophrenia. In the first center, clozapine was started at 25-50 mg followed by 50-100 mg as needed every 6 h on day 1, followed by increases of 50-100 mg/day. In the second center, titration was slower; clozapine initiated with 12.5-50 mg on day 1 followed by increases of 25-50 mg/day. The number of days between starting of clozapine until discharge was shorter in the rapid titration group (22.4 ± 8.72 vs 27.0 ± 10.5, p = 0.1). Number of days of total hospital stay were significantly shorter in the rapid titration group (29.6 ± 10.6 vs 41.2 ± 14.8, p = 0.002). Hypotension was more common in the rapid titration group and one patient had suspected myocarditis. Rapid clozapine titration appeared safe and effective. The length of stay following initiation of clozapine was shorter in the rapid-titration group, although this was not statistically significant. However starting clozapine earlier together with rapid titration has significantly shortened the length of hospital stay in patients with treatment refractory schizophrenia. PMID:26433727

  13. NONVERBAL DELAYED RECOGNITION IN THE RELATIVES OF SCHIZOPHRENIA PATIENTS WITH OR WITHOUT SCHIZOPHRENIA SPECTRUM

    PubMed Central

    Robles, Olalla; Blaxton, Teresa; Adami, Helene; Arango, Celso; Thaker, Gunvant; Gold, James

    2009-01-01

    Background There is increased interest in the study of cognitive deficits as possible endophenotypic markers for schizophrenia. The main goal of this study was to determine how familiality and schizophrenia spectrum personality symptomatology are related to performance of auditory and visuospatial delayed recognition memory tasks. Methods The study sample consisted of 162 subjects divided into five groups. The groups included 39 patients with a DSM-IV diagnosis of schizophrenia or schizophreniform disorder, first-degree relatives of schizophrenia patients, 22 with and 31 without schizophrenia spectrum personality traits, and healthy controls with no family history of psychosis, 22 with and 48 without schizophrenia spectrum traits. Auditory and visuospatial delayed recognition memory performance was assessed. Results Significant differences were observed between patients and healthy controls in both auditory [F1,79=7.358 p=.008] and visual [F1,47=34.67, p<.001] delayed recognition tasks. When comparing the four non-patient groups, auditory and visuospatial discriminability decreased as a function of familiality of schizophrenia (p<0.05). Deficits were more pronounced in relatives with schizophrenia spectrum traits [auditory d=0.7114; visual d = .0199]. Conclusions A biological relationship to schizophrenia increases the likelihood of impaired delayed recognition memory. Likewise, poorer performance is associated with schizophrenia spectrum phenotype only when combined with familiality. PMID:17916332

  14. Efficacy, safety, and impact on hospitalizations of paliperidone palmitate in recent-onset schizophrenia

    PubMed Central

    Zhang, Fan; Si, Tianmei; Chiou, Chiun-Fang; Harris, Anthony WF; Kim, Chang Yoon; Jahagirdar, Padmashree; Ascher, Steve

    2015-01-01

    Objective To evaluate the efficacy, safety, and impact on hospitalizations of long-acting injectable paliperidone palmitate (PP) treatment, in patients with recent-onset schizophrenia who had not responded satisfactorily to oral antipsychotics. Methods In this 18-month, open-label, Phase-IIIb study from Asia-Pacific region, patients (18–50 years) with recent-onset (≤5 years) schizophrenia unsatisfactorily treated with previous oral antipsychotics were initiated on PP 150 mg eq on day 1, 100 mg eq on day 8, followed by flexible once monthly maintenance doses of 50–150 mg eq. The number and duration of hospitalizations were compared using a mirror analysis method between two periods: retrospective (12 months before PP initiation) and prospective (12 and 18 months after PP treatment) periods. Results A total of 303 out of 521 (58%) patients (mean age, 28.7 years; 65.5% men, 92.5% Asian) completed the study. Positive and Negative Syndrome Scale (PANSS) total score improved significantly from baseline to month 18 (mean [standard deviation, SD] change: −11.3 [21.38], P<0.0001, primary endpoint). Subgroup analysis revealed greater improvements among patients with worse disease severity at baseline: PANSS ≥70 versus <70 (mean [SD] change: −23.1 [24.62] vs −4.7 [15.98], P<0.0001 each). Secondary efficacy endpoints such as Clinical Global Impression of Schizophrenia (CGI-SCH), Medication Satisfaction Questionnaire (MSQ) scores showed significant improvements (P<0.0001) from baseline; 33.3% patients achieved symptom remission. In mirror analyses set (N=474), PP significantly (P<0.0001) reduced mean number of hospitalization days/person/year (12-month: 74.3 vs 19.7; 18-month: 74.3 vs 18.9) as well as percentage of patients requiring hospitalization in past 12 months (12-month: 39.7% vs 24.6%; 18-month: 39.7% vs 25%), and PP treatment increased the proportion of patients not requiring hospitalization (12-month: 60.3% vs 75.4%; 18-month: 60.3% vs 75%) from

  15. Psychotherapy Techniques for Patients Diagnosed with Schizophrenia.

    PubMed

    Lotterman, Andrew C

    2016-01-01

    The paper describes how standard psychotherapy techniques need to be modified to suit the specialized needs of patients diagnosed with schizophrenia. Patients with psychosis often have lost their ability to use words to describe their inner states. As a result, traditional forms of psychotherapy which depend so crucially on the use of language are compromised. The goal of treatment at the start is to help the patient recover his ability to use language to describe his inner life. Eventually, this enables the patient to make use of more traditional forms of psychodynamic treatment. PMID:27052606

  16. Schizophrenia relapse, patient considerations, and potential role of lurasidone

    PubMed Central

    Citrome, Leslie

    2016-01-01

    When treating persons with schizophrenia, delaying time to relapse is a main goal. Antipsychotic medication has been the primary treatment approach, and there are a variety of different choices available. Lurasidone is a second-generation (atypical) antipsychotic agent that is approved for the treatment of schizophrenia and bipolar depression. Three long-term studies of lurasidone have examined time to relapse in persons with schizophrenia, including a classic placebo-controlled randomized withdrawal study and two 12-month active comparator studies (vs risperidone and vs quetiapine extended-release). Lurasidone 40–80 mg/d evidenced superiority over placebo (number needed to treat [NNT] vs placebo for relapse, 9). Lurasidone 40–160 mg/d was noninferior to quetiapine extended-release 200–800 mg/d on the outcome of relapse, and was superior on the outcome of avoidance of hospitalization (NNT 8) and the outcome of remission (NNT 7). Lurasidone demonstrated a lower risk for long-term weight gain than the active comparators. Demonstrated differences in tolerability profiles among the different choices of antipsychotics make it possible to attempt to match up an individual patient to the best choice for such patient based on past history of tolerability, comorbidities, and personal preferences, potentially improving adherence. PMID:27563237

  17. Schizophrenia relapse, patient considerations, and potential role of lurasidone.

    PubMed

    Citrome, Leslie

    2016-01-01

    When treating persons with schizophrenia, delaying time to relapse is a main goal. Antipsychotic medication has been the primary treatment approach, and there are a variety of different choices available. Lurasidone is a second-generation (atypical) antipsychotic agent that is approved for the treatment of schizophrenia and bipolar depression. Three long-term studies of lurasidone have examined time to relapse in persons with schizophrenia, including a classic placebo-controlled randomized withdrawal study and two 12-month active comparator studies (vs risperidone and vs quetiapine extended-release). Lurasidone 40-80 mg/d evidenced superiority over placebo (number needed to treat [NNT] vs placebo for relapse, 9). Lurasidone 40-160 mg/d was noninferior to quetiapine extended-release 200-800 mg/d on the outcome of relapse, and was superior on the outcome of avoidance of hospitalization (NNT 8) and the outcome of remission (NNT 7). Lurasidone demonstrated a lower risk for long-term weight gain than the active comparators. Demonstrated differences in tolerability profiles among the different choices of antipsychotics make it possible to attempt to match up an individual patient to the best choice for such patient based on past history of tolerability, comorbidities, and personal preferences, potentially improving adherence. PMID:27563237

  18. Challenging the Hypothesized Link to Season of Birth in Patients with Schizophrenia

    PubMed Central

    2011-01-01

    The cause of schizophrenia is unknown; however, one hypothesis is that seasonality of birth contributes to its development, with an excess of winter-spring births observed in those with schizophrenia. There are over 200 studies exploring this issue at the writing of this article with most of the studies revealing a decrease in late summer births and an increase number of winter-spring births of those individuals with the disease. The primary objective of this study was to evaluate the seasonality of birth for 376 institutionalized patients with schizophrenia receiving clozapine treatment in a New York State psychiatric hospital. This was a retrospective review of a clozapine database accessed between January 1, 2001 to January 1, 2011, which included date of birth for the national clozapine registry, confirming the accuracy of the information. The psychiatric diagnoses for the patients included in this study were documented to ensure that this research included individuals with schizophrenia. The author hypothesized that due to the long-term institutionalization often required for refractory schizophrenia, the New York state hospitalized patients were assumed to be of Northern Hemispheric birth origin. The study sample included 376 patients, 16 of which did not have a definitive diagnosis of schizophrenia. The author chose to evaluate all 376 patients in the sample due to the introduction of clozapine therapy, which would substantiate the presence of a refractory psychotic disorder, such as schizophrenia. The author found that the seasonality distribution did not reflect any difference in percentage from that which would be expected in the general population, challenging the hypothesis that seasonality of birth contributes to the development of schizophrenia. The author provides a review of literature and discusses some of the theories surrounding the season of birth hypothesis. A larger patient sample should be studied to confirm the findings of this smaller

  19. Auditory hallucinations suppressed by etizolam in a patient with schizophrenia.

    PubMed

    Benazzi, F; Mazzoli, M; Rossi, E

    1993-10-01

    A patient presented with a 15 year history of schizophrenia with auditory hallucinations. Though unresponsive to prolonged trials of neuroleptics, the auditory hallucinations disappeared with etizolam. PMID:7902201

  20. Metastatic breast cancer in patients with schizophrenia

    PubMed Central

    MEYER, AARON A.; HWANG, M.; FARASATPOUR, M.; JANARDHAN, R.; MARGENTHALER, J.A.; VIRGO, K.S.; JOHNSON, FRANK E.

    2013-01-01

    Breast cancer is a major health problem worldwide. The median survival duration for patients with metastatic breast cancer is two to three years. Approximately 1% of populations worldwide have schizophrenia. The manner in which schizophrenic patients fare when diagnosed with metastatic breast carcinoma (MBC) was evaluated. We queried the National Department of Veterans Affairs (DVA) datasets using computer codes for a pre-existing diagnosis of schizophrenia and a later diagnosis of breast carcinoma. Chart-based data concerning the identified subjects were then requested. Previously determined inclusion and exclusion criteria were applied to select evaluable patients from the medical records, prior to extracting demographic details and data concerning the treatment course in each subject. Ten patients had distant metastases at initial diagnosis, while seven developed MBC following prior curative-intent treatment. Two patients refused therapy. Ten did not comply with recommended management. Five harmed or threatened physicians, other caregivers or themselves. Schizophrenic patients with MBC often fail to understand the nature of their illnesses. Often they do not accept palliative treatment, while a number of them do not comply with therapy, once initiated. They often exhibit behaviors that are detrimental to themselves or others. Formal psychiatric consultation is therefore necessary in patients. Several detrimental behaviors may be predicted reliably by history alone. PMID:24649175

  1. The Relationship between Cognitive Decline and Psychopathology in Patients with Schizophrenia and Bipolar Disorder

    PubMed Central

    Kim, Moon-Doo; Seo, Hye-Jin; Yun, Hyunju; Jung, Young-Eun; Park, Joon Hyuk; Lee, Chang-In; Moon, Ji Hyun; Hong, Seong-Chul; Yoon, Bo-Hyun; Bahk, Won-Myong

    2015-01-01

    Objective The primary goals of the present study were to assess intellectual function in participants with schizophrenia or bipolar disorder (BD) and to investigate the relationships between cognitive decline and the severity of each type of psychopathology. Methods The present study included 51 patients with schizophrenia and 42 with BD who were recruited from the psychiatry outpatient clinic of Jeju University Hospital between March 2011 and March 2014. The Korean Wechsler Adult Intelligence Scale (K-WAIS) was administered to each of the 93 participants, and they were categorized into two groups based on their current intelligence quotient (IQ) and their estimated premorbid IQ: severely impaired group (SIG) and mildly impaired group (MIG). The Minnesota Multiple Personality Inventory (MMPI) and the Brief Psychiatric Rating Scale (BPRS) were used to assess psychopathology. Results The SIG schizophrenia participants exhibited significantly higher scores on the frequent (F) and schizophrenia (Sc) subscales of the MMPI, but significantly lower scores on the correction (K) and psychopathic deviate (Pd) subscales compared with the MIG schizophrenia participants. Furthermore, the BPRS scores were significantly higher in the SIG schizophrenia participants relative to the MIG schizophrenia participants. The SIG BD participants had significantly higher F, masculinity-femininity (Mf), paranoia (Pa), and Sc but significantly lower Pd scores compared with the MIG BD participants. Conclusion The present findings revealed a significant discrepancy between the estimated premorbid levels of cognitive function and current cognitive function in participants with schizophrenia or BD. Moreover, this discrepancy was correlated with severity of psychopathology in both groups. PMID:25912543

  2. Hospitalized Patients and Fungal Infections

    MedlinePlus

    ... but can also be caused by fungi. Hospital construction. Hospital staff do everything they can to prevent ... patients staying at hospitals where there is ongoing construction or renovation. 5 This is thought to be ...

  3. Burden on Family Caregivers Caring for Patients with Schizophrenia

    PubMed Central

    Shamsaei, Farshid; Cheraghi, Fatemeh; Bashirian, Saied

    2015-01-01

    Objective: The aim of this study ‎was to determine the prevalence ‎of the burden reported by family ‎caregivers of Patients with ‎schizophrenia.‎ Methods: This cross sectional ‎study involved face-to-face ‎interviews with family caregivers ‎of patients with schizophrenia. ‎Using convenience sampling, ‎‎225 caregivers were selected ‎from Farshchian psychiatry ‎Hospital in Hamadan, Iran from ‎July to September 2012. ‎Measures included patients and ‎caregivers’ demographic ‎variables and caregivers’ burden ‎using the Zarit Burden Interview ‎‎(ZBI). Data were analyzed by ‎SPSS-18 with Pearson ‎correlation and t-test.‎ Results: Using the ZBI, we found ‎that 7.6% of the caregivers ‎experienced “no to low” burden, ‎‎23.5% “mild to moderate”, 41.8% ‎‎“moderate to severe” and 27.1% ‎‎“severe” burden. The mean ‎average score of the responses ‎to ZBI was 51.73 (SD: ± 18.23). ‎The level of burden experienced ‎was significantly associated with ‎age, gender, and educational ‎level, relation to care recipient, ‎caregiving duration and duration ‎of schizophrenia illness.‎ Conclusion: ‎ ‏ ‏Mental health ‎professionals need to develop ‎more innovative programs for ‎families of schizophrenic ‎patients. Furthermore, as a ‎replacement for supporting the ‎families and easing their ‎burdens, it may be more ‎effective to include them in the ‎health care team by assigning ‎specific tasks and providing the ‎required resources to them to ‎perform such tasks. ‎ PMID:27006669

  4. Medication adherence in patients with schizophrenia.

    PubMed

    Phan, Stephanie V

    2016-01-01

    Medication nonadherence is common among patients with schizophrenia and due to a variety of factors including lack of insight, psychopathology, substance use disorder, issues associated with treatment, stigma, fragmentation of care, cultural influences, and socioeconomic status. Among this population, nonadherence is problematic because it can lead to decompensation or exacerbation of symptoms, relapse, rehospitalization or greater use of emergency psychiatric services, functional decline, and increased risk of death. Psychoeducational approaches alone are ineffective, but in combination with behavioral interventions, appear to be effective. Involving the patient's support system, in addition to other interventions, can improve treatment adherence. Many medication-related factors, such as effectiveness and tolerability of antipsychotics, regimen complexity, and past medication trials impact appropriate medication use. Therefore, optimizing the patient's pharmacotherapeutic regimens can improve adherence. Additional factors favorably influencing adherence include involving the patient in their treatment, fostering a therapeutic alliance, implementing/using reminder systems, and addressing substance use disorder. Medication nonadherence arises from multiple reasons that vary between patients. Thus, the most effective strategies to improve adherence are multifactorial and may involve both psychoeducational and behavioral techniques, as well as previously listed approaches. Strategies should be targeted toward the patient and their support system, whenever possible, to further improve the chances of appropriate medication use. Recognizing that all patients with schizophrenia are at risk for medication nonadherence is important. No one technique has been shown to be most effective; therefore, the risk for nonadherence should continually be assessed and multiple strategies should be targeted to the patient (and caregiver) and repeatedly implemented throughout the course

  5. Cannabis use and the course of schizophrenia: 10-year follow-up after first hospitalization

    PubMed Central

    Foti, Daniel J.; Kotov, Roman; Guey, Lin T.; Bromet, Evelyn J.

    2013-01-01

    Objective The authors examined the relationship between cannabis use and the course of illness in schizophrenia over 10 years following first psychiatric hospitalization. Method We assessed 229 patients with a schizophrenia-spectrum disorder five times: during the first admission, and 6 months, 2 years, 4 years, and 10 years later. Ratings of cannabis use and psychiatric symptoms (psychotic, negative, disorganized, and depressive) were made at each assessment. Results The lifetime rate of cannabis use was 66.2%, and survival analysis revealed that this usage was associated with an earlier onset of psychosis. The rates of current use ranged from 10% to 18% across assessments. Cannabis status was moderately stable, with concordance between waves ranging rtet = 0.48 – 0.78. Mixed-effects logistic regression revealed that changes in cannabis use were associated with changes in psychotic symptoms over time even after gender, age, socio-economic status, other drug use, antipsychotic medication use, and other symptoms were controlled. Structural equation modeling indicated that the association with psychotic symptoms was bi-directional. Conclusions Cannabis use is associated with an adverse course of psychotic symptoms in schizophrenia, and vice versa, even after taking into account other clinical, substance, and demographic variables. The specificity of this relationship suggests that clinical interventions to reduce cannabis use may be best targeted at individuals with prominent psychotic symptoms. PMID:20478874

  6. Internet delivered question and answer column for patients with schizophrenia.

    PubMed

    Maijala, Riikka; Anttila, Minna; Koivunen, Marita; Pitkänen, Anneli; Kuosmanen, Lauri; Välimäki, Maritta

    2015-01-01

    The purpose of this study was to describe the use of an Internet delivered question and answer column among patients with schizophrenia. The column was developed for research purposes. The study sample consisted of patients (N = 100) admitted to acute inpatient psychiatric care in two hospital districts. Descriptive data were collected from the column to which a nurse replied within 3 days and analysed using qualitative content analysis. The column had four to five questions weekly. The most common age of users was 18-24 years, and the gender distribution was almost equal. Column use was heaviest among students (44%) and least among unemployed people (19%). Out of 85 questions or comments sent to the column, 25 (29%) were related to program training and the remaining 60 (71%) were related to medication (31%), illness and tests (25%), other questions or comments (9%), daily life and coping with it (4%), and places to receive treatment (2%). An Internet delivered question and answer column can be included in the care of patients with schizophrenia. However, it requires a new type of basic and additional education in the field of mental health care in order for nurses to be able to provide nursing via the Internet forum. PMID:24960233

  7. Health care resource use and direct medical costs for patients with schizophrenia in Tianjin, People’s Republic of China

    PubMed Central

    Wu, Jing; He, Xiaoning; Liu, Li; Ye, Wenyu; Montgomery, William; Xue, Haibo; McCombs, Jeffery S

    2015-01-01

    Objective Information concerning the treatment costs of schizophrenia is scarce in People’s Republic of China. The aims of this study were to quantify health care resource utilization and to estimate the direct medical costs for patients with schizophrenia in Tianjin, People’s Republic of China. Methods Data were obtained from the Tianjin Urban Employee Basic Medical Insurance (UEBMI) database. Adult patients with ≥1 diagnosis of schizophrenia and 12-month continuous enrollment after the first schizophrenia diagnosis between 2008 and 2009 were included. Both schizophrenia-related, psychiatric-related, and all-cause related resource utilization and direct medical costs were estimated. Results A total of 2,125 patients were included with a mean age of 52.3 years, and 50.7% of the patients were female. The annual mean all-cause costs were $2,863 per patient with psychiatric-related and schizophrenia-related costs accounting for 84.1% and 62.0% respectively. The schizophrenia-related costs for hospitalized patients were eleven times greater than that of patients who were not hospitalized. For schizophrenia-related health services, 60.8% of patients experienced at least one hospitalization with a mean (median) length of stay of 112.1 (71) days and a mean cost of $1,904 per admission; 59.0% of patients experienced at least one outpatient visit with a mean (median) number of visits of 6.2 (4) and a mean cost of $42 per visit during the 12-month follow-up period. Non-medication treatment costs were the most important element (45.7%) of schizophrenia-related costs, followed by laboratory and diagnostic costs (19.9%), medication costs (15.4%), and bed fees (13.3%). Conclusion The costs related to the treatment of patients with schizophrenia were considerable in Tianjin, People’s Republic of China, driven mainly by schizophrenia-related hospitalizations. Efforts focusing on community-based treatment programs and appropriate choice of drug treatment have the potential

  8. Hospital length of stay in individuals with schizophrenia with and without cocaine-positive urine drug screens at hospital admission.

    PubMed

    Wu, Hanjing Emily; Mohite, Satyajit; Ngana, Ikenna; Burns, Wilma; Shah, Nurun; Schneider, Laurie; Schmitz, Joy M; Lane, Scott D; Okusaga, Olaoluwa O

    2015-01-01

    Despite the high prevalence of cocaine use disorder (CUD) in individuals with schizophrenia, current understanding of the effect of cocaine on psychiatric hospital length of stay (LOS) in individuals with schizophrenia is limited. We therefore retrospectively examined the medical records of 5106 hospital admissions due to exacerbation of schizophrenia. Linear regression and t-test were used to compare LOS between individuals with schizophrenia with cocaine-positive urine drug test results and those with negative test results. Individuals with schizophrenia who were also positive for cocaine had shorter LOS from both unadjusted (geometric mean LOS, 8.07 ± 1.92 vs. 11.83 ± 1.83 days; p < 0.001) and adjusted (β = 0.69; confidence interval, 0.63-0.76; p < 0.001) analyses. Our results suggest that individuals with schizophrenia who also have comorbid CUD may require shorter inpatient treatment during periods of exacerbation of symptoms. Replication of this finding has relevance in treatment planning and resource allocation for the subpopulation of individuals with schizophrenia who also have stimulant use disorders. PMID:25489749

  9. Can patients with schizophrenia undergo renal transplantation with success?

    PubMed

    Bouhlel, Saoussen

    2014-05-01

    We report a case of a 41-year-old man suffering from paranoid schizophrenia. The patient has been consulting in our psychiatric hospital since he was 29 years old. Eight years later, he developed kidney failure and required peritoneal dialysis. After more than two years, the nephrology team indicated a renal transplantation and his brother suggested giving his kidney. There were no obstacles for transplantation in the immune and histological compatibilities; the psychiatric staff decided to check the patient's compliance with medication. The patient was compliant to all his medications and to the salt-free diet after the transplant operation. Few weeks later, he developed steroid-induced diabetes. Through the last two years, he had psychotic exacerbations with major anxiety and fear of losing the transplant. These relapses were managed by increasing doses of antipsychotics without need for hospitalization. At the present time, three years after transplantation, the nephrologists are decreasing the immunosuppressive agents and the steroids. The renal function is optimum and the diabetes is stabilized. This case exemplifies the potential for schizophrenic patients to undergo renal transplantation and to comply with follow-up medical care through a close cooperation between the patient's family, the psychiatric staff and the nephrology team. PMID:24821159

  10. CANTAB Explicit Memory Is Less Impaired in Addicted Schizophrenia Patients

    ERIC Educational Resources Information Center

    Potvin, Stephane; Briand, Catherine; Prouteau, Antoinette; Bouchard, Roch-Hugo; Lipp, Olivier; Lalonde, Pierre; Nicole, Luc; Lesage, Alain; Stip, Emmanuel

    2005-01-01

    It has been suggested that in order to sustain the lifestyle of substance abuse, addicted schizophrenia patients would have less negative symptoms, better social skills, and less cognitive impairments. Mounting evidence supports the first two assumptions, but data lack regarding cognition in dual diagnosis schizophrenia. Seventy-six schizophrenia…

  11. Effects of Oxytocin on Neural Response to Facial Expressions in Patients with Schizophrenia.

    PubMed

    Shin, Na Young; Park, Hye Yoon; Jung, Wi Hoon; Park, Jin Woo; Yun, Je-Yeon; Jang, Joon Hwan; Kim, Sung Nyun; Han, Hyun Jung; Kim, So-Yeon; Kang, Do-Hyung; Kwon, Jun Soo

    2015-07-01

    Impaired facial emotion recognition is a core deficit in schizophrenia. Oxytocin has been shown to improve social perception in patients with schizophrenia; however, the effect of oxytocin on the neural activity underlying facial emotion recognition has not been investigated. This study was aimed to assess the effect of a single dose of intranasal oxytocin on brain activity in patients with schizophrenia using an implicit facial emotion-recognition paradigm. Sixteen male patients with schizophrenia and 16 age-matched healthy male control subjects participated in a randomized, double-blind, placebo-controlled crossover trial at Seoul National University Hospital. Delivery of a single dose of 40 IU intranasal oxytocin and the placebo was separated by 1 week. Drug conditions were compared by performing a region of interest (ROI) analysis of the bilateral amygdala on responses to the emotion recognition test. It was found that nasal spray decreased amygdala activity for fearful emotion and increased activity for happy faces. Further, oxytocin elicited differential effects between the patient and control groups. Intranasal oxytocin attenuated amygdala activity for emotional faces in patients with schizophrenia, whereas intranasal oxytocin significantly increased amygdala activity in healthy controls. Oxytocin-induced BOLD signal changes in amygdala in response to happy faces was related to attachment style in the control group. Our result provides new evidence of a modulatory effect of oxytocin on neural response to emotional faces for patients with schizophrenia. Future studies are needed to investigate the effectiveness of long-term treatment with intranasal oxytocin on neural activity in patients with schizophrenia. PMID:25666311

  12. The neuroanatomical basis of affective mentalizing in schizophrenia: comparison of patients with schizophrenia and patients with localized prefrontal lesions.

    PubMed

    Shamay-Tsoory, Simone G; Aharon-Peretz, Judith; Levkovitz, Yechiel

    2007-02-01

    Patients with schizophrenia show impaired emotional and social behavior, such as misinterpretation of social situations and lack of Theory of Mind (ToM). However, the neuroanatomical basis of impaired ToM and its nature in schizophrenia is still largely unknown. Based on previous findings, the present study suggests that impaired social cognition observed in schizophrenic patients may be similar to that observed in patients with prefrontal (PFC) damage due to impaired 'affective ToM' abilities, rather than to a general impairment in ToM. We examined the behavioral and neural mechanisms that underlie the social and communicative impairments observed in patients with schizophrenia and with PFC damage, by looking at differential patterns of ToM impairment in these individuals. The performance of 24 patients with schizophrenia was compared to the responses of patients with localized lesions in the ventromedial (VM) or dorsolateral PFC, patients with non-frontal lesions, and healthy control subjects. Patients with schizophrenia and those with VM lesions were impaired on 'affective ToM' tasks but not in cognitive ToM conditions. It was concluded that the pattern of mentalizing impairments in schizophrenia resembled those seen in patients with lesions of the frontal lobe, particularly with VM damage, providing support for the notion of a disturbance of the fronto-limbic circuits in schizophrenia. PMID:17182218

  13. Race and Hospital Diagnoses of Schizophrenia and Mood Disorders

    ERIC Educational Resources Information Center

    Barnes, Arnold

    2008-01-01

    Overdiagnosis or misdiagnosis of schizophrenia among African American clients is a longstanding and critical disparity in mental health services. Overdiagnosis of schizophrenia is detrimental because it increases the potential for treatment with the wrong medications. Inadequate assessment of mood disorders, co-occurring substance abuse, and…

  14. Association between antipsychotic/antidepressant drug treatments and hospital admissions in schizophrenia assessed using a mental health case register

    PubMed Central

    Cardinal, Rudolf N; Savulich, George; Mann, Louisa M; Fernández-Egea, Emilio

    2015-01-01

    Background: The impact of psychotropic drug choice upon admissions for schizophrenia is not well understood. Aims: To examine the association between antipsychotic/antidepressant use and time in hospital for patients with schizophrenia. Methods: We conducted an observational study, using 8 years’ admission records and electronically generated drug histories from an institution providing secondary mental health care in Cambridgeshire, UK, covering the period 2005–2012 inclusive. Patients with a coded ICD-10 diagnosis of schizophrenia were selected. The primary outcome measure was the time spent as an inpatient in a psychiatric unit. Antipsychotic and antidepressant drugs used by at least 5% of patients overall were examined for associations with admissions. Periods before and after drug commencement were compared for patients having pre-drug admissions, in mirror-image analyses correcting for overall admission rates. Drug use in one 6-month calendar period was used to predict admissions in the next period, across all patients, in a regression analysis accounting for the effects of all other drugs studied and for time. Results: In mirror-image analyses, sulpiride, aripiprazole, clozapine, and olanzapine were associated with fewer subsequent admission days. In regression analyses, sulpiride, mirtazapine, venlafaxine, and clozapine–aripiprazole and clozapine–amisulpride combinations were associated with fewer subsequent admission days. Conclusions: Use of these drugs was associated with fewer days in hospital. Causation is not implied and these findings require confirmation by randomized controlled trials. PMID:27336041

  15. Smaller than expected cognitive deficits in schizophrenia patients from the population-representative ABC catchment cohort.

    PubMed

    Lennertz, Leonhard; An der Heiden, Wolfram; Kronacher, Regina; Schulze-Rauschenbach, Svenja; Maier, Wolfgang; Häfner, Heinz; Wagner, Michael

    2016-08-01

    Most neuropsychological studies on schizophrenia suffer from sample selection bias, with male and chronic patients being overrepresented. This probably leads to an overestimation of cognitive impairments. The present study aimed to provide a less biased estimate of cognitive functions in schizophrenia using a population-representative catchment area sample. Schizophrenia patients (N = 89) from the prospective Mannheim ABC cohort were assessed 14 years after disease onset and first diagnosis, using a comprehensive neuropsychological test battery. A healthy control group (N = 90) was carefully matched according to age, gender, and geographic region (city, rural surrounds). The present sample was representative for the initial ABC cohort. In the comprehensive neuropsychological assessment, the schizophrenia patients were only moderately impaired as compared to the healthy control group (d = 0.56 for a general cognitive index, d = 0.42 for verbal memory, d = 0.61 for executive functions, d = 0.69 for attention). Only 33 % of the schizophrenia patients scored one standard deviation unit below the healthy control group in the general cognitive index. Neuropsychological performance did not correlate with measures of the clinical course including age at onset, number of hospital admissions, and time in paid work. Thus, in this population-representative sample of schizophrenia patients, neuropsychological deficits were less pronounced than expected from meta-analyses. In agreement with other epidemiological studies, this suggests a less devastating picture of cognition in schizophrenia. PMID:26233432

  16. Seropositivity and Serointensity of Toxoplasma gondii Antibodies and DNA among Patients with Schizophrenia

    PubMed Central

    Omar, Ainsah; Bakar, Osman Che; Adam, Nor Fatini; Osman, Hakim; Osman, Arina; Suleiman, Ahmad Hatim; Manaf, Mohd Rizal Abdul; Selamat, Mohd Ikhsan

    2015-01-01

    The aim of this cross sectional case control study was to examine the serofrequency and serointensity of Toxoplasma gondii (Tg) IgG, IgM, and DNA among patients with schizophrenia. A total of 101 patients with schizophrenia and 55 healthy controls from Sungai Buloh Hospital, Selangor, Malaysia and University Malaya Medical Center (UMMC) were included in this study. The diagnosis of schizophrenia was made based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The presence of Tg infection was examined using both indirect (ELISA) and direct (quantitative real-time PCR) detection methods by measuring Tg IgG and IgM and DNA, respectively. The serofrequency of Tg IgG antibodies (51.5%, 52/101) and DNA (32.67%, 33/101) among patients with schizophrenia was significantly higher than IgG (18.2%, 10/55) and DNA (3.64%, 2/55) of the controls (IgG, P=0.000, OD=4.8, CI=2.2-10.5; DNA, P=0.000, OD=12.9, CI=2.17-10.51). However, the Tg IgM antibody between patients with schizophrenia and controls was not significant (P>0.005). There was no significant difference (P>0.005) in both serointensity of Tg IgG and DNA between patients with schizophrenia and controls. These findings have further demonstrated the strong association between the active Tg infection and schizophrenia. PMID:25748706

  17. Resting EEG deficits in accused murderers with schizophrenia.

    PubMed

    Schug, Robert A; Yang, Yaling; Raine, Adrian; Han, Chenbo; Liu, Jianghong; Li, Liejia

    2011-10-31

    Empirical evidence continues to suggest a biologically distinct violent subtype of schizophrenia. The present study examined whether murderers with schizophrenia would demonstrate resting EEG deficits distinguishing them from both non-violent schizophrenia patients and murderers without schizophrenia. Resting EEG data were collected from five diagnostic groups (normal controls, non-murderers with schizophrenia, murderers with schizophrenia, murderers without schizophrenia, and murderers with psychiatric conditions other than schizophrenia) at a brain hospital in Nanjing, China. Murderers with schizophrenia were characterized by increased left-hemispheric fast-wave EEG activity relative to non-violent schizophrenia patients, while non-violent schizophrenia patients instead demonstrated increased diffuse slow-wave activity compared to all other groups. Results are discussed within the framework of a proposed left-hemispheric over-processing hypothesis specific to violent individuals with schizophrenia, involving left hemispheric hyperarousal deficits, which may lead to a homicidally violent schizophrenia outcome. PMID:21824754

  18. [Strategies for measuring medication adherence in patients with schizophrenia].

    PubMed

    Wang, Yunfang; Huang, Zhiping; Xu, Dong; Gong, Wenjie; Tang, Yuan; Xiao, Shuiyuan

    2016-02-01

    Long-term therapy should be administrated for patients with schizophrenia and the medication adherence is very important for the prognosis and outcome in these patients. In this study, we screened the literatures from various databases in accordance with our search criteria. A total of 11 literatures with the results of reliability and validity regarding the measurement of schizophrenia medication adherence were enrolled in our analysis. Based on the measurements, they were classified into subjective methods and objective ones. The objective methods include blood plasma and urine concentrations, pharmacy records, pill counts and Medication Event Monitoring System. The subjective methods include Drug Attitude Inventory, Rating of Medication Influences Scale, Brief Evaluation of Medication Influences and Beliefs, the Brief Adherence Rating Scale, Medication Adherence Rating Scale, and Morisky scales. In general, single method for measuring medication adherence in patients with schizophrenia is limited. We recommend researchers to use 2 or more methods when measuring the medication adherence in patients with schizophrenia. PMID:26932222

  19. Thirty Day Hospital Readmission for Medicaid Enrollees with Schizophrenia: The Role of Local Health Care Systems

    PubMed Central

    Busch, Alisa B.; Epstein, Arnold M.; McGuire, Thomas G.; Normand, Sharon-Lise T.; Frank, Richard G.

    2016-01-01

    Background Examining health care system characteristics possibly associated with 30-day readmission may reveal opportunities to improve healthcare quality as well as reduce costs. Aims of the Study Examine the relationship between 30-day mental health readmission for persons with schizophrenia and county-level community treatment characteristics. Methods Observational study of 18 state Medicaid programs (N=274 counties, representing 103,967 enrollees with schizophrenia--28,083 of whom received ≥1 mental health hospitalization) using Medicaid administrative and United States Area Health Resource File data from 2005. Medicaid is a federal-state program and major health insurance provider for low income and disabled individuals, and the predominant provider of insurance for individuals with schizophrenia. The Area Health Resource File provides county-level estimates of providers. We first fit a regression model examining the relationship between 30-day mental health readmission and enrollee characteristics (e.g., demographics, substance use disorder [SUD], and general medical comorbidity) from which we created a county-level demographic and comorbidity case-mix adjuster. The case-mix adjuster was included in a second regression model examining the relationship between 30-day readmission and county-level factors: 1) quality (antipsychotic/visit continuity, post-hospital follow-up); 2) mental health hospitalization (length of stay, admission rates); and 3) treatment capacity (e.g., population-based estimates of outpatient providers/clinics). We calculated predicted probabilities of readmission for significant patient and county-level variables. Results Higher county rates of mental health visits within 7-days post-hospitalization were associated with lower readmission probabilities (e.g., county rates of 7-day follow up of 55% versus 85%, readmission predicted probability(PP)[95%CI]=16.1%[15.8%-16.4%] versus 13.3%[12.9%-13.6%]). In contrast, higher county rates of

  20. Missing link in community psychiatry: When a patient with schizophrenia was expelled from her home.

    PubMed

    Chen, I-Ming; Wu, Kevin Chien-Chang; Chien, Yi-Ling; Chen, Yu-Hsiang; Lee, Sung-Tai

    2015-06-01

    Treatment and disposition of homeless patients with schizophrenia represent a great challenge in clinical practice. We report a case of this special population, and discuss the development of homelessness, the difficulty in disposition, their utilization of health services, and possible applications of mandatory community treatment in this group of patients. A 51-year-old homeless female was brought to an emergency department for left femur fracture caused by an assault. She was diagnosed with schizophrenia about 20 years ago but received little help from mental health services over the decades. During hospitalization, her psychotic symptoms were only partially responsive to treatment. Her family refused to handle caretaking duties. The social welfare system was mobilized for long-term disposition. Homeless patients with schizophrenia are characterized by family disruption, poor adherence to health care, and multiple emergency visits and hospitalization. We hope this article can provide information about the current mental health policy to medical personnel. It is possible that earlier intervention and better outcome can be achieved by utilizing mandatory community treatment in the future, as well as preventing patients with schizophrenia from losing shelters. PMID:26062968

  1. Drug Addiction in Patients With Chronic Schizophrenia and Its Relation With Psychopathology and Impulsiveness

    PubMed Central

    Shokrgozar, Somayeh; Ahmadi, Reza; Yousefnezhad, Azadeh; Roshandelrad, Mahbobeh; Khosravi, Termeh; Ellahi, Masuomeh; Pakdaman, Mahdiyeh; Eskandari, Ameneh

    2015-01-01

    Background: Using drugs is a common affliction in patients with Schizophrenia affecting their increasing death rate. They have to tolerate longer treatment time and staying in hospital and they further show more violence and their living quality decreases. It also seems that this factor is among the influential factors of unsuccessful results in treating these patients. Objectives: Despite all this, there is little data about drug consumption, psychopathology and demographic information in patients with chronic schizophrenia in Iran. This paper reviews the relation between drug consumption and the mentioned qualities in patients afflicted by chronic Schizophrenia. Methods: In this cross-sectional study, 100 patients with Schizophrenia were interviewed based on DSM-IV-TR diagnostic parameters and according to a psychiatrist´s views. The severity of psychopathology was evaluated, using PANSS, (SCID-I) DSM-IV and BARRAT. Results: The results show that in patients with chronic schizophrenia, there is a meaningful relation between cigarette consumption and education, gender, family background and BARRAT. It also has a direct correlation with Attention and Motor. Drug consumption has a meaningful relation with gender and Motor (p< 0.05). But it has no relation with BARRAT. Of the variables having a relation with correlation, cigarette and treatment period factors have a predicting effect for drug consumption. Conclusions: According to the results, drug and cigarette consumption is high among patients with Chronic Schizophrenia. Common cigarette consumption and its relation with impulsiveness increase, and death rate are the reasons which make us take the needed steps to have these patients quit smoking. PMID:26153213

  2. Motivation and Social Cognition in Patients with Schizophrenia.

    PubMed

    Fervaha, Gagan; Siddiqui, Ishraq; Foussias, George; Agid, Ofer; Remington, Gary

    2015-07-01

    Social cognition, referring to one's ability to perceive and process social cues, is an important domain in schizophrenia. Numerous studies have demonstrated that patients with schizophrenia have poorer performance on tests assessing social cognition relative to healthy comparison participants. However, whether variables such as motivation are related to performance on these tests in patients with schizophrenia is unclear. One thousand three-hundred and seventy-eight patients with schizophrenia completed the Facial Emotion Discrimination Task as a measure of emotional processing, a key facet of social cognition. Level of motivation was also evaluated in these patients using a derived measure from the Quality of Life Scale. The relationship between motivation and task performance was examined using bivariate correlations and logistic regression modeling, controlling for the impact of age and overall severity of psychopathology, the latter evaluated using the Positive and Negative Syndrome Scale. Motivation was positively related to performance on the social cognition test, and this relationship remained significant after controlling for potential confounding variables such as age and illness severity. Social cognition was also related to functioning, and the relationship was mediated by level of motivation. The present study found a significant relationship between motivation and performance on a test of social cognition in a large sample of patients with schizophrenia. These findings suggest that amotivation undermines task performance, or alternatively that poor social cognitive ability impedes motivation. Future studies evaluating social cognition in patients with schizophrenia should concurrently assess for variables such as effort and motivation. PMID:26135736

  3. Altered circadian clock gene expression in patients with schizophrenia.

    PubMed

    Johansson, Anne-Sofie; Owe-Larsson, Björn; Hetta, Jerker; Lundkvist, Gabriella B

    2016-07-01

    Impaired circadian rhythmicity has been reported in several psychiatric disorders. Schizophrenia is commonly associated with aberrant sleep-wake cycles and insomnia. It is not known if schizophrenia is associated with disturbances in molecular rhythmicity. We cultured fibroblasts from skin samples obtained from patients with chronic schizophrenia and from healthy controls, respectively, and analyzed the circadian expression during 48h of the clock genes CLOCK, BMAL1, PER1, PER2, CRY1, CRY2, REV-ERBα and DBP. In fibroblasts obtained from patients with chronic schizophrenia, we found a loss of rhythmic expression of CRY1 and PER2 compared to cells from healthy controls. We also estimated the sleep quality in these patients and found that most of them suffered from poor sleep in comparison with the healthy controls. In another patient sample, we analyzed mononuclear blood cells from patients with schizophrenia experiencing their first episode of psychosis, and found decreased expression of CLOCK, PER2 and CRY1 compared to blood cells from healthy controls. These novel findings show disturbances in the molecular clock in schizophrenia and have important implications in our understanding of the aberrant rhythms reported in this disease. PMID:27132483

  4. Neuropsychological change in patients with schizophrenia after treatment with quetiapine or haloperidol.

    PubMed Central

    Purdon, S E; Malla, A; Labelle, A; Lit, W

    2001-01-01

    OBJECTIVE: To assess the efficacy of quetiapine, a recently introduced second generation antipsychotic medication, in reducing cognitive impairment in patients with schizophrenia. DESIGN: Prospective, randomized, double-blind clinical trial. PATIENTS: 25 patients who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV) criteria for schizophrenia were recruited from 3 Canadian hospitals. INTERVENTION AND OUTCOME MEASURES: After a 48-hour washout period, 25 patients with schizophrenia were randomly assigned to double-blind treatment with quetiapine or haloperidol for 6 months and evaluated with rating scales for psychotic symptoms, mood and extrapyramidal side effects, as well as standardized neuropsychological measures sensitive to 6 cognitive domains: fine motor skill, attention span, verbal reasoning and fluency, visuospatial construction and fluency, executive skills and visuomotor tracking, and immediate recall of verbal and nonverbal materials. The measures were repeated 8 weeks and 6 months after treatment was initiated. RESULTS: Quetiapine improved psychosis and mood without inducing extrapyramidal symptoms. Quetiapine also had beneficial effects on cognitive skills, particularly verbal reasoning and fluency skills and immediate recall, with additional improvements on executive skills and visuomotor tracking and on the average of the 6 cognitive domains with sustained treatment. Patients taking haloperidol showed improvements in general clinical status, but no specific improvements on the positive syndrome, the negative syndrome, depression ratings or cognitive skills. CONCLUSIONS: These preliminary results support the potential value of quetiapine for improving cognitive impairment in patients with schizophrenia and emphasize the importance of further research with this promising atypical antipsychotic. PMID:11291531

  5. The prevalence and risk factors of stroke in patients with chronic schizophrenia

    PubMed Central

    Liang, Ying; Huang, Jian; Tian, Jingbin; Cao, Yuanyuan; Zhang, Guoling; Wang, Chungang; Cao, Ying; Li, Jianrong

    2016-01-01

    Objective To investigate the stroke risk and risk factors in patients with chronic schizophrenia. Patients and methods This study was a large-sample, cross-sectional survey. A total of 363 patients with chronic schizophrenia were selected from the Changping Traditional Chinese Medicine Hospital, Beijing, in August 2014. The patients were divided into either stroke group or control group based on the presence of stroke. Clinical evaluation included positive and negative syndrome scale assessment and a detailed questionnaire to collect the general information and disease-related conditions. Results The prevalence of stroke was 16.5% (60 cases). Stroke and control groups showed a significant difference in age, sex, smoking, combined medication, doses, negative factor score in positive and negative syndrome scale, body mass index, waist circumference, and systolic blood pressure. Multivariate analysis showed that a number of factors are significantly related to stroke, including age, sex, smoking, combined medication, doses, body mass index, and systolic blood pressure. Conclusion The prevalence of stroke is relatively higher in Chinese patients with chronic schizophrenia. Chronic schizophrenia patients are more likely to suffer from stroke; meanwhile, a number of risk factors were identified, including old age, female sex, smoking history, combined medication with a variety of drugs, high doses, obesity, and high blood pressure. PMID:27274246

  6. National survey of hospital patients.

    PubMed Central

    Bruster, S.; Jarman, B.; Bosanquet, N.; Weston, D.; Erens, R.; Delbanco, T. L.

    1994-01-01

    OBJECTIVE--To survey patients' opinions of their experiences in hospital in order to produce data that can help managers and doctors to identify and solve problems. DESIGN--Random sample of 36 NHS hospitals, stratified by size of hospital (number of beds), area (north, midlands, south east, south west), and type of hospital (teaching or non-teaching, trust or directly managed). From each hospital a random sample of, on average, 143 patients was interviewed at home or the place of discharge two to four weeks after discharge by means of a structured questionnaire about their treatment in hospital. SUBJECTS--5150 randomly chosen NHS patients recently discharged from acute hospitals in England. Subjects had been patients on medical and surgical wards apart from paediatric, maternity, psychiatric, and geriatric wards. MAIN OUTCOME MEASURES--Patients' responses to direct questions about preadmission procedures, admission, communication with staff, physical care, tests and operations, help from staff, pain management, and discharge planning. Patients' responses to general questions about their degree of satisfaction in hospitals. RESULTS--Problems were reported by patients, particularly with regard to communication with staff (56% (2824/5020) had not been given written or printed information); pain management (33% (1042/3162) of those suffering pain were in pain all or most of the time); and discharge planning (70% (3599/5124) had not been told about warning signs and 62% (3177/5119) had not been told when to resume normal activities). Hospitals failed to reach the standards of the Patient's Charter--for example, in explaining the treatment proposed and giving patients the option of not taking part in student training. Answers to questions about patient satisfaction were, however, highly positive but of little use to managers. CONCLUSIONS--This survey has highlighted several problems with treatment in NHS hospitals. Asking patients direct questions about what happened

  7. Schizophrenia

    MedlinePlus

    Schizophrenia is a serious brain illness. People who have it may hear voices that aren't there. ... job or take care of themselves. Symptoms of schizophrenia usually start between ages 16 and 30. Men ...

  8. Schizophrenia

    MedlinePlus

    ... may believe that people on the radio and television are talking directly to him or her. Sometimes ... schizophrenia are not violent; however, the risk of violence is greatest when schizophrenia is untreated. It is ...

  9. Schizophrenia

    MedlinePlus

    Schizophrenia is a mental disorder that makes it hard to tell the difference between what is real ... Schizophrenia is a complex illness. Mental health experts are not sure what causes it. Genes may play ...

  10. Odor Hedonic Capacity and Anhedonia in Schizophrenia and Unaffected First-Degree Relatives of Schizophrenia Patients

    PubMed Central

    Kamath, Vidyulata; Moberg, Paul J.; Kohler, Christian G.; Gur, Raquel E.; Turetsky, Bruce I.

    2013-01-01

    Objective: There is increasing evidence that schizophrenia patients have difficulties in the hedonic appraisal of odors. In a prior study, we assessed olfactory hedonic perception birhinally and found that males with schizophrenia failed to attach the appropriate hedonic valence to a pleasant odor, despite correctly perceiving changes in odor intensity. Female patients, in contrast, exhibited normal responses. The current study extends this work by examining odor valence processing in unaffected first-degree relatives of schizophrenia patients, to determine the extent to which this abnormality may be genetically mediated. We also examine odor valence processing unirhinally, rather than birhinally, to probe possible lateralized differences in patients’ hedonic processing deficits. Method: Individuals with schizophrenia (n = 54), first-degree unaffected family members (n = 22), and demographically matched controls (n = 45) were administered the Suprathreshold Amyl Acetate Odor Intensity and Odor Pleasantness Rating Test. Results: In contrast to family members and controls, both male and female schizophrenia probands underevaluated the hedonic characteristics of amyl acetate at lower concentrations and overevaluated its pleasantness at concentrations perceived as unpleasant by both controls and relatives. These patient-specific differences could not be explained by differences in smoking habit, medication use, or subjective ratings of odor intensity. However, they were associated with increased levels of anhedonia/asociality and negative symptomatology. Conclusions: Our findings suggest that both male and female schizophrenia patients have difficulties in the unirhinal appraisal of hedonic valence. Normal responses in unaffected first-degree relatives suggest that this is an environmentally, rather than genetically, mediated abnormality denoting negative symptomatology. PMID:21616912

  11. Validation of the Schizophrenia Quality of Life Scale Revision 4 (SQLS-R4) Among Patients with Schizophrenia

    PubMed Central

    Isjanovski, Viktor; Naumovska, Andromahi; Bonevski, Dimitar; Novotni, Antoni

    2016-01-01

    BACKGROUND: The main goal of psychiatric care is not to be focused only on reducing psychopathological symptoms, but on improvement of the patient’s quality of life. AIM: To examine validation and reliability SQLS-R4 among patients with schizophrenia. METHODS: The sample consisted of 61 outpatients with schizophrenia attending the Psychiatry Hospital “Skopje”. nclusion criteria for subject selection were: 1) age more than 18 years, 2) clinically stable (not acutely ill or has not been recently hospitalized at least for the past 3 months). They completed SQLS-R4 and SF36 questioners. RESULTS: The internal consistency reliability was satisfactory for both the psychosocial and vitality domains (Cronbach’s α = 0.928, 0.83). Most of the items were significantly correlated with own scale score (from 0.189 to 0.687). The average of the score for the psychosocial quality life was 39.9 ± 8.6 (sometimes), for the cognition and vitality was 26.5 ± 6.1 (sometimes) (SQLS-R4). There was moderate correlation between SF 36-energy with SQOLS - motivation and energy; SF 36-mental health correlation with SQOLS-psychosocial. CONCLUSION: SQLS-R4 appears to offer excellent potential as an easily administered and patient acceptable assessment and monitoring measure of quality of life (QoL). However, a principle psychometric criterion crucial to the use and validity of the instrument concerns the underlying factor structure.

  12. Cumulative genetic risk and prefrontal activity in patients with schizophrenia.

    PubMed

    Walton, Esther; Turner, Jessica; Gollub, Randy L; Manoach, Dara S; Yendiki, Anastasia; Ho, Beng-Choon; Sponheim, Scott R; Calhoun, Vince D; Ehrlich, Stefan

    2013-05-01

    The lack of consistency of genetic associations in highly heritable mental illnesses, such as schizophrenia, remains a challenge in molecular psychiatry. Because clinical phenotypes for psychiatric disorders are often ill defined, considerable effort has been made to relate genetic polymorphisms to underlying physiological aspects of schizophrenia (so called intermediate phenotypes), that may be more reliable. Given the polygenic etiology of schizophrenia, the aim of this work was to form a measure of cumulative genetic risk and study its effect on neural activity during working memory (WM) using functional magnetic resonance imaging. Neural activity during the Sternberg Item Recognition Paradigm was measured in 79 schizophrenia patients and 99 healthy controls. Participants were genotyped, and a genetic risk score (GRS), which combined the additive effects of 41 single-nucleotide polymorphisms (SNPs) from 34 risk genes for schizophrenia, was calculated. These risk SNPs were chosen according to the continuously updated meta-analysis of genetic studies on schizophrenia available at www.schizophreniaresearchforum.org. We found a positive relationship between GRS and left dorsolateral prefrontal cortex inefficiency during WM processing. GRS was not correlated with age, performance, intelligence, or medication effects and did not differ between acquisition sites, gender, or diagnostic groups. Our study suggests that cumulative genetic risk, combining the impact of many genes with small effects, is associated with a known brain-based intermediate phenotype for schizophrenia. The GRS approach could provide an advantage over studying single genes in studies focusing on the genetic basis of polygenic conditions such as neuropsychiatric disorders. PMID:22267534

  13. Occipital γ response to auditory stimulation in patients with schizophrenia.

    PubMed

    Basar-Eroglu, Canan; Mathes, Birgit; Brand, Andreas; Schmiedt-Fehr, Christina

    2011-01-01

    This study investigated changes in gamma oscillations during auditory sensory processing (auditory-evoked gamma responses, AEGR) and target detection (auditory event-related gamma responses, AERGR) in healthy controls (n=10) and patients with schizophrenia (n=10) using both single-trial and averaged time-frequency data analysis. The results show that single-trial gamma responses in patients were altered in magnitude and topographic pattern for both the AEGR and the AERGR experimental conditions, whereas no differences were found for the averaged evoked gamma response. At the single-trial level, auditory stimuli elicited higher gamma responses at both anterior and occipital sites in patients with schizophrenia compared to controls. Furthermore, in patients with schizophrenia target detection compared to passive listening to stimuli was related to increased single-trial gamma power at frontal sites. In controls enhancement of the gamma response was only apparent for the averaged gamma response, with a distribution largely restricted to anterior sites. The differences in oscillatory activity between healthy controls and patients with schizophrenia were not reflected in the behavioral measure (i.e., counting targets). We conclude that gamma activity triggered by auditory stimuli in schizophrenic patients might have less selectivity in timing and alterations in topography and may show changes in amplitude modulation with task demands. The present study may indicate that in patients with schizophrenia neuronal information is not adequately transferred, possibly due to an over-excitability of neuronal networks and excessive pruning of local connections in association cortex. PMID:21056599

  14. Relationship between first treatment contact and supernatural beliefs in caregivers of patients with schizophrenia.

    PubMed

    Grover, S; Nebhinani, N; Chakrabarti, S; Shah, R; Avasthi, A

    2014-06-01

    OBJECTIVE. To explore the relationship between attribution of symptoms to supernatural beliefs and first treatment contact in caregivers of patients with schizophrenia attending a tertiary care hospital located in North India. METHODS. A total of 122 caregivers (aged ≥ 18 years, staying with patient ≥ 1 year and involved in patients' care) of consecutive patients with diagnosis of schizophrenia (according to the ICD-10) were evaluated for their supernatural beliefs and first treatment contact. RESULTS. The first treatment contact was a government or private psychiatrist in slightly more than half (53.3%) of the patients, while it was faith healers in 23.8% of the patients. Around three quarters (74.6%) of the caregivers attributed patients' symptoms to ≥ 1 supernatural belief (like sorcery / witchcraft, ghosts, spirit intrusion, divine wrath, planetary influences, evil spirits, and bad deeds in previous life) and more than half (57.4%) of the caregivers attributed patients' symptoms to > 1 supernatural belief. It was observed that those who contacted faith healers for their patients' treatment had significantly higher attribution of the symptoms to supernatural causes. CONCLUSIONS. Supernatural beliefs were common in caregivers of patients with schizophrenia and the majority attributed their patients' symptoms to these beliefs. It signifies an urgent need for mental health literacy in India. PMID:24986200

  15. Hospital Patients Are Adult Learners.

    ERIC Educational Resources Information Center

    Caffarella, Rosemary S.

    Patient education is recognized by health care providers and patients themselves as an important component of adequate health care for hospital patients. Through this informational process, patients receive information about specific health problems, learn the necessary competencies to deal with them, and develop accepting attitudes toward the…

  16. A Cross-sectional, Comparative Study of Insight in Schizophrenia and Bipolar Patients in Remission

    PubMed Central

    Ramachandran, Arul Saravanan; Ramanathan, Rajkumar; Praharaj, Samir Kumar; Kanradi, Haridas; Sharma, Podila Satya Venkata Narasimha

    2016-01-01

    Aims: To study insight correlates in schizophrenia and bipolar mood disorder in remission among out-patients attending the Psychiatry Department of a Tertiary Care Hospital. Settings and Design: In a cross-sectional, naturalistic study, adult patients with schizophrenia and bipolar mood disorder in remission (n = 80; schizophrenia-40, mania-20, bipolar depression-20) were compared on insight measures and clinical correlates. Materials and Methods: Scale to Assess the Unawareness of Mental Disorders (SUMD) was used as the main tool to assess current and past measures of insight. Hogan's Drug Attitude Inventory was used to assess the drug attitude and compliance. Positive and Negative Symptom Scale for Schizophrenia, Young's Mania Rating Scale, and HAMD were used to rate psychopathology. Clinical Global Improvement was used as a screening tool for remission. Statistical Analysis: For comparison of the three clinical groups, analysis of variance and Chi-square test were used. In the post-hoc analysis, the Ryan-Einot-Gabriel-Welsch test was used to find the group difference. Results: About 40% in the schizophrenia group were unaware of their mental illness as against none in the bipolar group. The awareness of mental disorder for the current period, the awareness of the achieved effects of medications, and the awareness of social consequence was better in the bipolar group. The drug attitude (compliant positive attitude) increased as the SUMD item scale decreased or in other words, as the insight improved. Conclusions: Insight, both current and retrospect, showed significant differences between the schizophrenia and bipolar patients. Insight is significantly correlated with the observed compliance and drug attitude of the patient groups. PMID:27335515

  17. Etiology of cardiovascular disease in patients with schizophrenia: current perspectives.

    PubMed

    Emul, Murat; Kalelioglu, Tevfik

    2015-01-01

    Cardiovascular morbidity and mortality are important problems among patients with schizophrenia. A wide spectrum of reasons, ranging from genes to the environment, are held responsible for causing the cardiovascular risk factors that may lead to shortening the life expectancy of patients with schizophrenia. Here, we have summarized the etiologic issues related with the cardiovascular risk factors in schizophrenia. First, we focused on heritable factors associated with cardiovascular disease and schizophrenia by mentioning studies about genetics-epigenetics, in the first-episode or drug-naïve patients. In this context, the association and candidate gene studies about metabolic disturbances in schizophrenia are reviewed, and the lack of the effects of epigenetic/posttranscriptional factors such as microRNAs is mentioned. Increased rates of type 2 diabetes mellitus and disrupted metabolic parameters in schizophrenia are forcing clinicians to struggle with metabolic syndrome parameters and related issues, which are also the underlying causes for the risk of having cardiometabolic and cardiovascular etiology. Second, we summarized the findings of metabolic syndrome-related entities and discussed the influence of the illness itself, antipsychotic drug treatment, and the possible disadvantageous lifestyle on the occurrence of metabolic syndrome (MetS) or diabetes mellitus. Third, we emphasized on the risk factors of sudden cardiac death in patients with schizophrenia. We reviewed the findings on the arrhythmias such as QT prolongation, which is a risk factor for Torsade de Pointes and sudden cardiac death or P-wave prolongation that is a risk factor for atrial fibrillation. For example, the use of antipsychotics is an important reason for the prolongation of QT and some other cardiac autonomic dysfunctions. Additionally, we discussed relatively rare issues such as myocarditis and cardiomyopathy, which are important for prognosis in schizophrenia that may have originated

  18. Etiology of cardiovascular disease in patients with schizophrenia: current perspectives

    PubMed Central

    Emul, Murat; Kalelioglu, Tevfik

    2015-01-01

    Cardiovascular morbidity and mortality are important problems among patients with schizophrenia. A wide spectrum of reasons, ranging from genes to the environment, are held responsible for causing the cardiovascular risk factors that may lead to shortening the life expectancy of patients with schizophrenia. Here, we have summarized the etiologic issues related with the cardiovascular risk factors in schizophrenia. First, we focused on heritable factors associated with cardiovascular disease and schizophrenia by mentioning studies about genetics–epigenetics, in the first-episode or drug-naïve patients. In this context, the association and candidate gene studies about metabolic disturbances in schizophrenia are reviewed, and the lack of the effects of epigenetic/posttranscriptional factors such as microRNAs is mentioned. Increased rates of type 2 diabetes mellitus and disrupted metabolic parameters in schizophrenia are forcing clinicians to struggle with metabolic syndrome parameters and related issues, which are also the underlying causes for the risk of having cardiometabolic and cardiovascular etiology. Second, we summarized the findings of metabolic syndrome-related entities and discussed the influence of the illness itself, antipsychotic drug treatment, and the possible disadvantageous lifestyle on the occurrence of metabolic syndrome (MetS) or diabetes mellitus. Third, we emphasized on the risk factors of sudden cardiac death in patients with schizophrenia. We reviewed the findings on the arrhythmias such as QT prolongation, which is a risk factor for Torsade de Pointes and sudden cardiac death or P-wave prolongation that is a risk factor for atrial fibrillation. For example, the use of antipsychotics is an important reason for the prolongation of QT and some other cardiac autonomic dysfunctions. Additionally, we discussed relatively rare issues such as myocarditis and cardiomyopathy, which are important for prognosis in schizophrenia that may have

  19. Reduced protein synthesis in schizophrenia patient-derived olfactory cells

    PubMed Central

    English, J A; Fan, Y; Föcking, M; Lopez, L M; Hryniewiecka, M; Wynne, K; Dicker, P; Matigian, N; Cagney, G; Mackay-Sim, A; Cotter, D R

    2015-01-01

    Human olfactory neurosphere-derived (ONS) cells have the potential to provide novel insights into the cellular pathology of schizophrenia. We used discovery-based proteomics and targeted functional analyses to reveal reductions in 17 ribosomal proteins, with an 18% decrease in the total ribosomal signal intensity in schizophrenia-patient-derived ONS cells. We quantified the rates of global protein synthesis in vitro and found a significant reduction in the rate of protein synthesis in schizophrenia patient-derived ONS cells compared with control-derived cells. Protein synthesis rates in fibroblast cell lines from the same patients did not differ, suggesting cell type-specific effects. Pathway analysis of dysregulated proteomic and transcriptomic data sets from these ONS cells converged to highlight perturbation of the eIF2α, eIF4 and mammalian target of rapamycin (mTOR) translational control pathways, and these pathways were also implicated in an independent induced pluripotent stem cell-derived neural stem model, and cohort, of schizophrenia patients. Analysis in schizophrenia genome-wide association data from the Psychiatric Genetics Consortium specifically implicated eIF2α regulatory kinase EIF2AK2, and confirmed the importance of the eIF2α, eIF4 and mTOR translational control pathways at the level of the genome. Thus, we integrated data from proteomic, transcriptomic, and functional assays from schizophrenia patient-derived ONS cells with genomics data to implicate dysregulated protein synthesis for the first time in schizophrenia. PMID:26485547

  20. Attitudes toward Placebo-Controlled Clinical Trials of Patients with Schizophrenia in Japan

    PubMed Central

    Sugawara, Norio; Ishioka, Masamichi; Tsuchimine, Shoko; Tsuruga, Koji; Sato, Yasushi; Furukori, Hanako; Kudo, Shuhei; Tomita, Tetsu; Nakagami, Taku; Yasui-Furukori, Norio

    2015-01-01

    Background Although the use of placebo in clinical trials of schizophrenia patients is controversial because of medical and ethical concerns, placebo-controlled clinical trials are commonly used in the licensing of new drugs. Aims The objective of this study was to assess the attitudes toward placebo-controlled clinical trials among patients with schizophrenia in Japan. Method Using a cross-sectional design, we recruited patients (n = 251) aged 47.7±13.2 (mean±SD) with a DSM-IV diagnosis of schizophrenia or schizoaffective disorder who were admitted to six psychiatric hospitals from December 2013 to March 2014. We employed a 14-item questionnaire specifically developed to survey patients' attitudes toward placebo-controlled clinical trials. Results The results indicated that 33% of the patients would be willing to participate in a placebo-controlled clinical trial. Expectations for improvement of disease, a guarantee of hospital treatment continuation, and encouragement by family or friends were associated with the willingness to participate in such trials, whereas a belief of additional time required for medical examinations was associated with non-participation. Conclusions Fewer than half of the respondents stated that they would be willing to participate in placebo-controlled clinical trials. Therefore, interpreting the results from placebo-controlled clinical trials could be negatively affected by selection bias. PMID:26600382

  1. Aberrant network connectivity during error processing in patients with schizophrenia

    PubMed Central

    Voegler, Rolf; Becker, Michael P.I.; Nitsch, Alexander; Miltner, Wolfgang H.R.; Straube, Thomas

    2016-01-01

    Background Neuroimaging methods have pointed to deficits in the interaction of large-scale brain networks in patients with schizophrenia. Abnormal connectivity of the right anterior insula (AI), a central hub of the salience network, is frequently reported and may underlie patients’ deficits in adaptive salience processing and cognitive control. While most previous studies used resting state approaches, we examined right AI interactions in a task-based fMRI study. Methods Patients with schizophrenia and healthy controls performed an adaptive version of the Eriksen Flanker task that was specifically designed to ensure a comparable number of errors between groups. Results We included 27 patients with schizophrenia and 27 healthy controls in our study. The between-groups comparison replicated the classic finding of reduced activation in the midcingulate cortex (MCC) in patients with schizophrenia during the commission of errors while controlling for confounding factors, such as task performance and error frequency, which have been neglected in many previous studies. Subsequent psychophysiological interaction analysis revealed aberrant functional connectivity (FC) between the right AI and regions in the inferior frontal gyrus and temporoparietal junction. Additionally, FC between the MCC and the dorsolateral prefrontal cortex was reduced. Limitations As we examined a sample of medicated patients, effects of antipsychotic medication may have influenced our results. Conclusion Overall, it appears that schizophrenia is associated with impairment of networks associated with detection of errors, refocusing of attention, superordinate guiding of cognitive control and their respective coordination. PMID:26836622

  2. Homeless and Housed Inpatients with Schizophrenia: Disparities in Service Access upon Discharge from Hospital

    ERIC Educational Resources Information Center

    Burra, Tara A.; Hwang, Stephen W.; Rourke, Sean B.; Stergiopoulos, Vicky

    2012-01-01

    This study examines differences in services available at the time of discharge for homeless and housed psychiatric inpatients. Participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a general hospital psychiatric inpatient unit. Thirty homeless individuals and 21 housed controls (matched for diagnosis, gender,…

  3. Relationship between neutrophil/lymphocyte ratio with oxidative stress and psychopathology in patients with schizophrenia

    PubMed Central

    Kulaksizoglu, Burak; Kulaksizoglu, Sibel

    2016-01-01

    Introduction The aim of our study was to evaluate the relationship between neutrophil/lymphocyte ratio (NLR) and total antioxidant status (TAS), total oxidative status (TOS), oxidative stress index (OSI), paraoxonase, and total thiol (T.thl) in schizophrenic patients compared to healthy control group and investigate the relationship between these parameters and psychopathological symptoms. Methods The study population consisted of 61 healthy control subjects and 64 volunteer patients monitored in the outpatient clinics of psychiatry of Antalya Education and Research Hospital. Hemograms were determined by using a fully automated hematology analyzer (Beckman Coulter LH780). Serum TOS, TAS, paraoxonase, and T.thl were measured using a novel automated colorimetric measurement method developed by Erel. Sociodemographic data forms were completed by the participants. The Positive and Negative Syndrome Scale (PANSS) was used to assess the patients. Results Neutrophils, NLR, TAS, and TOS significantly increased, whereas lymphocytes, T.thl, and T.thl/OSI ratio were significantly lower in the schizophrenia patient group compared to the control group. A statistically significant positive relationship was found between PANSS positive subscale with leukocytes and significantly negative relationships were found between PANSS positive subscale with lymphocytes and T.thl/OSI ratio. Significant positive relationships were found between PANSS total subscale with leukocytes and NLR. Statistically significant negative relationships were found between PANSS total subscale with lymphocytes and T.thl/OSI ratio. In the group of patients with schizophrenia, a significant negative correlation was found between NLR with T.thl/OSI. In the group of patients with schizophrenia, a significant positive correlation was found between NLR with TOS and OSI. Conclusion By measuring NLR, which is simple, inexpensive, and suitable for routine use, we can obtain information about oxidative stress and

  4. Patients' accounts of stress and coping in schizophrenia.

    PubMed

    Hatfield, A B

    1989-11-01

    Many current approaches to the management of schizophrenia emphasize the influence of environmental stress on the course of the illness. Relatively neglected is the internal experience of schizophrenic patients as a source of stress and anxiety. The author draws on a wide range of first-person accounts by patients with schizophrenia to identify four internal sources of stress--altered perceptions, cognitive confusion, attentional deficit, and impaired identity--and to reveal the wisdom and creativity with which patients have come to terms with their illness. PMID:2680881

  5. How Patients With Schizophrenia Use the Internet: Qualitative Study

    PubMed Central

    Sibitz, Ingrid; Unger, Annemarie; Amering, Michaela

    2010-01-01

    Background The Internet is an important source of health information for people with psychiatric conditions. Little is known about the way patients with schizophrenia use the Internet when it comes to issues related to their illness. Data on their specific needs, difficulties, and the consequences related to Internet use are lacking. Objective Our objective was to investigate the nature and subjective consequences of health-related Internet use among patients with schizophrenia. Methods In all, 26 individual semistructured interviews were conducted and analyzed qualitatively in groups of 4 until theoretical saturation was achieved. Results Study results suggest that the Internet is an influential source of illness-related information for patients with schizophrenia. Many aspects of their behavior around the Internet resemble those of individuals not afflicted by mental illness. Importantly, problems specific to patients with schizophrenia were stimulus overflow, an inability to deal with the abundance of information, difficulties with concentration, lack of energy, paranoid ideas, symptom provocation, and the need to distance themselves from illness-related topics as part of the recovery process. Internet information was subjectively perceived as having the potential to significantly change patients’ attitudes toward medication and their relationships with doctors. Conclusions These findings provide insight into how individuals with schizophrenia handle illness-related Internet information. The data could contribute to the continuous development of Internet-based interventions and offer novel approaches to optimizing traditional treatment options. PMID:21169176

  6. Neurocognitive Vulnerability: Suicidal and Homicidal Behaviours in Patients With Schizophrenia

    PubMed Central

    Richard-Devantoy, Stéphane; Orsat, Manuel; Dumais, Alexandre; Turecki, Gustavo; Jollant, Fabrice

    2014-01-01

    Objective Schizophrenia is associated with an increase in the risk of both homicide and suicide. The objectives of this study were to systematically review all published articles that examined the relation between neurocognitive deficits and suicidal or homicidal behaviours in schizophrenia, and to identify vulnerabilities in suicidal and homicidal behaviour that may share a common pathway in schizophrenia. Methods: A systematic review of the literature was performed using MEDLINE to include all studies published up to August 31, 2012. Results: Among the 1760 studies, 7 neuropsychological and 12 brain imaging studies met the selection criteria and were included in the final analysis. The neuropsychological and functional neuroimaging studies were inconclusive. The structural imaging studies reported various alterations in patients with schizophrenia and a history of homicidal behaviour, including: reduced inferior frontal and temporal cortices, increased mediodorsal white matter, and increased amygdala volumes. Patients with a history of suicidal acts showed volumetric reductions in left orbitofrontal and superior temporal cortices, while right amygdala volume was increased, though, these findings have rarely been replicated. Finally, no study has directly compared neurocognitive markers of suicidal and homicidal risk. Conclusion: These results suggest that brain alterations, in addition to those associated with schizophrenia, may predispose some patients to a higher risk of homicide or suicide in particular circumstances. Moreover, some of these alterations may be shared between homicidal and suicidal patients. However, owing to several limitations, including the small number of available studies, no firm conclusions can be drawn and further investigations are necessary. PMID:24444320

  7. Hospital Libraries in Patient's Education.

    ERIC Educational Resources Information Center

    Iroka, Luke A.

    1988-01-01

    Reviews the positive effects of patient education, including the physician patient relationship, improvements in health status, and cost effectiveness. The status of hospital libraries in Nigeria is described, and suggestions for the implementation of patient education programs are made. (5 references) (CLB)

  8. Dietary patterns are associated with obesity in Japanese patients with schizophrenia

    PubMed Central

    2014-01-01

    Background Obesity among patients with schizophrenia is a growing concern because being overweight is widely regarded as a major risk factor for cardiovascular disease and premature death. Dietary patterns have been suggested as one modifiable factor that may play a role in development of obesity. The objective of this study was to examine the association between dietary patterns and obesity among patients with schizophrenia in Japan. Methods We recruited patients (n = 338) aged 44.0 ± 13.2 (mean ± SD) years with a DSM-IV diagnosis of schizophrenia who were admitted to four psychiatric hospitals using a cross-sectional design. Diet was assessed with a validated brief-type self-administered diet history questionnaire (BDHQ). Dietary patterns from 52 predefined food groups were extracted by principal component analysis. Results A total of 61 subjects (18.0%) were classified as obese. Three dietary patterns were identified: the healthy dietary pattern, the processed food dietary pattern, and the alcohol and accompanying dietary patterns. After adjusting for age and gender, patients within the high tertile of each healthy dietary pattern (OR = 0.29, 95% CI = 0.13 to 0.62) and processed food dietary pattern (OR = 0.44, 95% CI = 0.22 to 0.89) had a significantly lower risk for obesity compared with low tertile of dietary pattern. Conclusions Our findings suggest that dietary patterns, including higher intake of protein, fat, n-3 polyunsaturated fatty acids, n-6 polyunsaturated fatty acids, and vitamins, may be related to a decreased prevalence of obesity within patients with schizophrenia. Future longitudinal research exploring dietary patterns and obesity among patients with schizophrenia is warranted. PMID:24947974

  9. [Group psychoeducational intervention in relatives of patients suffering from schizophrenia].

    PubMed

    Palli, A; Kalantzi-Azizi, A; Ploumpidis, D N; Kontoangelos, K; Economou, M

    2015-01-01

    The present research paper aims at assessing the effectiveness of a psychoeducational intervention in relatives' groups of patients with schizophrenia or schizoaffective disorder. It examines the possible influence of the intervention on family members as well as on the course of the patient illness. Of a total of 131 relatives, 83 consisted the experimental group and 48 the control group. The relatives of the experimental group were divided into 5 groups and attended 18 psychoeducational sessions. Their patients as well s the patients and the relatives of the control group attended no specific intervention and continued their routine care. The psychoeducational intervention included education about the illness, communication skills training and training in problem-solving. It combined educational and psychotherapeutic techniques. The psychometric tools administered were: The Family Burden Scale, The Family Rituals Scale, The General Health Questionnaire GHQ-28, the Center for Epidemiological studies - Depression Scale (CES-D), the Opinions about Mental Illness Scale OMI, two scales concerning the knowledge about the illness, two questionnaires concerning expectations and feedback about the group process and questionnaires regarding sociodemographic characteristics of the sample and information about the illness. The number of hospitalizations of patients (n=91) during the research year was investigated. An interaction between group and measurement was found. While patient hospitalizations of both research groups did not differ significantly at the year before the study with X2=0.54, p=0.46), they differed when measured a year after the intervention, where patients in the intervention group had statistically significant fewer hospitalizations compared to the patients in the control group (x2=4.58, significant at p=0.032). As to the "compliance" in the medication, two statistical tests were conducted, taking into consideration that "compliance" by patients starting

  10. One patient with Sjogren's syndrome presenting schizophrenia-like symptoms.

    PubMed

    Lin, Ching-En

    2016-01-01

    Comorbid depression in patients with Sjogren's syndrome has been reported frequently, while comorbid psychosis in subjects with Sjogren's syndrome has rarely been reported. Here we report a patient with Sjogren's syndrome who presented with schizophrenia-like symptoms such as persecutory delusions and auditory hallucinations in contrast to her previous psychiatric presentations, which only included depression and anxiety. PMID:27042076

  11. Impaired coherence of life narratives of patients with schizophrenia.

    PubMed

    Allé, Mélissa C; Potheegadoo, Jevita; Köber, Christin; Schneider, Priscille; Coutelle, Romain; Habermas, Tilmann; Danion, Jean-Marie; Berna, Fabrice

    2015-01-01

    Self-narratives of patients have received increasing interest in schizophrenia since they offer unique material to study patients' subjective experience related to their illness, in particular the alteration of self that accompanies schizophrenia. In this study, we investigated the life narratives and the ability to integrate and bind memories of personal events into a coherent narrative in 27 patients with schizophrenia and 26 controls. Four aspects of life narratives were analyzed: coherence with cultural concept of biography, temporal coherence, causal-motivational coherence and thematic coherence. Results showed that in patients cultural biographical knowledge is preserved, whereas temporal coherence is partially impaired. Furthermore, causal-motivational and thematic coherence are significantly impaired: patients have difficulties explaining how events have modeled their identity, and integrating different events along thematic lines. Impairment of global causal-motivational and thematic coherence was significantly correlated with patients' executive dysfunction, suggesting that cognitive impairment observed in patients could affect their ability to construct a coherent narrative of their life by binding important events to their self. This study provides new understanding of the cognitive deficits underlying self-disorders in patients with schizophrenia. Our findings suggest the potential usefulness of developing new therapeutic interventions to improve autobiographical reasoning skills. PMID:26255756

  12. Treatment of postpsychotic depression with sertraline in patients with schizophrenia.

    PubMed

    Ros, L T

    2006-01-01

    Some authors treated a two groups of patients with postpsychotic depression in a groups of patients with schizophrenia. Sertraline proved better than imipramine in view of earlier onset of action and lower incidence, intensity and duration of adverse effects and lower risk of schizophrenie symtom recurrence (Ref 4). PMID:17125063

  13. Prevalence and attributes of criminality in patients with schizophrenia

    PubMed Central

    Ghoreishi, Abolfazl; Kabootvand, Soleiman; Zangani, Ebrahim; Bazargan-Hejazi, Shahrzad; Ahmadi, Alireza; Khazaie, Habibolah

    2015-01-01

    Abstract: Background: Existing research in law and psychiatry point to schizophrenia as a risk factor for violence and offense behaviors. The present study aims to: 1) report on the prevalence and types of offensive or criminal acts in patients with schizophrenia; 2) identify attributes of schizophrenic offenders; and 3) examine factors associated with offensive or criminal behaviors within a sample of schizophrenic offenders. Methods: This was a cross-sectional study of 358 patients with schizophrenia who were admitted to a psychiatric ward in Iran between 2004 and 2008. Study data was collected using patients’ medical, criminal records, as well as via personal interview with the family member. Study variables included criminality or offensive behavior, types of schizophrenia (paranoid vs. nonparanoid), experiencing hallucination, disease onset, and patients’ demographics. Results: Of the sample, 64.8% were male, 80.7% were 45 years old or younger, and 74.1% were either single or divorced. Slightly over 59 % were offenders with criminal status, of which, 9.8% were legal offenders and 48.6% were hidden offenders. The results of unadjusted logistic regression between these variables and criminality show, except for employment, marital status, and opium use, all other variables were statically associated with criminality. Conclusions: Methodological difficulties arising from this study, as well as, the role of mental health professionals, family, and legal system for prevention of violence in and by patients with schizophrenia are discussed. PMID:24879076

  14. Brain activation induced by psychological stress in patients with schizophrenia.

    PubMed

    Castro, M N; Villarreal, M F; Bolotinsky, N; Papávero, E; Goldschmidt, M G; Costanzo, E Y; Drucaroff, L; Wainsztein, A; de Achával, D; Pahissa, J; Bär, K-J; Nemeroff, C B; Guinjoan, S M

    2015-10-01

    Environmental influences are critical for the expression of genes putatively related to the behavioral and cognitive phenotypes of schizophrenia. Among such factors, psychosocial stress has been proposed to play a major role in the expression of symptoms. However, it is unsettled how stress interacts with pathophysiological pathways to produce the disease. We studied 21 patients with schizophrenia and 21 healthy controls aged 18 to 50years with 3T-fMRI, in which a period of 6min of resting state acquisition was followed by a block design, with three blocks of 1-min control-task, 1-min stress-task and 1-min rest after-task. Self-report of stress and PANSS were measured. Limbic structures were activated in schizophrenia patients by simple tasks and remained active during, and shortly after stress. In controls, stress-related brain activation was more time-focused, and restricted to the stressful task itself. Negative symptom severity was inversely related to activation of anterior cingulum and orbitofrontal cortex. Results might represent the neurobiological aspect of hyper-reactivity to normal stressful situations previously described in schizophrenia, thus providing evidence on the involvement of limbic areas in the response to stress in schizophrenia. Patients present a pattern of persistent limbic activation probably contributing to hypervigilance and subsequent psychotic thought distortions. PMID:26190301

  15. Transitive inference deficits in unaffected biological relatives of schizophrenia patients.

    PubMed

    Onwuameze, Obiora E; Titone, Debra; Ho, Beng-Choon

    2016-08-01

    Currently available treatments have limited efficacy in remediating cognitive impairment in schizophrenia. Efforts to facilitate cognition-enhancing drug discovery recommend the use of varied experimental cognitive paradigms (including relational memory) as assessment tools in clinical drug trials. Although relational memory deficits are increasingly being recognized as a reliable cognitive marker of schizophrenia, relational memory performance among unaffected biological relatives remains unknown. Therefore, we evaluated 73 adolescents or young adults (22 first- and 26 second-degree relatives of schizophrenia patients and 25 healthy controls (HC)) using a well-validated transitive inference (TI) experimental paradigm previously used to demonstrate relational memory impairment in schizophrenia. We found that TI deficits were associated with schizophrenia risk with first-degree relatives showing greater impairment than second-degree relatives. First-degree relatives had poorer TI performance with significantly lower accuracy and longer response times than HC when responding to TI probe pairs. Second-degree relatives had significantly quicker response times than first-degree relatives and were more similar to HC in TI performance. We further explored the relationships between TI performance and neurocognitive domains implicated in schizophrenia. Among HC, response times were inversely correlated with FSIQ, verbal learning, processing speed, linguistic abilities and working memory. In contrast, relatives (first-degree in particular) had a differing pattern of TI-neurocognition relationships, which suggest that different brain circuits may be used when relatives encode and retrieve relational memory. Our finding that unaffected biological relatives of schizophrenia patients have TI deficits lends further support for the use of relational memory construct in future pro-cognition drug studies. PMID:27050477

  16. Platelet serotonin concentration and depressive symptoms in patients with schizophrenia.

    PubMed

    Peitl, Vjekoslav; Vidrih, Branka; Karlović, Zoran; Getaldić, Biserka; Peitl, Milena; Karlović, Dalibor

    2016-05-30

    Depressive symptoms seem to be frequent in schizophrenia, but so far they have received less attention than other symptom domains. Impaired serotonergic neurotransmission has been implicated in the pathogenesis of depression and schizophrenia. The objectives of this study were to investigate platelet serotonin concentrations in schizophrenic patients with and without depressive symptoms, and to investigate the association between platelet serotonin concentrations and symptoms of schizophrenia, mostly depressive symptoms. A total of 364 patients were included in the study, 237 of which had significant depressive symptoms. Significant depressive symptoms were defined by the cut-off score of 7 or more on Calgary Depression Rating Scale (CDSS). Platelet serotonin concentrations were assessed by the enzyme-linked immunosorbent assay (ELISA). Prevalence of depression in patients with schizophrenia was 65.1%. Schizophrenic patients with depressive symptoms showed lower platelet serotonin concentrations (mean±SD; 490.6±401.2) compared to schizophrenic patients without depressive symptoms (mean±SD; 660.9±471.5). An inverse correlation was established between platelet serotonin concentration and depressive symptoms, with more severe symptoms being associated with lower platelet serotonin concentrations. Depressive symptoms in schizophrenic patients may be associated with reduced concentrations of platelet serotonin. PMID:27137969

  17. Impaired coherence of life narratives of patients with schizophrenia

    PubMed Central

    Allé, Mélissa C.; Potheegadoo, Jevita; Köber, Christin; Schneider, Priscille; Coutelle, Romain; Habermas, Tilmann; Danion, Jean-Marie; Berna, Fabrice

    2015-01-01

    Self-narratives of patients have received increasing interest in schizophrenia since they offer unique material to study patients’ subjective experience related to their illness, in particular the alteration of self that accompanies schizophrenia. In this study, we investigated the life narratives and the ability to integrate and bind memories of personal events into a coherent narrative in 27 patients with schizophrenia and 26 controls. Four aspects of life narratives were analyzed: coherence with cultural concept of biography, temporal coherence, causal-motivational coherence and thematic coherence. Results showed that in patients cultural biographical knowledge is preserved, whereas temporal coherence is partially impaired. Furthermore, causal-motivational and thematic coherence are significantly impaired: patients have difficulties explaining how events have modeled their identity, and integrating different events along thematic lines. Impairment of global causal-motivational and thematic coherence was significantly correlated with patients’ executive dysfunction, suggesting that cognitive impairment observed in patients could affect their ability to construct a coherent narrative of their life by binding important events to their self. This study provides new understanding of the cognitive deficits underlying self-disorders in patients with schizophrenia. Our findings suggest the potential usefulness of developing new therapeutic interventions to improve autobiographical reasoning skills. PMID:26255756

  18. Impact of vocational rehabilitation on social functioning, cognitive functioning, and psychopathology in patients with chronic schizophrenia

    PubMed Central

    Suresh Kumar, P. N.

    2008-01-01

    Aim: To assess the impact of vocational rehabilitation on psychopathology, social functioning and cognitive functioning in schizophrenia Materials and Methods: 34 patients with DSM IV diagnosis of chronic schizophrenia were compared 40 patients with same diagnosis but not attending vocational rehabilitation using PANSS, SCARF social functioning Index and MMSE. Results and Discussion: Basic psycho-socio-demographic data were comparable in both groups except more hospitalization in the no rehabilitation group. Comparison of social functioning, cognitive functioning and psychopathology showed significant improvement in rehabilitated patients. Cognitive functioning had positive correlation with occupational role in the rehabilitated group and negative correlation in the rehabilitated group. Social functioning had negative correlation with positive and negative symptoms, general psychopathology and total PANSS score and cognitive symptoms in patients without rehabilitation. Conclusion: The present concludes that there is a definite limitation in the domains of social functioning, cognitive functioning and psychopathology in chronic schizophrenia patients who had no rehabilitation. However vocational rehabilitation significantly improves these limitations, which in turn help these patients to integrate into the society so as to function efficiently in their roles as parents, home makers and social beings. PMID:19823610

  19. Obesity and smoking in patients with schizophrenia and normal controls: a case-control study.

    PubMed

    Fountoulakis, Konstantinos N; Siamouli, Melina; Panagiotidis, Panagiotis; Magiria, Stamatia; Kantartzis, Sotiris; Papastergiou, Natalia; Shoretsanitis, George; Pantoula, Eleonora; Moutou, Katerina; Kouidi, Evangelia; Deres, Symeon

    2010-03-30

    Cardiovascular risk factors, especially obesity and smoking are highly prevalent in patients with schizophrenia. Central obesity and the metabolic syndrome are conditions mostly attributed to the use of antipsychotic medication and lifestyle habits, and they constitute a significant health concern. Our study sample included 105 patients suffering from schizophrenia aged 36.25+/-10.03 and 156 normal control subjects aged 36.03+/-11.33. All patients were in- or out-patients of a private hospital. Clinical diagnosis was made according to DSM-IV-TR criteria. Height, weight, waist circumference and number of cigarettes smoked daily were recorded. Duration of illness was calculated based on records concerning the age of first onset of psychotic symptoms. Body Surface Area (BSA) and Body Mass Index (BMI) were calculated as well as % body fat, with the use of LifeWise Body Fat Analyzers No 63-1525. The results of analysis of variance suggested a significant main effect regarding diagnosis and sex as well as for their interaction. There were significant differences between patients and controls regarding body weight, waist circumference, BMI, BSA and % body fat, with patients, especially females, being more obese than controls. The results of the present study corroborate the increased prevalence of obesity in schizophrenia. The interpretation of this finding remains unclear. PMID:20079934

  20. The Twenty-Year Trajectory of Suicidal Activity Among Post-Hospital Psychiatric Men and Women with Mood Disorders and Schizophrenia.

    PubMed

    Kaplan, Kalman J; Harrow, Martin; Clews, Kelsey

    2016-07-01

    The Chicago Follow-up Study has followed the course of severe mental illness among psychiatric patients for more than 20 years after their index hospitalization. Among these patients are 97 schizophrenia patients, 45 patients with schizoaffective disorders, 102 patients with unipolar nonpsychotic depression, and 53 patients with a bipolar disorder. Maximum suicidal activity (suicidal ideation, suicidal attempts and suicide completions) generally declines over the 3 time periods (early, middle, and late follow-ups) following discharge from the acute psychiatric hospitalization for both males and females across diagnostic categories with two exceptions: female schizophrenia patients and female bipolar patients. A weighted mean suicidal activity score tended to decrease across follow-ups for male patients in the schizophrenia, schizoaffective, and depressive diagnostic groups with an uneven trend in this direction for the male bipolars. No such pattern emerges for our female patients except for female depressives. Males' suicidal activity seems more triggered by psychotic symptoms and potential chronic disability while females' suicidal activity seems more triggered by affective symptoms. PMID:26881891

  1. Anxiety in Patients with Schizophrenia: Epidemiology and Management.

    PubMed

    Temmingh, Henk; Stein, Dan J

    2015-01-01

    Anxiety symptoms can occur in up to 65 % of patients with schizophrenia, and may reach the threshold for diagnosis of various comorbid anxiety disorders, including obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). We review the clinical presentation, diagnosis, neurobiology, and management of anxiety in patients with schizophrenia, with a particular focus on pharmacotherapy. The prevalence of any anxiety disorder (at syndrome level) in schizophrenia is estimated to be up to 38 %, with social anxiety disorder (SAD) being the most prevalent. Severity of positive symptoms may correlate with severity of anxiety symptoms, but anxiety can occur independently of psychotic symptoms. While anxiety may be associated with greater levels of insight, it is also associated with increased depression, suicidality, medical service utilization, and cognitive impairment. Patients with anxiety symptoms are more likely to have other internalizing symptoms as opposed to externalizing symptoms. Diagnosis of anxiety in schizophrenia may be challenging, with positive symptoms obscuring anxiety, lower levels of emotional expressivity and communication impeding diagnosis, and conflation with akathisia. Higher diagnostic yield may be achieved by assessment following the resolution of the acute phase of psychosis as well as by the use of screening questions and disorder-specific self-report instruments. In schizophrenia patients with anxiety, there is evidence of underactive fear circuitry during anxiety-provoking stimuli but increased autonomic responsivity and increased responsiveness to neutral stimuli. Recent findings implicate the serotonin transporter (SERT) genes, brain-derived neurotropic factor (BDNF) genes, and the serotonin 1a (5HT1a) receptor, but are preliminary and in need of replication. There are few randomized controlled trials (RCTs) of psychotherapy for anxiety symptoms or disorders in schizophrenia. For pharmacotherapy, data from a few

  2. Attitudes toward metabolic adverse events among patients with schizophrenia in Japan

    PubMed Central

    Sugawara, Norio; Yasui-Furukori, Norio; Yamazaki, Manabu; Shimoda, Kazutaka; Mori, Takao; Sugai, Takuro; Matsuda, Hiroshi; Suzuki, Yutaro; Minami, Yoshitake; Ozeki, Yuji; Okamoto, Kurefu; Sagae, Toyoaki; Someya, Toshiyuki

    2016-01-01

    Background Metabolic syndrome is a growing concern among patients with schizophrenia because metabolic abnormalities are widely regarded as a major risk factor for cardiovascular disease and premature death. The current study assessed attitudes toward metabolic adverse events among patients with schizophrenia. Methods A brief questionnaire was constructed to investigate patient recognition of the following broad areas: dietary habits, lifestyle, self-monitoring, knowledge, and medical practice. Between January 2012 and June 2013, questionnaires were sent to patients associated with 520 outpatient facilities and 247 inpatient facilities belonging to the Japan Psychiatric Hospital Association. All of the participants (n=22,072; inpatients =15,170, outpatients =6,902) were diagnosed with schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, or the International Classification of Diseases, tenth revision. Results Approximately 55.0% (8,069/14,669) of inpatients and 44.8% of outpatients (2,978/6,649) reported that they did not exercise at all. Although 60.9% (4,116/6,760) of outpatients reported that they felt obese, only 35.6% (5,261/14,794) of inpatients felt obese. More than half of the inpatients (51.2%; 7,514/14,690) and outpatients (60.8%; 4,086/6,721) hoped to receive regular blood tests to prevent weight gain and diseases such as diabetes. Conclusion Although more than half of patients hoped to prevent weight gain and diabetes, only a minority of patients were mindful of eating balanced meals and having physical exercise. Educational efforts and the promotion of the best pharmacotherapy and monitoring practices are needed for patients with schizophrenia. PMID:26966364

  3. Schizophrenia

    MedlinePlus

    ... medical conditions and other psychiatric diagnoses, such as bipolar disorder. To be diagnosed with schizophrenia, a person must ... your story Mental Illness ADHD Anxiety Disorders Autism Bipolar Disorder Borderline Personality Disorder Depression Dissociative Disorders Eating Disorders ...

  4. Mortality over a 20-year period in patients with primary polydipsia associated with schizophrenia: a retrospective study.

    PubMed

    Hawken, Emily R; Crookall, Jake M; Reddick, Deirdre; Millson, Richard C; Milev, Roumen; Delva, Nicholas

    2009-02-01

    Primary polydipsia, excessive fluid intake without medical cause, is present in over 20% of seriously and persistently ill psychiatric inpatients. The long-term effects of primary polydipsia on longevity have not previously been examined. Inpatients in a psychiatric hospital were screened for polydipsia in 1985. Those identified to be polydipsic, the majority of whom suffered from schizophrenia, were re-evaluated in 2005 and compared with a control group of non-polydipsic patients. Chart reviews were conducted and follow-up data were obtained. Of 172 patients at the time of screening, 48 suffering from schizophrenia either had or went on to develop polydipsia; 42 non-polydipsic patients with schizophrenia from the original survey were randomly selected as controls. Primary polydipsia had a significant negative effect on longevity. The median age at death (age at which 50% of cases have died) was 59 years for polydipsic patients and 68 for non-polydipsic control patients. Adjusting for duration of schizophrenia, smoking, and diagnosis, a patient with polydipsia had a 74% greater chance of dying before a non-polydipsic patient (a hazard ratio of 2.84 [95% Confidence Interval (CI): 1.22-6.64]). Outcome was worst in patients with severe polydipsia: the median age at death was 57 years and a patient with severe polydipsia had a 75% greater chance of dying before a non-polydipsic patient (hazard ratio of 3.36 [95% CI: 1.31-8.60]). When polydipsia is associated with schizophrenia, mortality is increased in comparison to that in patients with schizophrenia who do not drink water to excess. PMID:18984069

  5. Clinical investigation of speech signal features among patients with schizophrenia

    PubMed Central

    ZHANG, Jing; PAN, Zhongde; GUI, Chao; CUI, Donghong

    2016-01-01

    Background A new area of interest in the search for biomarkers for schizophrenia is the study of the acoustic parameters of speech called 'speech signal features'. Several of these features have been shown to be related to emotional responsiveness, a characteristic that is notably restricted in patients with schizophrenia, particularly those with prominent negative symptoms. Aim Assess the relationship of selected acoustic parameters of speech to the severity of clinical symptoms in patients with chronic schizophrenia and compare these characteristics between patients and matched healthy controls. Methods Ten speech signal features-six prosody features, formant bandwidth and amplitude, and two spectral features-were assessed using 15-minute speech samples obtained by smartphone from 26 inpatients with chronic schizophrenia (at enrollment and 1 week later) and from 30 healthy controls (at enrollment only). Clinical symptoms of the patients were also assessed at baseline and 1 week later using the Positive and Negative Syndrome Scale, the Scale for the Assessment of Negative Symptoms, and the Clinical Global Impression-Schizophrenia scale. Results In the patient group the symptoms were stable over the 1-week interval and the 1-week test-retest reliability of the 10 speech features was good (intraclass correlation coefficients [ICC] ranging from 0.55 to 0.88). Comparison of the speech features between patients and controls found no significant differences in the six prosody features or in the formant bandwidth and amplitude features, but the two spectral features were different: the Mel-frequency cepstral coefficient (MFCC) scores were significantly lower in the patient group than in the control group, and the linear prediction coding (LPC) scores were significantly higher in the patient group than in the control group. Within the patient group, 10 of the 170 associations between the 10 speech features considered and the 17 clinical parameters considered were

  6. Patterns of Emotion Attribution are Affected in Patients with Schizophrenia.

    PubMed

    Romero-Ferreiro, María Verónica; Aguado, Luis; Rodriguez-Torresano, Javier; Palomo, Tomás; Rodriguez-Jimenez, Roberto

    2015-01-01

    Deficits in facial affect recognition have been repeatedly reported in schizophrenia patients. The hypothesis that this deficit is caused by poorly differentiated cognitive representation of facial expressions was tested in this study. To this end, performance of patients with schizophrenia and controls was compared in a new emotion-rating task. This novel approach allowed the participants to rate each facial expression at different times in terms of different emotion labels. Results revealed that patients tended to give higher ratings to emotion labels that did not correspond to the portrayed emotion, especially in the case of negative facial expressions (p < .001, η 2 = .131). Although patients and controls gave similar ratings when the emotion label matched with the facial expression, patients gave higher ratings on trials with "incorrect" emotion labels (p s < .05). Comparison of patients and controls in a summary index of expressive ambiguity showed that patients perceived angry, fearful and happy faces as more emotionally ambiguous than did the controls (p < .001, η 2 = .135). These results are consistent with the idea that the cognitive representation of emotional expressions in schizophrenia is characterized by less clear boundaries and a less close correspondence between facial configurations and emotional states. PMID:26255714

  7. Rumination and autobiographical memory impairment in patients with schizophrenia.

    PubMed

    Ricarte, J J; Hernández, J V; Latorre, J M; Danion, J M; Berna, F

    2014-12-01

    Although patients with schizophrenia exhibit autobiographical memory impairment, which is considered to be a limiting factor in their daily life, the mechanisms underlying such impairment have been rarely studied. In the current study, we investigate whether rumination and, in particular, brooding, which is a form of maladaptive repetitive thinking, may be linked to the difficulty that patients with schizophrenia experience when attempting to access specific autobiographical memories. Our results indicate that patients reported less specific autobiographical memories compared to control participants. Patients also displayed a higher level of brooding and had more depressive symptoms. According to the CaR-FA-X model (Williams et al., 2007), depression and brooding were associated with memory specificity in control participants. In contrast, neither depression nor brooding was correlated with memory specificity in patients. These results suggest that depression and rumination may not be directly related to patients' difficulty to recall specific memories and that other factors, such as metacognitive deficits, must first be considered when seeking interventions aimed to improve autobiographical memory in patients with schizophrenia. PMID:25464919

  8. Bed bathing patients in hospital.

    PubMed

    Downey, Lindsey; Lloyd, Hilary

    There are a number of circumstances that may affect an individual's ability to maintain personal hygiene. Hospitalised patients, and in particular those who are bedridden, may become dependent on nursing staff to carry out their hygiene needs. Assisting patients to maintain personal hygiene is a fundamental aspect of nursing care. However, it is a task often delegated to junior or newly qualified staff. This article focuses on the principles of bed bathing patients in hospital, correct procedure and the importance of maintaining patient dignity and respect in clinical practice. PMID:18543852

  9. The effect of brexpiprazole (OPC-34712) and aripiprazole in adult patients with acute schizophrenia: results from a randomized, exploratory study.

    PubMed

    Citrome, Leslie; Ota, Ai; Nagamizu, Kazuhiro; Perry, Pamela; Weiller, Emmanuelle; Baker, Ross A

    2016-07-01

    The aim of this study was to explore the effects of brexpiprazole and aripiprazole on efficacy, cognitive functioning, and safety in patients with acute schizophrenia. Patients who would benefit from hospitalization/continued hospitalization for acute relapse of schizophrenia were enrolled and randomized (2 : 1) to target doses of open-label brexpiprazole 3 mg/day or aripiprazole 15 mg/day for 6 weeks. Outcomes included change from baseline to week 6 in the Positive and Negative Syndrome Scale total score, Barratt Impulsiveness Scale 11-item score, and Cogstate computerized cognitive test battery scores. Patients treated with brexpiprazole (n=64) or aripiprazole (n=33) showed reductions in symptoms of schizophrenia as assessed by Positive and Negative Syndrome Scale total score (-22.9 and -19.4, respectively). A modest reduction in impulsivity was observed with brexpiprazole, but not aripiprazole (mean change in the Barratt Impulsiveness Scale 11-item total score: -2.7 and 0.1, respectively). No change in Cogstate scores was observed for either treatment. Brexpiprazole was well tolerated and the incidence of akathisia was lower in patients treated with brexpiprazole (9.4%) than aripiprazole (21.2%). Clinically relevant improvements in psychopathology were observed in patients with acute schizophrenia treated with brexpiprazole or aripiprazole. Brexpiprazole was well tolerated, with a lower incidence of akathisia than aripiprazole. PMID:26963842

  10. Violent Behavior among hospitalized medical and surgical patients.

    PubMed

    Ochitill, H N; Krieger, M

    1982-02-01

    To characterize violent behavior in hospitalized medical and surgical patients, we reviewed documented violent incidents at the San Francisco General Hospital during a two-year period. Twenty-nine incidents of verbal and physical violence occurred. One patient was gravely ill and three were delirious. All the incidents were associated with increased levels of tension and loss of impulse control. In most cases, contention with the staff regarding pain medication or ward regulations was a precipitating event. Of the 28 patients with mental disorders, 19 were substance abusers, six had organic brain syndrome, tw had neurosis, and one had schizophrenia. The findings suggest that physicians should be more sensitive to patient characteristics and to the situational characteristics of the violent incident. Explicit measures that anticipate and reduce violent behavior are reviewed. PMID:7058353

  11. Definitions and drivers of relapse in patients with schizophrenia: a systematic literature review

    PubMed Central

    2013-01-01

    Relapse in patients with schizophrenia has devastating repercussions, including worsening symptoms, impaired functioning, cognitive deterioration and reduced quality of life. This progressive decline exacerbates the burden of illness on patients and their families. Relapse prevention is identified as a key therapeutic aim; however, the absence of widely accepted relapse definition criteria considerably hampers achieving this goal. We conducted a literature review in order to investigate the reporting of relapses and the validity of hospitalization as a proxy for relapse in patients with schizophrenia. The primary aim was to assess the range and validity of methods used to define relapse in observational or naturalistic settings. The secondary aim was to capture information on factors that predicted or influenced the risk of relapse. A structured search of the PubMed database identified articles that discussed relapse, and hospitalization as a proxy of relapse, in patients with schizophrenia. National and international guidelines were also reviewed. Of the 150 publications and guidelines identified, 87 defined relapse and 62% of these discussed hospitalization. Where hospitalization was discussed, this was as a proxy for, or a component of, relapse in the majority of cases. However, hospitalization duration and type varied and were not always well defined. Scales were used to define relapse in 53 instances; 10 different scales were used and multiple scales often appeared within the same definition. There were 95 references to factors that may drive relapse, including non-adherence to antipsychotic medication (21/95), stress/depression (11/95) and substance abuse (9/95). Twenty-five publications discussed the potential of antipsychotic therapy to reduce relapse rates—continuous antipsychotic therapy was associated with reduced frequency and duration of hospitalization. Non-pharmacological interventions, such as psychoeducation and cognitive behavioural therapy

  12. Definitions and drivers of relapse in patients with schizophrenia: a systematic literature review.

    PubMed

    Olivares, José M; Sermon, Jan; Hemels, Michiel; Schreiner, Andreas

    2013-01-01

    Relapse in patients with schizophrenia has devastating repercussions, including worsening symptoms, impaired functioning, cognitive deterioration and reduced quality of life. This progressive decline exacerbates the burden of illness on patients and their families. Relapse prevention is identified as a key therapeutic aim; however, the absence of widely accepted relapse definition criteria considerably hampers achieving this goal. We conducted a literature review in order to investigate the reporting of relapses and the validity of hospitalization as a proxy for relapse in patients with schizophrenia. The primary aim was to assess the range and validity of methods used to define relapse in observational or naturalistic settings. The secondary aim was to capture information on factors that predicted or influenced the risk of relapse. A structured search of the PubMed database identified articles that discussed relapse, and hospitalization as a proxy of relapse, in patients with schizophrenia. National and international guidelines were also reviewed. Of the 150 publications and guidelines identified, 87 defined relapse and 62% of these discussed hospitalization. Where hospitalization was discussed, this was as a proxy for, or a component of, relapse in the majority of cases. However, hospitalization duration and type varied and were not always well defined. Scales were used to define relapse in 53 instances; 10 different scales were used and multiple scales often appeared within the same definition. There were 95 references to factors that may drive relapse, including non-adherence to antipsychotic medication (21/95), stress/depression (11/95) and substance abuse (9/95). Twenty-five publications discussed the potential of antipsychotic therapy to reduce relapse rates-continuous antipsychotic therapy was associated with reduced frequency and duration of hospitalization. Non-pharmacological interventions, such as psychoeducation and cognitive behavioural therapy, were

  13. Handedness and schizotypy in nonpsychotic relatives of patients with schizophrenia

    PubMed Central

    Tsuang, Hui-Chun; Liu, Chih-Min; Hwang, Tzung J.; Hsieh, Ming H.; Faraone, Stephen V.; Tsuang, Ming T.; Hwu, Hai-Gwo; Chen, Wei J.

    2010-01-01

    Existing studies have found the relationship between handedness and schizotypy to be inconsistent and had limited generalizability since only highly homogeneous groups have been investigated. This study aimed to examine the relation between handedness and the four schizotypal factors identified from a previous confirmatory factor analysis in a population of high familial loading for schizophrenia. Study subjects consisted of nonpsychotic first-degree relatives (850 parents and 334 siblings) of sib-pairs who were co-affected with schizophrenia. All participants were interviewed with the Diagnostic Interview for Genetic Studies, which contains a section of the modified Structured Interview for Schizotypy, and the Annett handedness questionnaire. Both categorical and continuous indicators for handedness were examined. Non-right handed siblings of schizophrenia patients displayed more positive schizotypal features than their right handed counterparts when the two-way Annett's handedness classification was adopted. No association was found when handedness was treated as continuous. The relationship between handedness and schizotypy was insignificant for parents probably due to the strong social pressure against left-handedness. We concluded that categorical non-right handedness was associated with positive schizotypy in nonpsychotic siblings of schizophrenia patients. The results indicate that an atypical cerebral lateralization underlying non-right handedness may be also a contributing factor to positive schizotypy. PMID:21308606

  14. Coping with negative symptoms of schizophrenia: patient and family perspectives.

    PubMed

    Mueser, K T; Valentiner, D P; Agresta, J

    1997-01-01

    An exploratory study was conducted of the strategies that schizophrenia patients and their relatives employ to cope with negative symptoms. Coping strategies and their perceived efficacy were elicited in semistructured interviews conducted separately with patients and relatives. Coping responses were coded according to the following dimensions: behavioral-cognitive, social-nonsocial, and problem focused-emotion focused. Overall, the number of coping strategies was related to perceived coping efficacy for both patients and relatives, regardless of the type of strategy. Perceived coping efficacy tended to be highest for apathy; intermediate for alogia, anhedonia, and inattention; and lowest for blunting. Relatives with more knowledge about schizophrenia used more coping strategies and reported higher levels of coping efficacy. Patient rejection by relatives and distress (either patient or relative) tended to not be related to coping strategies. The findings suggest that patients and relatives use a wide variety of strategies to cope with negative symptoms of schizophrenia. Future clinical work and research need to evaluate whether families may benefit from psychoeducational approaches to teaching them how to better manage negative symptoms. PMID:9165641

  15. Treatment with Ziprasidone for schizophrenia patients with OCD.

    PubMed

    Juven-Wetzler, Alzbeta; Fostick, Leah; Cwikel-Hamzany, Shlomit; Balaban, Evgenya; Zohar, Joseph

    2014-09-01

    Comorbidity of obsessive-compulsive disorder (OCD) has been observed in about 15% of schizophrenic patients and has been associated with poor prognosis. Therefore, there is a need for specific treatment options for these patients (schizo-obsessive, ScOCD). This is an open, prospective study, aiming to test the efficacy of Ziprasidone (80-200mg/d) in ScOCD patients and comparing the response to the treatment between stable schizophrenic (N=16) and stable ScOCD (N=29) patients. Treatment effect with Ziprasidone was different in schizophrenic patients when stratified based on OCD comorbidity. Overall, the effect on OCD symptoms (as measured by the Yale Brown Obsessive Compulsive Scale, YBOCS) was found to be bimodal-either no response or exacerbation (for 45% of the patients, n=13) or significant improvement of symptoms (55%, n=16). Those who improved in OCD symptoms, improved also in negative and general schizophrenia symptoms, while ScOCD-unimproved group worsened in all symptoms. Whereas schizophrenic patients without OCD responded in a modest Gaussian distribution, they improved in schizophrenia negative symptoms and in general anxiety. This data suggests that schizo-obsessive disorder is a distinct and complex condition with more than one underlying pathogenesis. Definition of these ScOCD subgroups defined by their response to Ziprasidone might contribute to personalized medicine within the OCD-schizophrenia spectrum. Moreover, this finding suggests that ScOCD may be considered as a special schizophrenic subtype and its inclusion in schizophrenia treatment studies need to be further explored due to its divergent response. PMID:25048540

  16. Alcohol abuse as the strongest risk factor for violent offending in patients with paranoid schizophrenia

    PubMed Central

    Kudumija Slijepčević, Marija; Jukić, Vlado; Novalić, Darko; Žarković-Palijan, Tija; Milošević, Milan; Rosenzweig, Ivana

    2014-01-01

    Aim To determine predictive risk factors for violent offending in patients with paranoid schizophrenia in Croatia. Method The cross-sectional study including male in-patients with paranoid schizophrenia with (N = 104) and without (N = 102) history of physical violence and violent offending was conducted simultaneously in several hospitals in Croatia during one-year period (2010-2011). Data on their sociodemographic characteristics, duration of untreated illness phase (DUP), alcohol abuse, suicidal behavior, personality features, and insight into illness were collected and compared between the groups. Binary logistic regression model was used to determine the predictors of violent offending. Results Predictors of violent offending were older age, DUP before first contact with psychiatric services, and alcohol abuse. Regression model showed that the strongest positive predictive factor was harmful alcohol use, as determined by AUDIT test (odds ratio 37.01; 95% confidence interval 5.20-263.24). Psychopathy, emotional stability, and conscientiousness were significant positive predictive factors, while extroversion, pleasantness, and intellect were significant negative predictive factors for violent offending. Conclusion This study found an association between alcohol abuse and the risk for violent offending in paranoid schizophrenia. We hope that this finding will help improve public and mental health prevention strategies in this vulnerable patient group. PMID:24778102

  17. INSIGHT AND SELF-STIGMA IN PATIENTS WITH SCHIZOPHRENIA.

    PubMed

    Vidović, Domagoj; Brecić, Petrana; Vilibić, Maja; Jukić, Vlado

    2016-03-01

    Poor insight and high level of self-stigma are often present among patients with schizophrenia and are related to poorer treatment adherence, poorer social function and rehabilitation, aggressive behavior, higher level of depression, social anxiety, lower quality of life and self-esteem. Reports on a relationship between insight and stigma are controversial. We examined the relationship of the level of insight and self-stigma in a sample of 149 patients with schizophrenia. Insight was measured with the Scale to assess Unawareness of Mental Disorder and self-stigma with the Internalized Stigma of Mental Illness. Results showed 88.6% of the patients to have high or moderate insight, with a mean value of 2.73. General insight showed the highest level (2.58) and insight in positive symptoms the lowest level (2.9). The self-stigma score in general was 2.13, with stereotype endorsement being lowest (1.98). According to study results, 77.1% of patients felt minimal or low self-stigma across all subscales, except for stigma resistance subscale. Statistically significant correlation was found between insight and four subscales of self-stigma, while no correlation was found for the stigma resistance subscale only. These results imply the need of individually tailored antistigma and insight promoting programs for patients with schizophrenia. PMID:27333714

  18. Personality dimensions of schizophrenia patients compared to control subjects by gender and the relationship with illness severity

    PubMed Central

    2014-01-01

    Background Personality traits and schizophrenia present gender differences; however, gender has not been considered in most studies on personality and schizophrenia. This study aims to identify the different personality dimensions of schizophrenia patients and healthy control subjects by gender and to explore the relationship between personality dimensions and illness severity variables by analyzing data for males and females separately. Methods Temperament and Character Inventory-Revised dimensions were compared by gender between 161 schizophrenia patients and 214 healthy controls from a population-based sample using independent t-tests. We then investigated whether personality dimensions are related to illness severity variables using correlation analyses and bivariate logistic regression, also by gender. Results The patients had significantly higher scores for harm avoidance (HA) and self-transcendence (ST) and lower scores for reward dependence (RD), cooperativeness (C), and self-directedness (SD) than the controls. Similar results were obtained when the sample was stratified by gender, however the differences were higher and more significant for HA among males and for RD among females. The number of admissions to a psychiatric hospital positively correlated with novelty seeking (NS) in males and negatively with SD in females. In males, SD and ST negatively correlated with the number of suicide attempts. Conclusions Male and female patients present difficulties for regulating and adapting behavior to achieve goals (SD) and for identifying and accepting others (C), as well as a great sense of spirituality and universe identification (ST). However, male patients are more characterized by being fearful, doubtful and easily fatigued (HA), while female patients are characterized by presenting difficulties maintaining and pursuing associated reward behaviors (RD). Furthermore, male and female patients who are frequently admitted to psychiatric hospitals and male

  19. Quality of life in caregivers of patients with schizophrenia: A literature review

    PubMed Central

    Caqueo-Urízar, Alejandra; Gutiérrez-Maldonado, José; Miranda-Castillo, Claudia

    2009-01-01

    Background A couple of decades ago, hospitals or psychiatric institutions were in charge of caring for patients with schizophrenia; however, nowadays this role is performed by one or more patient's relatives. Evidence shows that informal caregivers experience negative changes in their quality of life (QOL). The aim of this study is to review the main factors associated with the QOL of caregivers of people with schizophrenia. Methods A search through databases from journals published last decade between 1998 and 2008 was performed. In accordance with the inclusion criteria, titles and abstracts of citations obtained from the search were examined independently by two authors and irrelevant articles discarded. The full text of those studies considered relevant by either reviewer were obtained and assessed independently. Where differences of opinion rose they were resolved by discussion. Out of the 258 references, 37 were included in the review. Studies which assessed factors associated with caregivers of people with schizophrenia's quality of life were included and the information summarized. Results Evidence suggest that physical, emotional and economic distress affect negatively caregiver's QOL as a result of a number of unfulfilled needs such as, restoration of patient functioning in family and social roles, economic burden, lack of spare time, among other factors. Conclusion Decreased QOL may be associated with caregivers' burden, lack of social support, course of the disease and family relationships problems. In addition, in developing countries, QOL is affected by caregivers' economic burden. High quality research is needed in order to identify factors associated with QOL over time and testing the efficacy of interventions aiming to improve QOL in caregivers of patients with schizophrenia. PMID:19747384

  20. Hospital treatment of HIV patients.

    PubMed

    Ola, Samuel Olawale

    2006-12-01

    Treatment of patients with HIV/AIDS in Nigeria has progressed from the stage of inactivity, unconcern, abandonment and neglect to the present stage of holistic care involving treatment of the infection with Highly Active Anti Retroviral Agents, complications of the disease and side effects of antiretroviral therapy as well as that of human behavioural responses towards the disease with hope and promising outcome. The goal of the treatment is to prolong the patient's life while maintaining the best possible quality of health and life. It is now a continuum of care between the hospital and the different sectors of the community. Hospital treatment of patients with HIV-AIDS is complex and yet a simple task if there is healthy interaction of the patients and health care providers in a milieu of well equipped hospital setting with available treatment facilities for proper management of diseases. Similarly, for the care to achieve its goal, it requires a joint participation of the community and the commitment of the government not only on curtailment of the reservoir of HIV infection by antiretroviral therapy but total eradication of diseases, poverty and ignorance in all its entirety. PMID:18050774

  1. USING COMPUTATIONAL PATIENTS TO EVALUATE ILLNESS MECHANISMS IN SCHIZOPHRENIA

    PubMed Central

    Hoffman, Ralph E.; Grasemann, Uli; Gueorguieva, Ralitza; Quinlan, Donald; Lane, Douglas; Miikkulainen, Risto

    2011-01-01

    Background Various malfunctions involving working memory, semantics, prediction error, and dopamine neuromodulation have been hypothesized to cause disorganized speech and delusions in schizophrenia. Computational models may provide insights into why some mechanisms are unlikely, suggest alternative mechanisms, and tie together explanations of seemingly disparate symptoms and experimental findings. Methods Eight corresponding illness mechanisms were simulated in DISCERN, an artificial neural network model of narrative understanding and recall. For this study, DISCERN learned sets of “autobiographical” and “impersonal” crime stories with associated emotion-coding. In addition, 20 healthy controls and 37 patients with schizophrenia or schizoaffective disorder matched for age, gender and parental education were studied using a delayed story-recall task. A goodness-of-fit analysis was performed to determine the mechanism best reproducing narrative breakdown profiles generated by healthy controls and patients with schizophrenia. Evidence of delusion-like narratives was sought in simulations best matching the narrative breakdown profile of patients. Results All mechanisms were equivalent in matching the narrative breakdown profile of healthy controls. However, exaggerated prediction-error signaling during consolidation of episodic memories, termed hyperlearning, was statistically superior to other mechanisms in matching the narrative breakdown profile of patients. These simulations also systematically confused “autobiographical” agents with “impersonal” crime story agents to model fixed, self-referential delusions. Conclusions Findings suggest that exaggerated prediction-error signaling in schizophrenia intermingles and corrupts narrative memories when incorporated into long-term storage, thereby disrupting narrative language and producing fixed delusional narratives. If further validated by clinical studies, these computational patients could provide a

  2. Hospital Contacts With Infection and Risk of Schizophrenia: A Population-Based Cohort Study With Linkage of Danish National Registers

    PubMed Central

    Nielsen, Philip R.; Benros, Michael. E.; Mortensen, Preben B.

    2014-01-01

    Infections and immune responses have been suggested to play an important role in the etiology of schizophrenia. Several studies have reported associations between maternal infections during pregnancy and the child’s risk of schizophrenia; however, infection during childhood and adolescence unrelated to maternal infection during pregnancy has not been studied to nearly the same extent and the results are far from conclusive. Data were drawn from 2 population-based registers, the Danish Psychiatric Central Register and the Danish National Hospital Register. We used a historical population-based cohort design and selected all individuals born in Denmark between 1981 and 1996 (n = 843 390). We identified all individuals with a first-time hospital contact with schizophrenia from 1991 through 2010. Out of the 3409 individuals diagnosed with schizophrenia, a total of 1549 individuals had had a hospital contact with infection before their schizophrenia diagnosis (45%). Our results indicate that individuals who have had a hospital contact with infection are more likely to develop schizophrenia (relative risk [RR] = 1.41; 95% CI: 1.32–1.51) than individuals who had not had such a hospital contact. Bacterial infection was the type of infection that was associated with the highest risk of schizophrenia (RR = 1.63; 95% CI: 1.47–1.82). Our study does not exclude that a certain type of infection may have a specific effect; yet, it does suggest that schizophrenia is associated with a wide range of infections. This association may be due to inflammatory responses affecting the brain or genetic and environmental risk factors aggregating in families. PMID:24379444

  3. Paranoid symptoms in patients on a general hospital psychiatric unit. Implications for diagnosis and treatment.

    PubMed

    Freedman, R; Schwab, P J

    1978-03-01

    Paranoid symptoms were found in 40% of patients admitted to a university general hospital psychiatric unit during a ten-month period. Fifty-eight percent of this group had frank paranoid delusions, while the rest had ideas of reference or generalized suspiciousness. Only one half of those who had paranoid delusions had paranoid schizophrenia. A significant number had affective disorders or organic brain disorder. Ideas of reference and suspiciousness were found in many patients who were not psychotic. The therapeutic implications of these findings are reported in three patients who were inadequately treated for affective disorders because the presence of paranoid symptomatology had led to an incorrect diagnosis of schizophrenia. PMID:727891

  4. A clinical study of neurological soft signs in patients with schizophrenia

    PubMed Central

    Dutta, Mithun; Nath, Kamal; Baruah, Aparajeeta; Naskar, Subrata

    2016-01-01

    Background and Aim: Neurological soft signs (NSSs) are “objectively measured, nonlocalizing abnormalities, not related to impairment of a specific brain region, reflecting improper cortical-subcortical and intercortical connections.” The possibility of NSS as an endophenotype in schizophrenia has been studied across the globe. We aimed at finding the prevalence of NSS among patients with schizophrenia as well as the associations of NSS between various sociodemographic and illness variables. Subjects and Methods: One hundred patients between the age group of 16 and 60 years were serially selected from the inpatient department of a tertiary care hospital who have been diagnosed as a case of schizophrenia according to the International Classification of Diseases version 10 during 1 year period. A semi-structured pro forma was used to collect various demographic as well as illness data, and subjects were clinically evaluated for NSS using neurological evaluation scale. Results: The prevalence of NSSs was found to be 67%, significant association was found between NSS and age, occupation, and duration of illness. A statistically significant correlation was found between NSS and age, NSS and duration of illness. Conclusion: The validity of NSS as an endophenotype lies in the fact that it should be independent of all sociodemographic and illness variables. However, our study evaluated some statistically significant findings between them. Hence, further researches are required with properly adjusted controls to find if the associations obtained between NSS and different variables here are true or whether there are some confounding factors included. PMID:27365957

  5. Is Nonverbal Communication Disrupted in Interactions Involving Patients With Schizophrenia?

    PubMed Central

    Lavelle, Mary; Healey, Patrick G.T.; McCabe, Rosemarie

    2013-01-01

    Background: Nonverbal communication is a critical feature of successful social interaction and interpersonal rapport. Social exclusion is a feature of schizophrenia. This experimental study investigated if the undisclosed presence of a patient with schizophrenia in interaction changes nonverbal communication (ie, speaker gesture and listener nodding). Method: 3D motion-capture techniques recorded 20 patient (1 patient, 2 healthy participants) and 20 control (3 healthy participants) interactions. Participants rated their experience of rapport with each interacting partner. Patients’ symptoms, social cognition, and executive functioning were assessed. Four hypotheses were tested: (1) Compared to controls, patients display less speaking gestures and listener nods. (2) Patients’ increased symptom severity and poorer social cognition are associated with patients’ reduced gesture and nods. (3) Patients’ partners compensate for patients’ reduced nonverbal behavior by gesturing more when speaking and nodding more when listening. (4) Patients’ reduced nonverbal behavior, increased symptom severity, and poorer social cognition are associated with others experiencing poorer rapport with the patient. Results: Patients gestured less when speaking. Patients with more negative symptoms nodded less as listeners, while their partners appeared to compensate by gesturing more as speakers. Patients with more negative symptoms also gestured more when speaking, which, alongside increased negative symptoms and poorer social cognition, was associated with others experiencing poorer patient rapport. Conclusions: Patients’ symptoms are associated with the nonverbal behavior of patients and their partners. Patients’ increased negative symptoms and gesture use are associated with poorer interpersonal rapport. This study provides specific evidence about how negative symptoms impact patients’ social interactions. PMID:22941744

  6. Schizophrenia

    MedlinePlus

    There are no medical tests to diagnose schizophrenia. A psychiatrist should examine the person and make the diagnosis. The diagnosis is made based on an interview of the person and family members. The psychiatrist will ask: How long symptoms have lasted ...

  7. Aripiprazole-associated tic in a schizophrenia patient

    PubMed Central

    Guo, Xieli; Lu, Dali; Jiang, Yugang

    2015-01-01

    Tic disorder, characterized by the presence of both motor and vocal tics is common in adolescents and adults. Antipsychotics including typical antipsychotics and atypical antipsychotics are generally recognized by experts as the most effective pharmacological treatment for tics. However, previous studies suggest that tic-like symptoms might manifest during treatment with atypical antipsychotics such as clozapine, quetiapine, but not aripiprazole. We present the first case, to our knowledge, of an adult schizophrenia patient who developed tics during treatment with aripiprazole. PMID:25848286

  8. Psychosocial functioning of individuals with schizophrenia in community housing facilities and the psychiatric hospital in Zurich.

    PubMed

    Jaeger, Matthias; Briner, David; Kawohl, Wolfram; Seifritz, Erich; Baumgartner-Nietlisbach, Gabriela

    2015-12-15

    Individuals with severe mental illness frequently have difficulties in obtaining and maintaining adequate accommodation. If they are not willing or able to adapt to requirements of traditional supported housing institutions they may live in sheltered and emergency accommodation. Adequate mental health services are rarely available in these facilities. The aim of the present study was to evaluate mental health, functional and social status of individuals living in community sheltered housing facilities. A cross-sectional survey of n=338 individuals in sheltered housing compared to a sample of patients at intake in acute inpatient psychiatry (n=619) concerning clinical and social variables was carried out in the catchment area of Zurich. Matched subsamples of individuals with schizophrenia (n=168) were compared concerning functioning and impairments on the Health of the Nation Outcome Scales (HoNOS). Individuals with schizophrenia in sheltered housing (25% of the residents) have significantly more problems concerning substance use, physical illness, psychopathological symptoms other than psychosis and depression, and relationships, daily activities and occupation than patients with schizophrenia at intake on an acute psychiatric ward. Community sheltered accommodation although conceptualized to prevent homelessness in the general population de facto serve as housing facilities for individuals with schizophrenia and other severe mental illness. PMID:26416587

  9. Normal neurocognitive performance after extended practice in patients with schizophrenia.

    PubMed

    Wexler, B E; Hawkins, K A; Rounsaville, B; Anderson, M; Sernyak, M J; Green, M F

    1997-08-29

    This study evaluated new methods for improving the performance of patients with schizophrenia on specific neurocognitive tasks. Patients (n = 22) practiced sustained perceptual, memory and motor tasks 5 times/week for 10 weeks. Tasks were initially easy enough for patients to do well, but were made gradually more difficult over the 10 weeks. Patients received base pay and performance-based monetary supplements. No coaching or ongoing instruction was provided, and performance gains were assumed to depend upon implicit learning. High functioning healthy controls (n = 5) were given the same tasks at difficulty levels comparable to those achieved by patients after 10 weeks of practice. After 10 weeks of practice, 16 of the 22 patients performed as well or better than the best control on the perceptual and memory tasks, and 11 patients performed within the range of control subjects on the motor task. Half of the patients retested 6 months after training maintained supranormal performance, while the others showed marked performance declines. Patients with schizophrenia appear to have greater potential for neurocognitive improvement, and potentially for employment, than generally appreciated. PMID:9323348

  10. Predictors of suicide attempts in 3.322 patients with affective disorders and schizophrenia spectrum disorders.

    PubMed

    Gallego, Juan A; Rachamallu, Vivekananda; Yuen, Eunice Y; Fink, Sabina; Duque, Laura M; Kane, John M

    2015-08-30

    This study explores risk factors for suicide attempts using the electronic health records of 3322 patients with either schizophrenia spectrum disorders or affective disorders who underwent a comprehensive psychiatric evaluation at the Emergency Department at the Long Island Jewish Medical Center or the Hillside Evaluation Center at The Zucker Hillside Hospital from August 3rd 2011 to July 5th 2012. Multivariate regression analyses showed, after adjusting for sex, that previous suicidal attempts and financial or relationship losses were significantly associated with a current suicidal attempt. Additionally, higher odds of having a suicidal attempt were also found in those subjects with a diagnosis of an affective disorder, compared to a schizophrenia spectrum diagnosis, and those patients in the children/adolescent group compared to those in the adult/elderly group. Our study results confirm and expand results from prior studies. Therefore, physicians should be alert for the presence of any or all of these factors upon evaluation of psychiatric patients, and if present, either psychiatric hospitalization or a close psychiatric follow up in collaboration with family and a therapist would be key in reducing the risk of potential suicidal behavior. PMID:26077849

  11. Predictors of Suicide Attempts in 3.322 Patients with Affective Disorders and Schizophrenia Spectrum Disorders

    PubMed Central

    Yuen, Eunice Y.; Fink, Sabina; Duque, Laura M.; Kane, John M.

    2015-01-01

    This study explores risk factors for suicide attempts using the electronic health records of 3,322 patients with either schizophrenia spectrum disorders or affective disorders who underwent a comprehensive psychiatric evaluation at the Emergency Department at the Long Island Jewish Medical Center or the Hillside Evaluation Center at The Zucker Hillside Hospital from August 3rd 2011 to July 5th 2012. Multivariate regression analyses showed, after adjusting for sex, that previous suicidal attempts and financial or relationship losses were significantly associated with a current suicidal attempt. Additionally, higher odds of having a suicidal attempt were also found in those subjects with a diagnosis of an affective disorder, compared to a schizophrenia spectrum diagnosis, and those patients in the children/adolescent group compared to those in the adult/elderly group. Our study results confirm and expand results from prior studies. Therefore, physicians should be alert for the presence of any or all of these factors upon evaluation of psychiatric patients, and if present, either psychiatric hospitalization or a close psychiatric follow up in collaboration with family and a therapist would be key in reducing the risk of potential suicidal behavior. PMID:26077849

  12. Effect of Adenine on Clozapine-induced Neutropenia in Patients with Schizophrenia: A Preliminary Study

    PubMed Central

    Takeuchi, Ippei; Kishi, Taro; Hanya, Manako; Uno, Junji; Fujita, Kiyoshi; Kamei, Hiroyuki

    2015-01-01

    Objective This study examined the utility of adenine for preventing clozapine-induced neutropenia. Methods This retrospective study examined the effect of adenine on clozapine-induced neutropenia in patients with treatment-resistant schizophrenia and was conducted at Okehazama Hospital in Japan from July 2010 to June 2013. Adenine was available for use from June 2011 onwards. Twenty-one patients started receiving clozapine treatment from July 2010 to April 2011 (the pre-adenine adoption group), and 47 patients started receiving it from May 2011 to June 2013 (the post-adenine adoption group). The effects of adenine were assessed based on changes in the patients’ leukocyte counts and the frequency of treatment discontinuation due to clozapine-induced neutropenia. Results Sixty-eight patients were treated with clozapine from July 2010 to June 2013. Of the 21 patients in the pre-adenine adoption group, 4 discontinued treatment due to clozapine-induced neutropenia, whereas only 2 of the 47 patients in the post-adenine adoption group discontinued treatment. The frequency of treatment discontinuation due to clozapine-induced neutropenia was significantly lower in post-adenine adoption group than in the pre-adenine adoption group (p=0.047). Conclusion Adenine decreased the frequency of treatment discontinuation due to clozapine-induced neutropenia. Our data suggest that combined treatment with clozapine and adenine is a safe and effective strategy against treatment-resistant schizophrenia. PMID:26243842

  13. Different facets of schizophrenia illustrated by the analysis of the homes of three patients diagnosed with schizophrenia.

    PubMed

    Murawiec, Sławomir; Britmann, Jonathan; Krysta, Krzysztof

    2013-09-01

    Diagnosis and observation of patients' behaviour during outpatient visits or hospitalisations strips the diagnostic process of the opportunity to consider their places of residence as their natural environment. In this way, patients present their symptoms and problems outside of the context of their daily life. Community-based psychiatric care, on the other hand, provides a chance to include, in the diagnostic process the environment created by a patient in their home. This image of a patient's external reality can reflect a certain mental reality. Such elements as furniture and other objects, their number, quality, distribution may reflect the inner mental world of the objects featuring in a person's mind. In some cases, this can become a valuable contribution to a diagnostic process. A description of three patients, all treated for schizophrenia, has been presented in this paper in order to explore this possible relationship. The first individual, "Patient N" lives in a flat in a state of extreme depletion of elements. "Patient N" suffers from chronic schizophrenia with severe negative symptoms. The second individual, "Patient D", has been also diagnosed with schizophrenia. Yet his home is filled with a huge number of elements, writings on the wall, things, figurines and objects of symbolic meaning. A closer examination of his psychopathological symptoms (fantastic, colourful, bizarre content) and history of his illness (unstable diagnosis of schizophrenia), and unpredictable response to antipsychotics may indicate a dissociative type of schizophrenia. Finally, "Patient K's" main living space is dominated by cats that live with him. Patient K was exposed to physical violence as a child and to him cats represent safe, non-threatening objects. He has been also treated for paranoid schizophrenia. The differences between these patients' personal histories and the courses of their illnesses are clearly manifested in the way they create their immediate environment

  14. Partial compliance in schizophrenia and the impact on patient outcomes.

    PubMed

    Llorca, Pierre-Michel

    2008-11-30

    This review evaluates the impact of partial compliance on treatment outcomes in schizophrenia and discusses strategies that may be implemented to enhance compliance. As such, a search of English language articles evaluating compliance in schizophrenia was performed using Medline and EMBASE, with no time limits. Abstracts and posters presented at key psychiatry congresses were also reviewed. Results demonstrated that partial compliance with antipsychotic medication is a significant barrier to achieving optimal outcomes in schizophrenia. The problem increases with the duration of treatment, and is difficult to monitor. The impact of partial compliance is significant, leading to increases in psychotic symptoms, the risk of relapse and rehospitalization, and even suicide. Compliance is a complex phenomenon, influenced by aspects of the illness itself such as cognitive impairment and patients' health beliefs. The patient's environment and therapeutic alliance also influence medication compliance. Behavioural and pharmacological measures should be used together to improve compliance. While atypical antipsychotics have demonstrated improvements in psychotic symptoms, insight and cognition, these may not be enough to ensure compliance with oral daily medication. Long-acting risperidone may therefore bring together the benefits of the atypical antipsychotics with the long-acting injection delivery system required to build a platform for improved outcomes. PMID:18849080

  15. Anterior Cingulate Cortex Activation Is Related to Learning Potential on the WCST in Schizophrenia Patients

    ERIC Educational Resources Information Center

    Pedersen, Anya; Wilmsmeier, Andreas; Wiedl, Karl H.; Bauer, Jochen; Kueppers, Kerstin; Koelkebeck, Katja; Kohl, Waldemar; Kugel, Harald; Arolt, Volker; Ohrmann, Patricia

    2012-01-01

    The remediation of executive function in patients with schizophrenia is important in rehabilitation because these skills affect the patient's capacity to function in the community. There is evidence that instructional techniques can improve deficits in the Wisconsin Card Sorting Test (WCST) in some schizophrenia patients. We used a standard…

  16. Are There Gender-Specific Risk Factors for Suicidal Activity among Patients with Schizophrenia and Depression?

    ERIC Educational Resources Information Center

    Kaplan, Kalman J.; Harrow, Martin; Faull, Robert N.

    2012-01-01

    Are there gender-specific risk factors for suicidal activity among patients with schizophrenia and depression? A total of 74 schizophrenia patients (51 men, 23 women) and 77 unipolar nonpsychotic depressed patients (26 men, 51 women) from the Chicago Follow-up Study were studied prospectively at 2 years posthospitalization and again at 7.5 years.…

  17. Transition to Psychosis: Evaluation of the First-Degree Relatives of Patients with Schizophrenia

    PubMed Central

    Hormozpour, Mehdi; Amini‎, Homayoun; Pajouhanfar, Sara; Faghankhani, Masoomeh; Rahmani, Arash; Sharifi‎, Vandad

    2016-01-01

    Objective: Schizophrenia and other psychoses have devastating personal and social impacts and many efforts have been devoted to study ‎prodromal syndromes for psychosis in order to achieve earlier detection and interventions. However, only few studies have been ‎performed in developing countries on this subject, and there is a dearth of evidence in the Iranian population. In this study, we ‎focused on conversion rate to psychosis and changes in prodromal symptoms in a group of first-degree relatives of patients with ‎schizophrenia and to compare the conversion rate in those with and without prodromal symptoms as assessed by the Structured ‎Interview for Prodromal Syndromes (SIPS) and Scale of Prodromal Symptoms (SOPS).‎‎ Method: Participants were the first-degree relatives of hospitalized patients with schizophrenia at Roozbeh Hospital, Tehran, Iran. At baseline, ‎a trained psychiatrist interviewed the participants using the SIPS and the SOPS and assigned them to high- or low-risk groups either ‎based on the presence of prodromal criteria or seeking mental health services. After 12 months, the same examiner re-evaluated ‎the participants in order to determine the changes in their symptoms and identify the probable transitions to psychosis.‎ Results: One hundred participants, 50 participants within each of high- or low-risk groups, were recruited at baseline. Eight participants ‎dropped out of the study. At the follow-up, the rate of transition to full psychosis among high-risk group was 13% (95% CI [0.029, ‎‎0.23]), whereas none of the low-risk participants developed psychosis. None of the high-risk participants demonstrated attenuation ‎in their prodromal states after a one-year follow-up. In contrast, of the 50 low-risk participants, three experienced prodromal ‎symptoms for psychosis during this period. High-risk participant’s illustrated higher severity in almost all of the SOPS items compared ‎to the low-risk participants at

  18. Association between Medication Adherence and Duration of Outpatient Treatment in Patients with Schizophrenia

    PubMed Central

    Kikuyama, Hiroki; Ohta, Munehiro; Kanazawa, Tetsufumi; Okamura, Takehiko; Yoneda, Hiroshi

    2016-01-01

    Objective Medication adherence is important in the treatment of schizophrenia, and critical periods during treatment may be associated with relapse. However, the relationship between adherence and duration of outpatient treatment (DOT) remains unclear. The authors aimed to clarify the relationship between adherence and DOT at a psychiatric hospital in Japan. Methods For outpatients with schizophrenia who regularly visit Shin-Abuyama hospital, the authors conducted a single questionnaire survey (five questions covering gender, age, DOT, medication shortages, and residual medication) over one month period. Participants were divided into two groups whether DOT were from more than one year to within five years or not. Mantel-Haenszel analysis and logistic regression analysis were performed on the data regarding the medication adherence. Results Effective answers were received for 328 patients. The residual medication rate was significantly higher among those receiving outpatient treatment from more than one year to within five years than five years than those receiving outpatient treatment for more than five years or less than one year (p=0.016). Conclusion This survey suggests that there are critical periods during which patients are most prone to poor adherence. Because poor adherence increases the risk of relapse, specific measures must be taken to improve adherence during these periods. PMID:27482242

  19. A randomized study of cognitive remediation for forensic and mental health patients with schizophrenia.

    PubMed

    Ahmed, Anthony O; Hunter, Kristin M; Goodrum, Nada M; Batten, Nancy-Jane; Birgenheir, Denis; Hardison, Erik; Dixon, Thaddeus; Buckley, Peter F

    2015-09-01

    Cognitive remediation has proven efficacy for improving neurocognition in people with schizophrenia. The current study evaluated the benefits of cognitive remediation on neurocognition, functioning, psychotic symptoms, and aggression in a sample of forensic and mental health patients. Care recipients with schizophrenia or schizoaffective disorder (N = 78) receiving services in the forensic and mental health units of a state hospital were randomized to participate in cognitive remediation versus computer games control activities. Participants' neurocognition, functional capacity, experiential recovery, psychotic symptoms, and aggression incidents were assessed at baseline and posttreatment. Cognitive remediation was associated with improvements in several neurocognitive domains and circumscribed domains of functional capacity. People assigned to cognitive remediation experiences greater reductions in negative symptoms, agitation/excitement, and verbal and physical aggression. In addition to improving neurocognition in long-term hospitalized forensic and mental health patients, cognitive remediation may enhance efforts at reducing negative symptoms, emotion dysregulation, and aggression incidents. Forensic settings may represent a new frontier for the clinical dissemination of cognitive remediation. PMID:26228394

  20. Research on the Effect of the Foot Bath and Foot Massage on Residual Schizophrenia Patients.

    PubMed

    Kito, Kazuko; Suzuki, Keiko

    2016-06-01

    Researchers performed foot baths and massages for residual schizophrenia patients to gauge the effects on psychiatric symptoms. Subjects were six residual schizophrenia patients hospitalized in a psychiatric hospital. Three times a week for 4weeks, they received an 8-minute effleurage massage to their legs after a 10-minute foot bath. The effect of physiological relaxation was identified by a significant decline in heart rate in all cases. The results of the Positive and Negative Symptom Scale are as follows: a mean score of 29.0 was measured before treatment, which lowered to 21.5 after treatment, indicating that foot care improved their negative symptoms (p<0.05).The results of the Quality of Life Scale before the foot care intervention, were 10.5 and increased to 34.0 after the intervention, indicating improvement in their quality of life (p<0.05). The results of the two measurements indicate that foot baths and massages were effective in improving psychiatric symptoms. PMID:27256944

  1. Perception of service satisfaction and quality of life of patients living with schizophrenia in Lagos, Nigeria

    PubMed Central

    Afe, Taiwo Opekitan; Bello-Mojeed, Mashudat; Ogunsemi, Olawale

    2016-01-01

    Objective: To assess service-satisfaction and quality of life among patients with schizophrenia in a tertiary psychiatric healthcare facility in Lagos, Nigeria. Methods: Cross-sectional survey of 101 (out of 120) patients diagnosed with schizophrenia attending the outpatient clinic of the Federal Neuro-Psychiatric Hospital Yaba, Lagos, Nigeria. The Structured Clinical Interview for DSM-IV diagnosis (SCID), Charleston Psychiatric Out-patient Scale (CPOSS), and the World-Health Organisation Quality of Life –Bref scale (WHOQOL-BREF) was used in assessing diagnosis, patient satisfaction and subjective quality of life respectively. Results: The ages of the patient ranged from 19-81. Males (49.5%) and females (50.5%) had almost equal distribution. Mean duration of attendance was 8.7years ± 8.50. Service satisfaction ranged between 25-60 on the CPOSS. Areas that had higher mean scores on CPOSS were with items (1) Helpfulness of the records clerk (3.70±1.1), (7) Helpfulness of services received (3.69±1.0). Subjective quality of life was high (3.65±1.8), satisfaction with health was also high (3.40±1.1). Service satisfaction correlated with Quality of life at P < 0.00. PMID:27114651

  2. Improving functional outcomes for schizophrenia patients in the Netherlands using Cognitive Adaptation Training as a nursing intervention - A pilot study.

    PubMed

    Quee, Piotr J; Stiekema, Annemarie P M; Wigman, Johanna T W; Schneider, Harald; van der Meer, Lisette; Maples, Natalie J; van den Heuvel, Edwin R; Velligan, Dawn I; Bruggeman, Richard

    2014-09-01

    Cognitive Adaptation Training (CAT) improves functional outcomes in schizophrenia outpatients living in the United States. The effectiveness of CAT for patients living outside the US as well as for long-term hospitalized patients remains to be determined. In addition, it has not yet been studied whether CAT can be successful if patients receive the treatment from psychiatric nurses. This pilot study investigated the effectiveness and feasibility of CAT as a nursing intervention in the Netherlands. Thirty schizophrenia patients (long-term hospitalized patients: 63%) participated in this study. Sixteen patients received treatment as usual (TAU)+CAT, and fourteen patients received TAU. Patients in CAT participated in the treatment for eight months, consisting of weekly home-visits by a psychiatric nurse, supervised by a psychologist. After eight months, CAT interventions were integrated in the usual treatment. Outcome measures were the Multnomah Community Ability Scale (MCAS), the Social and Occupational Functioning Scale (SOFAS), and the Negative Symptom Assessment-Motivation subscale (NSA-M). For inpatients, work-related activities were also tracked for 16 months after baseline. Patients receiving TAU+CAT had better scores on the MCAS (trend), compared to TAU patients. Moreover, inpatients' work-related activities increased in TAU+CAT, relative to TAU inpatients, reaching significance after ten months. Improvements on the SOFAS and NSA-M were not significant. These results indicate that CAT as a nursing intervention may improve outcomes in patients with schizophrenia living in the Netherlands, including long-term hospitalized patients. However, since the current study was designed for exploratory purposes, larger randomized controlled studies are needed to confirm our results and to investigate the long-term effects of CAT as a nursing intervention systematically. PMID:25000912

  3. Long-acting injectables and risk for rehospitalization among patients with schizophrenia in the home care program in Taiwan.

    PubMed

    Ju, Po-Chung; Chou, Frank Huang-Chih; Lai, Te-Jen; Chuang, Po-Ya; Lin, Yung-Jung; Yang, Ching-Wen Wendy; Tang, Chao-Hsiun

    2014-02-01

    We aimed at evaluating the relationship between medication and treatment effectiveness in a home care setting among patients with schizophrenia. Patients with schizophrenia hospitalized between 2004 and 2009 with a primary International Classification of Diseases, Ninth Revision, Clinical Modification code of 295 were identified from Psychiatric Inpatient Medical Claims Data released by the National Health Research Institute in Taiwan. Patients who joined the home care program after discharge and were prescribed long-acting injection (LAI) (the LAI group) or oral antipsychotic medications (the oral group) were included as study subjects. The final sample for the study included 810 participants in the LAI group and 945 in the oral group. Logistic regression was performed to examine the independent effect of LAI medication on the risk for rehospitalization within the 12-month observation window after controlling for patient and hospital characteristics and propensity score quintile adjustment. The unadjusted odds ratio for rehospitalization risk was 0.80 (confidence interval, 0.65-0.98) for the LAI group compared to the oral group. The adjusted odds ratio was further reduced to 0.78 (confidence interval, 0.63-0.97). Results remained unchanged when the propensity score quintiles were entered into the regression for further adjustment. In a home care setting, patients treated with long-acting antipsychotic agents are at a significantly lower risk for psychiatric rehospitalization than those treated with oral medication. Consequently, LAI home-based treatment for the prevention of schizophrenia relapse may lead to substantial clinical and economic benefits. PMID:24145217

  4. Noncompaction and Dilated Cardiomyopathy in a Patient with Schizophrenia

    PubMed Central

    Stöllberger, Claudia

    2016-01-01

    Objectives. Psychosis and left ventricular hypertrabeculation (or noncompaction) (LVHT) have not been described in the same patient. Here we report a patient with a long-term history of schizophrenia who was later diagnosed with dilated cardiomyopathy (dCMP) and LVHT. Case Report. A 47-year-old Caucasian male developed nondifferentiated schizophrenia at the age of 26 y. Since the age of 33 y he was regularly drinking alcohol. At the age of 47 y he developed heart failure. Transthoracic echocardiography showed an enlarged left ventricle, reduced systolic function, and surprisingly LVHT in the apical segment. Additionally, the left atrium was enlarged, the right ventricular cavities were mildly enlarged, and there were pulmonary hypertension and a small pericardial effusion. Cardiac MRI confirmed the echocardiographic findings. Since coronary angiography was normal, dilated cardiomyopathy was additionally diagnosed. Since he was taking clozapine during years, dilated cardiomyopathy could be due to not only alcohol consumption but also the long-term neuroleptic medication. Conclusions. LVHT may be associated with nondifferentiated psychosis. Management of LVHT is challenging in patients with psychosis due to poor compliance and adherence of these patients. Patients with LVHT and psychosis need particular attention since they usually take cardiotoxic drugs for a long time, which may further deteriorate the prognosis of LVHT. PMID:27547471

  5. Motive-oriented therapeutic relationship building for patients diagnosed with schizophrenia

    PubMed Central

    Westermann, Stefan; Cavelti, Marialuisa; Heibach, Eva; Caspar, Franz

    2015-01-01

    Treatment options for patients with schizophrenia demand further improvement. One way to achieve this improvement is the translation of findings from basic research into new specific interventions. Beyond that, addressing the therapy relationship has the potential to enhance both pharmacological and non-pharmacological treatments. This paper introduces motive-oriented therapeutic relationship (MOTR) building for schizophrenia. MOTR enables therapists to proactively adapt to their patient’s needs and to prevent problematic behaviors. For example, a patient might consider medication as helpful in principle, but the rejection of medication might be one of his few remaining means for his acceptable motive to stay autonomous despite hospitalization. A therapist who is motive-oriented proactively offers many degrees of freedom to this patient in order to satisfy his need for autonomy and to weaken the motivational basis for not taking medication. MOTR makes use of findings from basic and psychotherapy research and is generic in this respect, but at the same time guides therapeutic action precisely and flexibly in a patient oriented way. PMID:26388804

  6. Thirty Days without a Bite: Wernicke’s Encephalopathy in a Patient with Paranoid Schizophrenia

    PubMed Central

    Langlois, Mélanie; Doré, Marie-Claire; Laforce, Robert

    2016-01-01

    Wernicke’s Encephalopathy (WE) is a preventable neurologic condition characterized by altered mental status, ophthalmoplegia, and ataxia. Although historically associated with alcoholism, a few authors have described WE in patients with non-alcohol related psychiatric disorders. We report herein the case of a 36-year-old young man with paranoid schizophrenia who was brought to hospital for confusion and difficulties with his vision. His roommate said he had gone about thirty days without eating ‘…because he was on a slimming cure’. History and physical examination suggested WE as a result of isolation and poor diet leading to nutritional deficiency. This was confirmed by brain magnetic resonance imaging showing classic thalamic, mammillary bodies and brainstem lesions. Of note, his cognitive profile was far more heterogeneous than what had classically been described in the literature and involved both cortical and subcortical pathology, generating memory but also significant executive deficits. Intravenous treatment with thiamine was given and our patient showed mild improvements in visual acuity and nystagmus. However, persistent cognitive and physical disabilities consistent with Korsakoff syndrome remained, and he now lives in a supervised home. This case illustrates the tragic consequences of nutritional deficiencies in a patient with paranoid schizophrenia. The threshold to suspect WE in schizophrenic patients should be lowered and in doubt prophylactic parenteral thiamine should be administered. PMID:27088109

  7. Polygenic risk for schizophrenia associated with working memory-related prefrontal brain activation in patients with schizophrenia and healthy controls.

    PubMed

    Kauppi, Karolina; Westlye, Lars T; Tesli, Martin; Bettella, Francesco; Brandt, Christine L; Mattingsdal, Morten; Ueland, Torill; Espeseth, Thomas; Agartz, Ingrid; Melle, Ingrid; Djurovic, Srdjan; Andreassen, Ole A

    2015-05-01

    Schizophrenia is a highly heritable and polygenic disease, and identified common genetic variants have shown weak individual effects. Many studies have reported altered working memory (WM)-related brain activation in schizophrenia, preferentially in the frontal lobe. Such differences in brain activations could reflect inherited alterations possibly involved in the disease etiology, or rather secondary disease-related mechanisms. The use of polygenic risk scores (PGRS) based on a large number of risk polymorphisms with small effects is a valuable approach to examine the effect of cumulative genetic risk on brain functioning. This study examined the impact of cumulative genetic risk for schizophrenia on WM-related brain activations, assessed with functional magnetic resonance imaging. For each participant (63 schizophrenia patients and 118 healthy controls), we calculated a PGRS for schizophrenia based on 18 862 single-nucleotide polymorphism in a large multicenter genome-wide association study including 9146 schizophrenia patients and 12 111 controls, performed by the Psychiatric Genomics Consortium. As expected, the PGRS was significantly higher in patients compared with healthy controls. Further, the PGRS was related to differences in frontal lobe brain activation between high and low WM demand. Specifically, even in absence of main effects of diagnosis, increased PGRS was associated with decreased activation difference in the right middle-superior prefrontal cortex (BA 10/11) and the right inferior frontal gyrus (BA 45). This effect was seen in both cases and controls, and was not influenced by sex, age, or task performance. The findings support the notion of dysregulation of frontal lobe functioning as an inherited vulnerability factor in schizophrenia. PMID:25392519

  8. Retrospective Study of Japanese Patients with Schizophrenia Treated with Aripiprazole

    PubMed Central

    Tanioka, Tetsuya; Fuji, Syoko; Kataoka, Mika; King, Beth; Tomotake, Masahito; Yasuhara, Yuko; Locsin, Rozzano; Sekido, Keiko; Mifune, Kazushi

    2012-01-01

    Aim. The purpose of this retrospective study was to evaluate changes in clinical indicators which influence the quality of life (QOL) of patients with schizophrenia treated by antipsychotic therapy before and after switching to aripiprazole. Methods. A retrospective chart review of 27 patients diagnosed with schizophrenia and who were switched from one antipsychotic to aripiprazole was performed. Clinical indicators about the daily dosage of antipsychotics and antiparkinsonian drugs, psychiatric condition, and glucose/lipid metabolism, clinical evaluation by nursing observation were used to measure the responsiveness of subjects to aripiprazole. Results. Of the 27 subjects, 14 responded to the switch to aripiprazole with significant improvement of the Brief Psychiatric Rating Scale (BPRS) score (P = 0.04), significant decrease in dosage of antipsychotics in 71% of patients (P = 0.03), and tendency toward reduction in dosage of antiparkinsonian drugs (P = 0.07) and body mass index (BMI) (P = 0.06). However, 8 of 27 subjects had a significant increase in lipid levels after switching to aripiprazole (P = 0.01). Conclusion. QOL for subjects who responded to the switch to aripiprazole improved as indicated by lower doses of antipsychotic and antiparkinson medications, improvement in BPRS score, and a decrease in BMI. Results indicate little influence on patient's QOL. PMID:22970386

  9. Investigation of Anti-Toxocara and Anti-Toxoplasma Antibodies in Patients with Schizophrenia Disorder

    PubMed Central

    Khademvatan, Shahram; Khajeddin, Niloufar; Izadi, Sakineh; Yousefi, Elham

    2014-01-01

    Objective. The aim of the present study was to examine the relationship between Toxoplasma gondii and Toxocara spp. infections in patients with schizophrenia disorder. Method. A total of 100 patients with schizophrenia disorder and 95 healthy individuals participated in the study. Participants were tested for the presence of anti-T. gondii and anti-Toxocara spp. antibodies by ELISA and Western blotting. Data were analyzed using Chi-square test and Fisher9s exact test. Results. There were no differences in T. gondii IgG seroprevalence between patients with schizophrenia and healthy individuals (P = 0.1), but there were differences in seroprevalence between males and females with schizophrenia (P = 0.009). In contrast, Toxocara spp. IgG seroprevalence was greater in patients with schizophrenia disorder than in healthy individuals (P = 0.02), but there were no differences in seroprevalence between men and women with schizophrenia (P = 0.5). Finally, there were no differences in seroprevalence of T. gondii or Toxocara spp. IgG among different subtypes of schizophrenia, various age groups, residential area, or clinical course of treatment (P > 0.05). Conclusion. The present study suggests that patients with schizophrenia disorder are at elevated risk of Toxocara spp. infection. Moreover, contamination with T. gondii is a risk factor for schizophrenia in women. PMID:24834353

  10. Grey matter, an endophenotype for schizophrenia? A voxel-based morphometry study in siblings of patients with schizophrenia

    PubMed Central

    van der Velde, Jorien; Gromann, Paula M.; Swart, Marte; de Haan, Lieuwe; Wiersma, Durk; Bruggeman, Richard; Krabbendam, Lydia; Aleman, André

    2015-01-01

    Background Grey matter, both volume and concentration, has been proposed as an endophenotype for schizophrenia given a number of reports of grey matter abnormalities in relatives of patients with schizophrenia. However, previous studies on grey matter abnormalities in relatives have produced inconsistent results. The aim of the present study was to examine grey matter differences between controls and siblings of patients with schizophrenia and to examine whether the age, genetic loading or subclinical psychotic symptoms of selected individuals could explain the previously reported inconsistencies. Methods We compared the grey matter volume and grey matter concentration of healthy siblings of patients with schizophrenia and healthy controls matched for age, sex and education using voxel-based morphometry (VBM). Furthermore, we selected subsamples based on age (< 30 yr), genetic loading and subclinical psychotic symptoms to examine whether this would lead to different results. Results We included 89 siblings and 69 controls in our study. The results showed that siblings and controls did not differ significantly on grey matter volume or concentration. Furthermore, specifically selecting participants based on age, genetic loading or subclinical psychotic symptoms did not alter these findings. Limitations The main limitation was that subdividing the sample resulted in smaller samples for the subanalyses. Furthermore, we used MRI data from 2 different scanner sites. Conclusion These results indicate that grey matter measured through VBM might not be a suitable endophenotype for schizophrenia. PMID:25768029

  11. Effects of object size on unimanual and bimanual movements in patients with schizophrenia.

    PubMed

    Wang, Shu-Mei; Kuo, Li-Chieh; Ouyang, Wen-Chen; Hsu, Hsiao-Man; Lin, Keh-Chung; Ma, Hui-Ing

    2014-01-01

    Schizophrenia affects not only mental function but also movement. We compared the movement of patients with mild schizophrenia and healthy control participants during a bimanual assembly task and examined whether changes in object size affected unimanual and bimanual movements. Fifteen patients with schizophrenia and 15 age- and gender-matched control participants were instructed to bimanually reach for and assemble objects. We manipulated the object size for the left hand (large vs. small) and measured movement time, peak velocity, and bimanual synchronization to represent movement speed, forcefulness, and bimanual coordination. Patients with schizophrenia showed slower and less forceful unimanual movements and less coordinated bimanual movements than control participants. Increasing the object size elicited faster and more forceful unimanual movements and more coordinated bimanual movements in patients. The results suggest the need for movement rehabilitation in patients with schizophrenia and the possibility of manipulating object size to optimize patients' movements. These results benefit the practice of evidence-based therapy. PMID:24581410

  12. Emotional prosody modulates attention in schizophrenia patients with hallucinations.

    PubMed

    Alba-Ferrara, L; de Erausquin, G A; Hirnstein, M; Weis, S; Hausmann, M

    2013-01-01

    Recent findings have demonstrated that emotional prosody (EP) attracts attention involuntarily (Grandjean et al., 2008). The automat shift of attention toward emotionally salient stimuli can be overcome by attentional control (Hahn et al., 2010). Attentional control is impaired in schizophrenia, especially in schizophrenic patients with hallucinations because the "voices" capture attention increasing the processing load and competing for top-down resources. The present study investigates how involuntary attention is driven by implicit EP in schizophrenia with auditory verbal hallucinations (AVH) and without (NAVH). Fifteen AVH patients, 12 NAVH patients and 16 healthy controls (HC) completed a dual-task dichotic listening paradigm, in which an emotional vocal outburst was paired with a neutral vocalization spoken in male and female voices. Participants were asked to report the speaker's gender while attending to either the left or right ear. NAVH patients and HC revealed shorter response times for stimuli presented to the attended left ear than the attended right ear. This laterality effect was not present in AVH patients. In addition, NAVH patients and HC showed faster responses when the EP stimulus was presented to the unattended ear, probably because of less interference between the attention-controlled gender voice identification task and involuntary EP processing. AVH patients did not benefit from presenting emotional stimuli to the unattended ear. The findings suggest that similar to HC, NAVH patients show a right hemispheric bias for EP processing. AVH patients seem to be less lateralized for EP and therefore might be more susceptible to interfering involuntary EP processing; regardless which ear/hemisphere receives the bottom up input. PMID:23459397

  13. Negative symptoms in schizophrenia: a study in a large clinical sample of patients using a novel automated method

    PubMed Central

    Patel, Rashmi; Jayatilleke, Nishamali; Broadbent, Matthew; Chang, Chin-Kuo; Foskett, Nadia; Gorrell, Genevieve; Hayes, Richard D; Jackson, Richard; Johnston, Caroline; Shetty, Hitesh; Roberts, Angus; McGuire, Philip; Stewart, Robert

    2015-01-01

    Objectives To identify negative symptoms in the clinical records of a large sample of patients with schizophrenia using natural language processing and assess their relationship with clinical outcomes. Design Observational study using an anonymised electronic health record case register. Setting South London and Maudsley NHS Trust (SLaM), a large provider of inpatient and community mental healthcare in the UK. Participants 7678 patients with schizophrenia receiving care during 2011. Main outcome measures Hospital admission, readmission and duration of admission. Results 10 different negative symptoms were ascertained with precision statistics above 0.80. 41% of patients had 2 or more negative symptoms. Negative symptoms were associated with younger age, male gender and single marital status, and with increased likelihood of hospital admission (OR 1.24, 95% CI 1.10 to 1.39), longer duration of admission (β-coefficient 20.5 days, 7.6–33.5), and increased likelihood of readmission following discharge (OR 1.58, 1.28 to 1.95). Conclusions Negative symptoms were common and associated with adverse clinical outcomes, consistent with evidence that these symptoms account for much of the disability associated with schizophrenia. Natural language processing provides a means of conducting research in large representative samples of patients, using data recorded during routine clinical practice. PMID:26346872

  14. Global and Temporal Cortical Folding in Patients with Early-Onset Schizophrenia

    ERIC Educational Resources Information Center

    Penttila, Jani; Paillere-Martinot, Marie-Laure; Martinot, Jean-Luc; Mangin, Jean-Francois; Burke, Lisa; Corrigall, Richard; Frangou, Sophia; Cachia, Arnaud

    2008-01-01

    Disturbances in the temporal lobes and alterations in cortical folding in adult on-set schizophrenia are studied using magnetic resonance T1 images of 51 patients. The study showed that patients with early on-set schizophrenia had lower global sulcal indices in both hemispheres and the left collateral sulcus has a lower sulcal index irrespective…

  15. Event-related brain potential correlates of prospective memory in symptomatically remitted male patients with schizophrenia

    PubMed Central

    Chen, Guoliang; Zhang, Lei; Ding, Weiyan; Zhou, Renlai; Xu, Peng; Lu, Shan; Sun, Li; Jiang, Zhongdong; Li, Huiju; Li, Yansong; Cui, Hong

    2015-01-01

    Prospective memory (PM) refers to the ability to remember to perform intended actions in the future. Although PM deficits are a prominent impairment in schizophrenia, little is still known about the nature of PM in symptomatically remitted patients with schizophrenia. To address this issue, event-related brain potentials (ERPs) were recorded from 20 symptomatically remitted patients with schizophrenia and 20 healthy controls during an event-based PM paradigm. Behavioral results showed that symptomatically remitted patients with schizophrenia performed poorly on the PM task compared with healthy controls. On the neural level, the N300, a component of the ERPs related to PM cue detection, was reliable across these two groups, suggesting a degree of functional recovery of processes supporting cue detection in patients with symptomatically remitted schizophrenia. By contrast, the amplitude of the prospective positivity, a component of the ERPs related to PM intention retrieval, was significantly attenuated in symptomatically remitted schizophrenia patients relative to healthy controls. Furthermore, a significant positive correlation between the amplitude of the prospective positivity and accuracy on the PM task was found in those patients, indicating that patients’ poor performance on this task may result from the failure to recover PM cue-induced intention from memory. These results provide evidence for the existence of altered PM processing in patients with symptomatically remitted schizophrenia, which is characterized by a selective deficit in retrospective component (intention retrieval) of PM. Therefore, these findings shed new light on the neurophysiological processes underlying PM in schizophrenia patients during clinical remission. PMID:26483650

  16. Hospital Closure and Insights into Patient Dispersion

    PubMed Central

    Garg, N.; Husk, G.; Nguyen, T.; Onyile, A.; Echezona, S.; Kuperman, G.

    2015-01-01

    Summary Background Hospital closures are becoming increasingly common in the United States. Patients who received care at the closing hospitals must travel to different, often farther hospitals for care, and nearby remaining hospitals may have difficulty coping with a sudden influx of patients. Objectives Our objectives are to analyze the dispersion patterns of patients from a closing hospital and to correlate that with distance from the closing hospital for three specific visit types: emergency, inpatient, and ambulatory. Methods In this study, we used data from a health information exchange to track patients from Saint Vincent’s Medical Center, a hospital in New York City that closed in 2010, to determine where they received emergency, inpatient, and ambulatory care following the closure. Results We found that patients went to the next nearest hospital for their emergency and inpatient care, but ambulatory encounters did not correlate with distance. Discussion It is likely that patients followed their ambulatory providers as they transitioned to another hospital system. Additional work should be done to determine predictors of impact on nearby hospitals when another hospital in the community closes in order to better prepare for patient dispersion. PMID:25848422

  17. Secondary association of PDLIM5 with paranoid schizophrenia in Emirati patients.

    PubMed

    Moselhy, Hamdy; Eapen, Valsamma; Akawi, Nadia A; Younis, Ali; Salih, Badr; Othman, Aws R; Yousef, Said; Clarke, Raymond A; Ali, Bassam R

    2015-09-01

    Schizophrenia is a clinically and genetically heterogeneous disorder of unknown etiology. PDLIM5 variants have been linked to schizophrenia and other related neuropsychiatric disorders and upregulated in the brain of schizophrenia patients suggesting a possible pathogenic role in disease progression. The aim of this study is to examine the potential association of schizophrenia in Emirati patients with previously reported variants in PDLIM5, PICK1, NRG3 or DISC1 genes. Consequently, we found a secondary association between PDLIM5 variants and the paranoid subtype of schizophrenia in Emirati Arabs suggesting that PDLIM5 may represent a determinate/marker for schizophrenia subtype specification. However, no associations were found with variants in PICK1, NRG3 or DISC1 genes. PMID:26925374

  18. Coping among the caregivers of patients with schizophrenia

    PubMed Central

    Grover, Sandeep; Pradyumna; Chakrabarti, Subho

    2015-01-01

    Coping is understood as the process of managing external or internal demands that are considered as taxing or exceeding the resources of the person. There is no formal classification of coping strategies, and these are understood as adaptive versus maladaptive and problem focuses versus emotion-focused. Understanding the commonly used coping strategies in a particular group of subjects can provide valuable insights for designing interventions to reduce the stress. In this review, we look at the literature which is available with regards to the coping strategies used by the caregivers of patients with schizophrenia. Findings suggest that caregivers of patients with schizophrenia use mixed type of coping mechanisms to deal with the stress of caregiving. The coping strategies are shown to have association with variables such as caregiver burden, caregiving experience, expressed emotions, social support, psychological morbidity in the caregivers, quality of life of caregivers and psychopathology in patients. One of the major limitations of the literature is that there is a lot of variability in the assessment instruments used across different studies to assess coping. PMID:26257476

  19. Treating drug-dependent patients in hospitals.

    PubMed

    Skene, Loane; Keays, David; Gardner, Bruce

    2002-08-01

    Are hospital staff legally permitted to test drug-dependent patients for drugs or infectious disease without the patient's consent in order to treat the patient or to protect themselves or other patients? What should staff do with "suspicious" items in the patient's possession (drugs, credit cards in different names, firearms)? Can drug-dependent patients lawfully use illicit drugs in hospital? Who should supply and administer them? PMID:12242876

  20. Neuropsychological correlates of P50 sensory gating in patients with schizophrenia.

    PubMed

    Sánchez-Morla, Eva María; Santos, José Luis; Aparicio, Ana; García-Jiménez, María Ángeles; Soria, Carmen; Arango, Celso

    2013-01-01

    Impaired inhibition of P50 cerebral evoked response is one of the best validated endophenotypes in schizophrenia. There are controversial data on the relationship between P50 evoked potential deficit and measures of cognitive function in schizophrenia. A comprehensive clinical and neurocognitive assessment plus an evaluation of P50 sensory gating was performed in 160 schizophrenia patients and 64 controls. Neurocognitive scores from each cognitive domain were converted to demographically-adjusted T-scores (age, gender, and years of education) for all study participants. The relationship between P50 and neurocognitive variables was assessed via parametric and nonparametric correlations and categorical strategies: we compared neuropsychological test scores in patients and controls in the lowest P50 quartile vs. the highest. Controls had better performance than schizophrenia patients in all cognitive domains. Schizophrenia patients had significantly higher P50 ratios than controls, and no significant correlation was found between P50 gating measures and neuropsychological test scores in schizophrenia patients or healthy controls. Moreover, no differences in neurocognitive performance were found between subjects in the lowest P50 ratio quartile vs. the highest in healthy controls or patients with schizophrenia. We concluded that there is no evidence of an association between P50 ratio and cognitive measures in schizophrenia patients, and this seems to be also the case in healthy controls. PMID:23148896

  1. Patients with schizophrenia or schizoaffective disorder who receive multiple electroconvulsive therapy sessions: characteristics, indications, and results

    PubMed Central

    Iancu, Iulian; Pick, Nimrod; Seener-Lorsh, Orit; Dannon, Pinhas

    2015-01-01

    Background While electroconvulsive therapy (ECT) has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M)-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions. The aims of this study were to characterize a series of patients who received 30 ECT sessions or more, to describe treatment regimens in actual practice, and to examine the results of C/M-ECT in terms of safety and efficacy, especially the effect on aggression and functioning. Methods We performed a retrospective chart review of 20 consecutive patients (mean age 64.6 years) with schizophrenia (n=16) or schizoaffective disorder (n=4) who received at least 30 ECT sessions at our ECT unit, and also interviewed the treating physician and filled out the Clinical Global Impression-Severity, Global Assessment of Functioning, and the Staff Observation Aggression Scale-Revised. Results Patients received a mean of 91.3 ECT sessions at a mean interval of 2.6 weeks. All had been hospitalized for most or all of the previous 3 years. There were no major adverse effects, and cognitive side effects were relatively minimal (cognitive deficit present for several hours after treatment). We found that ECT significantly reduced scores on the Staff Observation Aggression Scale-Revised subscales for verbal aggression and self-harm, and improved Global Assessment of Functioning scores. There were reductions in total aggression scores, subscale scores for harm to objects and to others, and Clinical Global Impression-Severity scores, these were not statistically significant. Conclusion C/M-ECT is safe and effective for chronically hospitalized patients. It improves general functioning and reduces verbal aggression and self-harm. More research using other aggression tools is needed to determine its effects and to reproduce our findings in prospective and controlled studies. PMID

  2. Patient Engagement in Hospital Fall Prevention.

    PubMed

    Tzeng, Huey-Ming; Yin, Chang-Yi

    2015-01-01

    Injurious falls are the most prevalent in-hospital adverse event, and hospitalized patients are at a greater risk of falling than the general population. Patient engagement in hospital fall prevention could be a possible approach to reducing falls and fall-related injuries. To engage patients, bedside nursing staff must first understand the concept of patient centeredness and then incorporate patient centeredness in clinical practice. Clinicians should move from being experts to being enablers. To conceptualize the knowledge gaps identified, a conceptual model was developed to guide future research and quality improvement efforts in hospital settings. This model could be used as a guide to advance nursing leadership in hospital fall prevention via promoting patient engagement (e.g., developing patient-centered fall prevention interventions with patients' input). PMID:26845821

  3. Implementing Patient Safety Initiatives in Rural Hospitals

    ERIC Educational Resources Information Center

    Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary

    2009-01-01

    Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…

  4. Schizophrenia.

    PubMed

    Owen, Michael J; Sawa, Akira; Mortensen, Preben B

    2016-07-01

    Schizophrenia is a complex, heterogeneous behavioural and cognitive syndrome that seems to originate from disruption of brain development caused by genetic or environmental factors, or both. Dysfunction of dopaminergic neurotransmission contributes to the genesis of psychotic symptoms, but evidence also points to a widespread and variable involvement of other brain areas and circuits. Disturbances of synaptic function might underlie abnormalities of neuronal connectivity that possibly involves interneurons, but the precise nature, location, and timing of these events are uncertain. At present, treatment mainly consists of antipsychotic drugs combined with psychological therapies, social support, and rehabilitation, but a pressing need for more effective treatments and delivery of services exists. Advances in genomics, epidemiology, and neuroscience have led to great progress in understanding the disorder, and the opportunities for further scientific breakthrough are numerous--but so are the challenges. PMID:26777917

  5. [The relation to the humor and laugh in patients with schizophrenia].

    PubMed

    Stefanenko, E A; Enikolopov, S N; Ivanova, E M

    2014-01-01

    This study provides the data on gelotophobia (the fear of being laughed at), gelotophilia (the joy of being laughed at) and katagelasticism (the joy of laughing at others) in patients with schizophrenia in comparison with controls. Gelotophobia was significantly higher and katagelasticism was significantly lower in psychiatric patients than in controls. The negative correlation was found between gelotophobia and the duration of illness among patients with paranoid schizophrenia. Gelotophilia and katagelasticism were correlated positively both in patients and controls. In patients with schizotypal disorder, gelotophobia was also correlated with katagelasticism. High scores on katagelasticism and gelotophilia typical for men in the control group became typical for women in schizophrenia group. PMID:24637813

  6. Distorted perception of the subjective temporal distance of autobiographical events in patients with schizophrenia.

    PubMed

    Potheegadoo, Jevita; Cuervo-Lombard, Christine; Berna, Fabrice; Danion, Jean-Marie

    2012-03-01

    Disturbances of perception of subjective time have been described in schizophrenia but have not been experimentally studied until now. We investigated how patients with schizophrenia estimate the subjective temporal distance (TD) of past personal events, i.e. how these events are perceived as subjectively close or distant in time. Twenty-five patients with schizophrenia and 25 control participants recalled 24 autobiographical memories from four different life periods. They estimated the subjective TD and rated the amount of detail of each memory. Results showed that patients with schizophrenia had a distorted perception of subjective TD. Their memories were significantly less detailed than those of controls and, unlike control participants, the amount of memory detail was not significantly correlated with subjective TD. Poor access to memory detail may account for distortions of perception of subjective time in patients with schizophrenia. PMID:21993451

  7. Serum trace element differences between Schizophrenia patients and controls in the Han Chinese population.

    PubMed

    Cai, Lei; Chen, Tianlu; Yang, Jinglei; Zhou, Kejun; Yan, Xiaomei; Chen, Wenzhong; Sun, Liya; Li, Linlin; Qin, Shengying; Wang, Peng; Yang, Ping; Cui, Donghong; Burmeister, Margit; He, Lin; Jia, Wei; Wan, Chunling

    2015-01-01

    Little is known about the trace element profile differences between Schizophrenia patients and healthy controls; previous studies about the association of certain elements with Schizophrenia have obtained conflicting results. To identify these differences in the Han Chinese population, inductively coupled plasma-mass spectrometry was used to quantify the levels of 35 elements in the sera of 111 Schizophrenia patients and 110 healthy participants, which consisted of a training (61/61 for cases/controls included) and a test group including remaining participants. An orthogonal projection to latent structures model was constructed from the training group (R(2)Y = 0.465, Q(2)cum = 0.343) had a sensitivity of 76.0% and a specificity of 71.4% in the test group. Single element analysis indicated that the concentrations of cesium, zinc, and selenium were significantly reduced in patients with Schizophrenia in both the training and test groups. The meta-analysis including 522 cases and 360 controls supported that Zinc was significantly associated with Schizophrenia (standardized mean difference [SMD], -0.81; 95% confidence intervals [CI], -1.46 to -0.16, P = 0.01) in the random-effect model. Information theory analysis indicated that Zinc could play roles independently in Schizophrenia. These results suggest clear element profile differences between patients with Schizophrenia and healthy controls, and reduced Zn level is confirmed in the Schizophrenia patients. PMID:26456296

  8. Normal cognitive conflict resolution in psychosis patients with and without schizophrenia.

    PubMed

    Smid, Henderikus G O M; Bruggeman, Richard; Martens, Sander

    2016-01-01

    Schizophrenia is thought to be associated with impairments of executive functions, among which conflict control functions play an important role. The available evidence, however, suggests that conflict control is intact in schizophrenia, despite being based on methods that have successfully unveiled conflict control problems in other disorders. Differences between schizophrenia patients and healthy controls in stimulus perception, selective attention, alertness, processing speed and reaction time variability may have been previously overlooked. By controlling for these potential confounders, the present experiments were aimed to be more rigorous tests of the hypothesis that psychosis and schizophrenia are associated with impairments of conflict control. To that end, 27 healthy controls and 53 recent-onset psychosis patients with (n = 27) and without schizophrenia (n = 26) with comparable age, intelligence, and education level, performed three iconic conflict control tasks: the Simon task, the Eriksen flanker task, and the Stroop task, all equipped with neutral trials, and analyzed for various potential confounders. They further performed a battery of standard neuropsychological tests. Schizophrenia patients showed no increased conflict effects in any of the 3 tasks for any alternative measures used. Nonschizophrenia patients only showed abnormally increased response competition in the Simon task. All patients nevertheless demonstrated impaired control of attention and verbal memory. These findings indicate that the type of conflict control engaged by conflict tasks is intact in recent-onset schizophrenia, suggesting that a major component of executive function is spared in schizophrenia. We discuss these findings in terms of proactive and reactive control. PMID:26569036

  9. Serum trace element differences between Schizophrenia patients and controls in the Han Chinese population

    PubMed Central

    Cai, Lei; Chen, Tianlu; Yang, Jinglei; Zhou, Kejun; Yan, Xiaomei; Chen, Wenzhong; Sun, Liya; Li, Linlin; Qin, Shengying; Wang, Peng; Yang, Ping; Cui, Donghong; Burmeister, Margit; He, Lin; Jia, Wei; Wan, Chunling

    2015-01-01

    Little is known about the trace element profile differences between Schizophrenia patients and healthy controls; previous studies about the association of certain elements with Schizophrenia have obtained conflicting results. To identify these differences in the Han Chinese population, inductively coupled plasma-mass spectrometry was used to quantify the levels of 35 elements in the sera of 111 Schizophrenia patients and 110 healthy participants, which consisted of a training (61/61 for cases/controls included) and a test group including remaining participants. An orthogonal projection to latent structures model was constructed from the training group (R2Y = 0.465, Q2cum = 0.343) had a sensitivity of 76.0% and a specificity of 71.4% in the test group. Single element analysis indicated that the concentrations of cesium, zinc, and selenium were significantly reduced in patients with Schizophrenia in both the training and test groups. The meta-analysis including 522 cases and 360 controls supported that Zinc was significantly associated with Schizophrenia (standardized mean difference [SMD], −0.81; 95% confidence intervals [CI], −1.46 to −0.16, P = 0.01) in the random-effect model. Information theory analysis indicated that Zinc could play roles independently in Schizophrenia. These results suggest clear element profile differences between patients with Schizophrenia and healthy controls, and reduced Zn level is confirmed in the Schizophrenia patients. PMID:26456296

  10. Mortality of Geriatric and Younger Patients with Schizophrenia in the Community

    ERIC Educational Resources Information Center

    Ran, Mao-Sheng; Chan, Cecilia Lai-Wan; Chen, Eric Yu-Hai; Tang, Cui-Ping; Lin, Fu-Rong; Li, Li; Li, Si-Gan; Mao, Wen-Jun; Hu, Shi-Hui; Schwab, Gerhard; Conwell, Yeates

    2008-01-01

    Little is known about the differences in mortality among non-institutionalized geriatric and younger patients with schizophrenia. In this study long-term mortality and suicidal behavior of all the geriatric (age greater than or equal to 65 years), middle-age (age 41-64 years), and young (age 15-40 years) subjects with schizophrenia living in a…

  11. Long-Term Effect of Prefrontal Lobotomy on Verbal Fluency in Patients with Schizophrenia

    ERIC Educational Resources Information Center

    Stip, Emmanuel; Bigras, Marie-Josee.; Mancini-Marie, Adham; Cosset, Marie-Eve.; Black, Deborah; Lecours, Andre-Roch

    2004-01-01

    Objective: This study investigated the long-term effects of bilateral prefrontal leukotomy on lexical abilities in schizophrenia subjects. Method: We compared performances of leukotomized (LSP), non-leukotomized schizophrenia patients (NLSP) and normal controls, using a test of verbal fluency. Multiple case and triple comparison design were…

  12. Perceived patient-parent relationships and neural representation of parents in schizophrenia.

    PubMed

    Choi, Soo-Hee; Lee, Sang-Hoon; Park, Hae-Jeong; Chun, Ji Won; Kang, Jee In; Kim, Jae-Jin

    2013-04-01

    Having a relationship with one's parents is a fundamental social interaction and is a significant environmental factor in the long-term course of illness in schizophrenia. We explored subjective reports regarding the communicative relationship with parents and the implicit behavioral and neural responses of patients toward stimuli that referred to parents. Fourteen outpatients with schizophrenia and 15 healthy volunteers with living parents were scanned using a functional magnetic resonance imaging while performing an imaginary sentence completion test that involved contemplation of their mothers and fathers. In patients with schizophrenia, subjective reports of better communicative fluency with one's mother were associated with faster response time and lower incomplete rate, reflecting favorable responses toward mothers. Relative to control participants, patients with schizophrenia demonstrated greater neural activation in the superior temporal sulcus and the parahippocampal gyrus for parental stimuli. When patients with schizophrenia contemplated their mothers, activities in these regions were associated with a level of negative symptoms or affective ambivalence in patients. The results indicated that parental cues are processed in a more socially driven manner, and that perceived communicative relationships with one's parents can be used to estimate implicit responses, especially in relation to mothers in patients with schizophrenia. Furthermore, the findings of the current study suggest that affective ambivalence toward one's mother is one such implicit response and emphasize the importance of prudent family interventions in the psychiatric rehabilitation of patients with schizophrenia. PMID:22678652

  13. Impaired Prepulse Inhibition and Prepulse-Elicited Reactivity but Intact Reflex Circuit Excitability in Unmedicated Schizophrenia Patients: a Comparison With Healthy Subjects and Medicated Schizophrenia Patients

    PubMed Central

    Csomor, Philipp A.; Yee, Benjamin K.; Feldon, Joram; Theodoridou, Anastasia; Studerus, Erich; Vollenweider, Franz X.

    2009-01-01

    Deficient sensorimotor gating as indexed by prepulse inhibition (PPI) of the startle response has been reported repeatedly in patients suffering from schizophrenia. According to the widely accepted “protective hypothesis,” PPI reflects the protection of ongoing information processing against interference by other stimuli. Alternatively, it has been proposed that PPI might be regulated by startle reflex circuit excitability. In the present study, we evaluated these 2 conceptually divergent approaches underlying the regulation of PPI. To this end, we assessed sensorimotor gating as indexed by PPI, the reactivity to the prepulse-alone stimulus indexed as prepulse-elicited reactivity (PPER), and acoustic blink reflex excitability in terms of paired pulse suppression (PPS) within a single recording session in 13 unmedicated and 24 medicated (11 first break) schizophrenia patients in comparison to 43 healthy control subjects. The results showed that PPI was significantly reduced in unmedicated, but not in medicated schizophrenia patients. Furthermore, unmedicated patients could be distinguished from the medicated patients and control subjects in terms of PPER. In contrast to PPI, PPS did not differ between patients and control subjects. These findings are in line with the “protective hypothesis” of PPI and indicate that reduced sensorimotor gating in schizophrenia patients might be based on a reduced perception and/or processing of the prepulse stimulus. The extent to which PPER may or may not be causally associated with sensorimotor gating in schizophrenia has to be further investigated in human and animal studies. PMID:18245063

  14. Memory deficit in patients with schizophrenia and posttraumatic stress disorder: relational vs item-specific memory

    PubMed Central

    Jung, Wookyoung; Lee, Seung-Hwan

    2016-01-01

    It has been well established that patients with schizophrenia have impairments in cognitive functioning and also that patients who experienced traumatic events suffer from cognitive deficits. Of the cognitive deficits revealed in schizophrenia or posttraumatic stress disorder (PTSD) patients, the current article provides a brief review of deficit in episodic memory, which is highly predictive of patients’ quality of life and global functioning. In particular, we have focused on studies that compared relational and item-specific memory performance in schizophrenia and PTSD, because measures of relational and item-specific memory are considered the most promising constructs for immediate tangible development of clinical trial paradigm. The behavioral findings of schizophrenia are based on the tasks developed by the Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) initiative and the Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRACS) Consortium. The findings we reviewed consistently showed that schizophrenia and PTSD are closely associated with more severe impairments in relational memory compared to item-specific memory. Candidate brain regions involved in relational memory impairment in schizophrenia and PTSD are also discussed. PMID:27274250

  15. Multisensory stimuli elicit altered oscillatory brain responses at gamma frequencies in patients with schizophrenia.

    PubMed

    Stone, David B; Coffman, Brian A; Bustillo, Juan R; Aine, Cheryl J; Stephen, Julia M

    2014-01-01

    Deficits in auditory and visual unisensory responses are well documented in patients with schizophrenia; however, potential abnormalities elicited from multisensory audio-visual stimuli are less understood. Further, schizophrenia patients have shown abnormal patterns in task-related and task-independent oscillatory brain activity, particularly in the gamma frequency band. We examined oscillatory responses to basic unisensory and multisensory stimuli in schizophrenia patients (N = 46) and healthy controls (N = 57) using magnetoencephalography (MEG). Time-frequency decomposition was performed to determine regions of significant changes in gamma band power by group in response to unisensory and multisensory stimuli relative to baseline levels. Results showed significant behavioral differences between groups in response to unisensory and multisensory stimuli. In addition, time-frequency analysis revealed significant decreases and increases in gamma-band power in schizophrenia patients relative to healthy controls, which emerged both early and late over both sensory and frontal regions in response to unisensory and multisensory stimuli. Unisensory gamma-band power predicted multisensory gamma-band power differently by group. Furthermore, gamma-band power in these regions predicted performance in select measures of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) test battery differently by group. These results reveal a unique pattern of task-related gamma-band power in schizophrenia patients relative to controls that may indicate reduced inhibition in combination with impaired oscillatory mechanisms in patients with schizophrenia. PMID:25414652

  16. Multisensory stimuli elicit altered oscillatory brain responses at gamma frequencies in patients with schizophrenia

    PubMed Central

    Stone, David B.; Coffman, Brian A.; Bustillo, Juan R.; Aine, Cheryl J.; Stephen, Julia M.

    2014-01-01

    Deficits in auditory and visual unisensory responses are well documented in patients with schizophrenia; however, potential abnormalities elicited from multisensory audio-visual stimuli are less understood. Further, schizophrenia patients have shown abnormal patterns in task-related and task-independent oscillatory brain activity, particularly in the gamma frequency band. We examined oscillatory responses to basic unisensory and multisensory stimuli in schizophrenia patients (N = 46) and healthy controls (N = 57) using magnetoencephalography (MEG). Time-frequency decomposition was performed to determine regions of significant changes in gamma band power by group in response to unisensory and multisensory stimuli relative to baseline levels. Results showed significant behavioral differences between groups in response to unisensory and multisensory stimuli. In addition, time-frequency analysis revealed significant decreases and increases in gamma-band power in schizophrenia patients relative to healthy controls, which emerged both early and late over both sensory and frontal regions in response to unisensory and multisensory stimuli. Unisensory gamma-band power predicted multisensory gamma-band power differently by group. Furthermore, gamma-band power in these regions predicted performance in select measures of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) test battery differently by group. These results reveal a unique pattern of task-related gamma-band power in schizophrenia patients relative to controls that may indicate reduced inhibition in combination with impaired oscillatory mechanisms in patients with schizophrenia. PMID:25414652

  17. Schizophrenia patients differentiation based on MR vascular perfusion and volumetric imaging

    NASA Astrophysics Data System (ADS)

    Spanier, A. B.; Joskowicz, L.; Moshel, S.; Israeli, D.

    2015-03-01

    Candecomp/Parafac Decomposition (CPD) has emerged as a framework for modeling N-way arrays (higher-order matrices). CPD is naturally well suited for the analysis of data sets comprised of observations of a function of multiple discrete indices. In this study we evaluate the prospects of using CPD for modeling MRI brain properties (i.e. brain volume and gray-level) for schizophrenia diagnosis. Taking into account that 3D imaging data consists of millions of pixels per patient, the diagnosis of a schizophrenia patient based on pixel analysis constitutes a methodological challenge (e.g. multiple comparison problem). We show that the CPD could potentially be used as a dimensionality redaction method and as a discriminator between schizophrenia patients and match control, using the gradient of pre- and post Gd-T1-weighted MRI data, which is strongly correlated with cerebral blood perfusion. Our approach was tested on 68 MRI scans: 40 first-episode schizophrenia patients and 28 matched controls. The CPD subject's scores exhibit statistically significant result (P < 0.001). In the context of diagnosing schizophrenia with MRI, the results suggest that the CPD could potentially be used to discriminate between schizophrenia patients and matched control. In addition, the CPD model suggests for brain regions that might exhibit abnormalities in schizophrenia patients for future research.

  18. Profiling cognitive impairment in treatment-resistant schizophrenia patients.

    PubMed

    Frydecka, Dorota; Beszłej, Jan Aleksander; Gościmski, Piotr; Kiejna, Andrzej; Misiak, Błażej

    2016-01-30

    The aim of this study was to compare cognitive performance between schizophrenia patients with and without treatment resistance (TRS and non-TRS patients) taking into account psychopathological symptoms and antipsychotic treatment. The following cognitive tests were administered to 53 TRS patients and 32 non-TRS subjects: Rey Auditory Verbal Learning Test (RAVLT), Trail Making Tests (TMT-A and TMT-B), verbal fluency tests (FAS test and Supermarket), as well as selected Wechsler Adults Intelligence Scale (WAIS-R-PI) subtests: Digit Symbol Coding Test, Digit Span Forward and Backward and Similarities. TRS patients performed significantly worse in comparison with non-TRS patients on the measures of processing speed (TMT-A, Stroop test, FAS test, Supermarket test, Digit Symbol Coding test), verbal fluency (FAS test, Supermarket test), cognitive flexibility and executive functions (Stroop test) after controlling for age, illness duration, clinical symptoms severity, the number of years of completed education and antipsychotics' dose. Cognitive performance was associated with negative and general symptomatology. Anticholinergic activity of antipsychotics had debilitating effect on cognitive functioning in non-TRS patients (FAS test) and in TRS patients (TMT-B test, Stroop test, RAVLT subtests, Digit Coding test and Similarities test), while low anticholinergic activity of antipsychotics was associated with better cognitive performance in non-TRS patients (Backward Digit Span test) and in TRS patients (Similarities test). Results of this study indicate that cognitive deficits are more robust in TRS patients than in non-TRS subjects, and are associated with clinical symptoms as well as the treatment with antipsychotics that exert high anticholinergic activity. PMID:26706131

  19. Inflammation and Elevation of Interleukin-12p40 in Patients with Schizophrenia.

    PubMed

    Bedrossian, Nora; Haidar, Mariam; Fares, Jawad; Kobeissy, Firas H; Fares, Youssef

    2016-01-01

    Schizophrenia is a serious mental illness with chronic symptoms and significant impairment in psychosocial functioning, which suggests that it likely has neurodegenerative characteristics. Inflammatory markers such as pro-inflammatory cytokines are well-known etiological contributors for psychiatric disorders, including schizophrenia. Although, the role of inflammation in schizophrenia is becoming evident, the number of studies in this area is relatively scarce, especially in Lebanon, and increased procedural thoroughness is needed. Cytokines play a key role in the activation of the immune system and strongly influence neurotransmission. Previous investigation of plasma levels showed dysregulation of interleukin (IL)-12. However, genotypical variations of this interleukin have not been investigated for patients with schizophrenia yet. Thus, in this paper, we aimed to compute and assess IL-12p40 levels in the sera of individuals with schizophrenia from different provinces in Lebanon and compare it to controls. Healthy subjects comprised 60 individuals with a male/female (M/F) ratio of 31/29, whereas patients with schizophrenia consisted of 63 subjects with an M/F ratio of 30/33. The mean age for healthy controls was 30 years, whereas that for patients with schizophrenia was 35 years. A standardized enzyme-linked immunosorbent assay (ELISA) technique was used to measure the concentration of IL-12p40 in all collected sera (n = 123). The mean IL-12p40 levels in patients with schizophrenia were significantly higher than in healthy controls (p = 0.002). Healthy females had a significantly higher concentration of IL-12p40 than healthy males (p = 0.009). Female patients with schizophrenia had significantly higher concentrations of IL-12p40 than their male counterparts (p < 0.001), healthy females (p = 0.018), and healthy males (p < 0.001), respectively. Male patients with schizophrenia had significantly higher concentrations of IL-12p40 than healthy males (p = 0.023). The

  20. Inflammation and Elevation of Interleukin-12p40 in Patients with Schizophrenia

    PubMed Central

    Bedrossian, Nora; Haidar, Mariam; Fares, Jawad; Kobeissy, Firas H.; Fares, Youssef

    2016-01-01

    Schizophrenia is a serious mental illness with chronic symptoms and significant impairment in psychosocial functioning, which suggests that it likely has neurodegenerative characteristics. Inflammatory markers such as pro-inflammatory cytokines are well-known etiological contributors for psychiatric disorders, including schizophrenia. Although, the role of inflammation in schizophrenia is becoming evident, the number of studies in this area is relatively scarce, especially in Lebanon, and increased procedural thoroughness is needed. Cytokines play a key role in the activation of the immune system and strongly influence neurotransmission. Previous investigation of plasma levels showed dysregulation of interleukin (IL)-12. However, genotypical variations of this interleukin have not been investigated for patients with schizophrenia yet. Thus, in this paper, we aimed to compute and assess IL-12p40 levels in the sera of individuals with schizophrenia from different provinces in Lebanon and compare it to controls. Healthy subjects comprised 60 individuals with a male/female (M/F) ratio of 31/29, whereas patients with schizophrenia consisted of 63 subjects with an M/F ratio of 30/33. The mean age for healthy controls was 30 years, whereas that for patients with schizophrenia was 35 years. A standardized enzyme-linked immunosorbent assay (ELISA) technique was used to measure the concentration of IL-12p40 in all collected sera (n = 123). The mean IL-12p40 levels in patients with schizophrenia were significantly higher than in healthy controls (p = 0.002). Healthy females had a significantly higher concentration of IL-12p40 than healthy males (p = 0.009). Female patients with schizophrenia had significantly higher concentrations of IL-12p40 than their male counterparts (p < 0.001), healthy females (p = 0.018), and healthy males (p < 0.001), respectively. Male patients with schizophrenia had significantly higher concentrations of IL-12p40 than healthy males (p = 0.023). The

  1. Hospital and patient characteristics of uncompensated hospital care: policy implications.

    PubMed

    Saywell, R M; Zollinger, T W; Chu, D K; MacBeth, C A; Sechrist, M E

    1989-01-01

    For this study, a sample of 1,689 patients classified as "charity" and "bad debt" cases in 1986 were identified from 27 general acute care hospitals and one tertiary hospital in Indiana. Half of the hospitals were in rural areas and 57 percent were small (less than 150 beds). Most of the patients (87.2 percent) incurred uncompensated amounts under $2,500, and 40 percent of the cases were below $500. About 72 percent of the patients with uncompensated care were from the same county as the location of the hospital (range from 30.9% to 100.0%). The majority of the cases (79.4 percent) with over $5,000 in uncompensated care were treated in urban hospitals. The average age of these patients was 27.2 years. Fifty-four percent of the patients were single, 60.7 percent were female, and nearly all (83.0 percent) were discharged to home care. Only 44.6 percent of the patients with uncompensated care had no insurance; 46.8 percent had some form of commercial insurance which covered part of the charges for care. The most common diagnosis for these patients was pregnancy and childbirth (22.8 percent), with injury and poisoning second (10.7 percent). The cases with $5,000 or more in bad debt (about 4 percent of the cases) account for 28.3 percent of the total uncollected amount. Bad debt represents a cost of doing business. Any national effort to contain health care costs must address this problem. PMID:2738351

  2. Language lateralization in female patients with schizophrenia: an fMRI study.

    PubMed

    Sommer, I E C; Ramsey, N F; Mandl, R C W; Kahn, R S

    2003-04-01

    Gender differences in schizophrenia are among the most consistently reported findings in schizophrenia research. However, the biological substrate underlying these gender differences is still largely unknown. Differences in language lateralization between men and women may underlie some gender differences in schizophrenia. In previous functional imaging studies, language lateralization was found to be decreased in male schizophrenia patients as compared to healthy males, which was due to enhanced language activation of the right hemisphere as compared to the healthy males. It could be hypothesized that decreased language lateralization in schizophrenia is gender specific, i.e. decreased lateralization in male patients and normal lateralization in female patients. To test this hypothesis, language activation was measured in 12 right-handed female patients with schizophrenia and 12 healthy females, and compared to findings in 12 male patients and 12 male controls of an earlier study. Language lateralization was significantly lower in the female patients (0.44) as compared to the female controls (0.75), which was due to increased activation of the right-sided language areas (patients: 19 voxels; controls: 8 voxels), while left hemisphere activation was similar in patients and controls. When these data are compared to the male patients and controls, both patient groups had lower lateralization than their healthy counterparts, but there was no difference between male and female patients. In both sexes, decreased lateralization resulted from increased right hemispheric language activation, which suggests a failure to inhibit nondominant language areas in schizophrenia. These findings indicate that lower language lateralization in women is not likely to underlie gender differences in schizophrenia. PMID:12591582

  3. Using focus groups to design a psychoeducation program for patients with schizophrenia and their family members

    PubMed Central

    Song, Yan; Liu, Dan; Chen, Yuxiang; He, Guoping

    2014-01-01

    The purpose of this project was to determine what factors to be considered in planning a psychoeducation program to better meet the needs of patients with schizophrenia and their family members. Methods: Three focus group sessions were conducted and recorded, transcribed, and analyzed by members of the research team. Results: Patients hoped to grasp the fullest possible knowledge about schizophrenia, whereas the factors influencing the efficacy of the schizophrenia health education curriculum included: discrimination, non-understanding of family members, easy to forget, unreasonable timetable. Health education was mainly in the form of classroom teaching. Conclusions: 1. At present, there are a few psychiatric education courses in China; 2. Patients and their family members are eager to acquire knowledge about the contents of schizophrenia; 3. Misconceptions would hinder the rehabilitation of patients; 4. Worry about being discriminated; 5. There is a different knowledge demand between the patients and their family members. PMID:24482705

  4. An Indian experience of neurocognitive endophenotypic markers in unaffected first-degree relatives of schizophrenia patients

    PubMed Central

    Solanki, Ram Kumar; Kumar, Ashok; Satija, Yogesh; Gupta, Suresh; Singh, Paramjeet

    2016-01-01

    Context: Multiple vulnerability genes interact with environmental factors to develop a range of phenotypes in the schizophrenia spectrum. Endophenotypes can help characterize the impact of risk genes by providing genetically relevant traits that are more complaisant than the behavioral symptoms that classify mental illness. Aims: We aimed to investigate the neurocognitive endophenotypic markers for schizophrenia in Indian population. Settings and Design: In a cross-sectional study, we assessed neurocognitive functioning in 40 unaffected first-degree relatives (FDR) of schizophrenia patients with an equal number of healthy controls. Materials and Methods: FDR schizophrenia group was compared with the control group on measures of short-term memory, verbal working memory, auditory verbal memory on indices of immediate recall and recognition, visuospatial working memory, visual attention, and executive functions. Results: The study found that FDR schizophrenia scored poorly on all tested measures of neurocognition except visual attention. On calculating composite score, we found that composite neurocognitive score better discriminated the FDR schizophrenia from the control group. Conclusions: Neurocognitive measures of short-term memory, verbal working memory, auditory verbal memory, visuospatial working memory, and executive functions significantly differentiate FDR of patients with schizophrenia from controls and can be considered as endophenotypic markers of schizophrenia in non-Caucasian population. The exactitude of this approach can be increased by calculating a composite neurocognitive score which combines various neurocognitive measures. PMID:26985100

  5. Hospitalization for Hypoglycemia in Japanese Diabetic Patients

    PubMed Central

    Sako, Akahito; Yasunaga, Hideo; Matsui, Hiroki; Fushimi, Kiyohide; Hamasaki, Hidetaka; Katsuyama, Hisayuki; Tsujimoto, Tetsuro; Goto, Atsushi; Yanai, Hidekatsu

    2015-01-01

    Abstract We aimed to elucidate the epidemiology, patient demographics, and clinical outcomes of hospitalization for hypoglycemia in diabetic patients using a Japanese large-scale database. We conducted a retrospective study using a national inpatient database of acute care hospitals in Japan. Diabetic patients ages ≥15 years with hypoglycemia as a main diagnosis for hospitalization were eligible. We estimated the annual number of hospitalizations in Japan and compared the annual admission rate by age and treatment groups. We also analyzed the association between patient characteristics and in-hospital mortality. Among 22.7 million discharge records from July 2008 and March 2013, a total of 25,071 patients were eligible. The mean age was 73.4 years, and the mean body mass index (BMI) was 22.3 kg/m2. The estimated annual hospitalization for hypoglycemia in Japan was ∼20,000. Annual admission rates for hypoglycemia per 1000 diabetic patients and 1000 diabetic patients receiving insulin or oral hypoglycemic agents were 2.1 and 4.1, respectively. Patients <40 years and >70 years old were at a higher risk of hospitalization. In-hospital mortality was 3.8%, and risk factors associated with poor survival were male sex, older age, lower bed capacity, community hospital, low BMI, coma at admission, and higher Charlson Comorbidity Index. To prevent severe hypoglycemia that leads to death and complications, individualized and careful glycemic control are important, especially in very old or young patients and in those with comorbid conditions or low BMI. PMID:26107672

  6. Spatial working memory deficits in schizophrenia patients and their first degree relatives from Palau, Micronesia.

    PubMed

    Myles-Worsley, Marina; Park, Sohee

    2002-08-01

    Spatial working memory deficits associated with dorsolateral prefrontal dysfunction have been found in Caucasian samples of schizophrenia patients and their first-degree relatives. This study evaluated spatial working memory function in affected and unaffected members of multiplex schizophrenia families from the Republic of Palau to determine whether the spatial working memory deficits associated with schizophrenia extend to this non-Caucasian population. Palau is an isolated island nation in Micronesia with an elevated prevalence of schizophrenia and an aggregation of cases in large multigenerational families. Our objective was to evaluate the potential for spatial working memory function to serve as one of multiple endophenotypes in a genetic linkage study of these Palauan schizophrenia families. A spatial delayed response task requiring resistance to distraction and a sensorimotor control task were used to assess spatial working memory in 32 schizophrenia patients, 28 of their healthy first-degree relatives, and 19 normal control subjects. Schizophrenia patients and their relatives were significantly less accurate than normal control subjects on the spatial delayed response task but not on the sensorimotor control task. On both tasks, patients and relatives were slower to respond than the normal controls. There were no age or gender effects on accuracy, and working memory performance in schizophrenia patients was not significantly correlated with medication dosage. In summary, spatial working memory deficits that have been found in Caucasian schizophrenia patients and relatives were confirmed in this isolated Pacific Island family sample. These results suggest that spatial working memory deficits may be a potentially useful addition to the endophenotypic characterization of family members to be used in a comprehensive genome wide linkage analysis of these Palauan families. PMID:12210274

  7. Analysis of heart rate variability during auditory stimulation periods in patients with schizophrenia.

    PubMed

    Akar, Saime Akdemir; Kara, Sadık; Latifoğlu, Fatma; Bilgiç, Vedat

    2015-02-01

    The vulnerability-stress model is a hypothesis for symptom development in schizophrenia patients who are generally characterized by cardiac autonomic dysfunction. Therefore, measures of heart rate variability (HRV) have been widely used in schizophrenics for assessing altered cardiac autonomic regulations. The goal of this study was to analyze HRV of schizophrenia patients and healthy control subjects with exposure to auditory stimuli. More specifically, this study examines whether schizophrenia patients may exhibit distinctive time and frequency domain parameters of HRV from control subjects during at rest and auditory stimulation periods. Photoplethysmographic signals were used in the analysis of HRV. Nineteen schizophrenic patients and twenty healthy control subjects were examined during rest periods, while exposed to periods of white noise (WN) and relaxing music. Results indicate that HRV in patients was lower than that of control subjects indicating autonomic dysfunction throughout the entire experiment. In comparison with control subjects, patients with schizophrenia exhibited lower high-frequency power and a higher low-frequency to high-frequency ratio. Moreover, while WN stimulus decreased parasympathetic activity in healthy subjects, no significant changes in heart rate and frequency-domain HRV parameters were observed between the auditory stimulation and rest periods in schizophrenia patients. We can conclude that HRV can be used as a sensitive index of emotion-related sympathetic activity in schizophrenia patients. PMID:24831932

  8. Comparison of Plasma Neurosteroid and Prolactin Levels in Patients with Schizophrenia and Healthy Individuals

    PubMed Central

    Riahi, Forough; Izadi-mazidi, Maryam; Ghaffari, Ali; Yousefi, Elham

    2016-01-01

    Background. The present study aimed to compare plasma levels of cortisol, testosterone, dehydroepiandrosterone (DHEA), and prolactin in patients with schizophrenia and healthy individuals. Method. A total of 100 patients with schizophrenia disorder (69 men and 31 women) and 190 healthy individuals (94 men and 96 women) participated in this cross-sectional study. They were tested for hormone levels and completed demographic questionnaires. Data were analyzed using multivariate analysis of variance (MANOVA) and one-way analysis of variance. Results. Serum testosterone level was significantly higher in men with schizophrenia than in healthy men. Women with schizophrenia had a significantly higher level of testosterone and lower level of prolactin compared to healthy women. There were no significant differences in hormone levels across various subtypes of schizophrenia. No significant differences also were observed in hormones levels in patients with first-episode schizophrenia disorder compared to those in patients with recurrent episodes. Conclusion. This study indicated that abnormal testosterone and prolactin levels might be associated with pathophysiology of schizophrenia disorder. PMID:27293968

  9. Comparison of Plasma Neurosteroid and Prolactin Levels in Patients with Schizophrenia and Healthy Individuals.

    PubMed

    Riahi, Forough; Izadi-Mazidi, Maryam; Ghaffari, Ali; Yousefi, Elham; Khademvatan, Shahram

    2016-01-01

    Background. The present study aimed to compare plasma levels of cortisol, testosterone, dehydroepiandrosterone (DHEA), and prolactin in patients with schizophrenia and healthy individuals. Method. A total of 100 patients with schizophrenia disorder (69 men and 31 women) and 190 healthy individuals (94 men and 96 women) participated in this cross-sectional study. They were tested for hormone levels and completed demographic questionnaires. Data were analyzed using multivariate analysis of variance (MANOVA) and one-way analysis of variance. Results. Serum testosterone level was significantly higher in men with schizophrenia than in healthy men. Women with schizophrenia had a significantly higher level of testosterone and lower level of prolactin compared to healthy women. There were no significant differences in hormone levels across various subtypes of schizophrenia. No significant differences also were observed in hormones levels in patients with first-episode schizophrenia disorder compared to those in patients with recurrent episodes. Conclusion. This study indicated that abnormal testosterone and prolactin levels might be associated with pathophysiology of schizophrenia disorder. PMID:27293968

  10. Insight into Obsessive-Compulsive Symptoms and Awareness of Illness in Adolescent Schizophrenia Patients with and without OCD

    ERIC Educational Resources Information Center

    Faragian, Sarit; Kurs, Rena; Poyurovsky, Michael

    2008-01-01

    A substantial proportion of adolescent schizophrenia patients also has obsessive-compulsive disorder (OCD). As the reliability of OCD identification in schizophrenia has been challenged, we evaluated insight into OCD symptoms and awareness of schizophrenia, using the Brown Assessment of Beliefs Scale and the Scale to Assess Unawareness of Mental…

  11. Left globus pallidus abnormality in never-medicated patients with schizophrenia

    SciTech Connect

    Early, T.S.; Reiman, E.M.; Raichle, M.E.; Spitznagel, E.L.

    1987-01-01

    Schizophrenia is a severe psychiatric disorder characterized by onset in young adulthood, the occurrence of hallucinations and delusions, and the development of enduring psychosocial disability. The pathophysiology of this disorder remains unknown. Studies of cerebral blood flow and metabolism designed to identify brain abnormalities in schizophrenia have been limited by inadequate methods of anatomical localization and the possibility of persistent medication effects. The authors have now used positron emission tomography and a validated method of anatomical localization in an attempt to identify abnormalities of regional cerebral blood flow in newly diagnosed never-medicated patients with schizophrenia. An exploratory study of 5 patients and 10 normal control subjects identified abnormally high blood flow in the left globus pallidus of patients with schizophrenia. A replication study of 5 additional patients and 10 additional control subjects confirmed this finding. No other abnormalities were found.

  12. Left globus pallidus abnormality in never-medicated patients with schizophrenia.

    PubMed Central

    Early, T S; Reiman, E M; Raichle, M E; Spitznagel, E L

    1987-01-01

    Schizophrenia is a severe psychiatric disorder characterized by onset in young adulthood, the occurrence of hallucinations and delusions, and the development of enduring psychosocial disability. The pathophysiology of this disorder remains unknown. Studies of cerebral blood flow and metabolism designed to identify brain abnormalities in schizophrenia have been limited by inadequate methods of anatomical localization and the possibility of persistent medication effects. We have now used positron emission tomography and a validated method of anatomical localization in an attempt to identify abnormalities of regional cerebral blood flow in newly diagnosed never-medicated patients with schizophrenia. An exploratory study of 5 patients and 10 normal control subjects identified abnormally high blood flow in the left globus pallidus of patients with schizophrenia. A replication study of 5 additional patients and 10 additional control subjects confirmed this finding. No other abnormalities were found. PMID:3467374

  13. Adjunctive Minocycline in Clozapine Treated Schizophrenia Patients with Persistent Symptoms

    PubMed Central

    Kelly, Deanna L.; Sullivan, Kelli M.; McEvoy, Joseph P; McMahon, Robert P.; Wehring, Heidi J.; Liu, Fang; Warfel, Dale; Vyas, Gopal; Richardson, Charles M.; Fischer, Bernard A.; Keller, William R.; Mathew Koola, Maju; Feldman, Stephanie; Russ, Jessica C.; Keefe, Richard S.; Osing, Jennifer; Hubzin, Leeka; August, Sharon; Walker, Trina M.; Buchanan, Robert W.

    2015-01-01

    Objective Clozapine is the most effective antipsychotic for treatment refractory people with schizophrenia, yet many patients only partially respond. Accumulating preclinical and clinical data suggest benefits with minocycline. We tested adjunct minocycline to clozapine in a 10 week, double blind placebo-controlled trial. Primary outcomes tested were positive and cognitive symptoms, while avolition, anxiety/depression and negative symptoms were secondary outcomes. Methods Schizophrenia and schizoaffective participants (N=52) with persistent positive symptoms were randomized to receive adjunct minocycline (100 mg oral capsule twice daily) (N=29) or placebo (N=23). Results Brief Psychiatric Rating Scale (BPRS) psychosis factor (p=0.098, effect size ES=0.39) and BPRS total score (p=0.075, effect size 0.55) were not significant. A ≥30% change in total BPRS symptoms was observed in 7/28 (25%) among minocycline and 1/23 (4%) among placebo participants, respectively (p=0.044). Global cognitive function (MATRICS Consensus Cognitive Battery, MCCB) did not differ, although there was a significant variation in size of treatment effects among cognitive domains (p=0.03), with significant improvement in working memory favoring minocycline (p=0.023, ES 0.41). The SANS total score did not differ, but significant improvement in avolition with minocycline was noted (p=0.012, ES=0.34). Significant improvement in the BPRS anxiety/depression factor was observed with minocycline (p=0.028, ES=0.49). Minocycline was well tolerated with significantly fewer headaches and constipation compared to placebo. Conclusion Minocycline’s effect on the MCCB composite score and positive symptoms were not statistically significant. Significant improvements with minocycline were seen in working memory, avolition and anxiety/depressive symptoms in a chronic population with persistent symptoms. Larger studies are needed to validate these findings. PMID:26082974

  14. Evidence of activation of the Toll-like receptor-4 proinflammatory pathway in patients with schizophrenia

    PubMed Central

    García-Bueno, Borja; Gassó, Patricia; MacDowell, Karina S.; Callado, Luis F.; Mas, Sergi; Bernardo, Miguel; Lafuente, Amalia; Meana, J. Javier; Leza, Juan C.

    2016-01-01

    Background Alterations in the innate immune/inflammatory system may underlie the pathophysiology of schizophrenia, but we do not understand the mechanisms involved. The main agents of innate immunity are the Toll-like receptors (TLRs), which detect molecular patterns associated with damage and pathogens. The TLR first reported was TLR4, and it is still the most studied one. Methods We aimed to describe putative modifications to the TLR4 proinflammatory pathway using 2 different strategies in 2 cohorts of patients with schizophrenia and matched controls: 1) quantification of protein and mRNA expression in postmortem prefrontal cortex samples from 30 patients with schizophrenia and 30 controls, and 2) identification of single nucleotide polymorphisms associated with the risk of schizophrenia using whole blood samples from 214 patients with schizophrenia and 216 controls. Results We found evidence of alterations in the expression of the initial elements of the TLR4 signalling pathway (TLR4, Myeloid differentiation primary response gene 88 [MyD88] and nuclear factor-κ B [NF-κB]) in the PFC of patients with schizophrenia. These alterations seem to depend on the presence/absence of antipsychotic treatment at death. Moreover, a polymorphism within the MyD88 gene was significantly associated with schizophrenia risk. Limitations The use of 2 different approaches in 2 different cohorts, the lack of a complementary neuropsychiatric group, the possible confounding effects of antipsychotic treatment and suicide are the main limitations of our study. Conclusion The evidence from this dual approach suggests there is an altered innate immune response in patients with chronic schizophrenia in which the TLR4 proinflammatory pathway could be affected. Improved understanding of the stimuli and mechanisms responsible for this response could lead to improved schizophrenia treatment and better control of the side effects of current antipsychotics. PMID:27070349

  15. Higher Plasma S100B Concentrations in Schizophrenia Patients, and Dependently Associated with Inflammatory Markers.

    PubMed

    Hong, Wu; Zhao, Min; Li, Haozhe; Peng, Fanglan; Wang, Fan; Li, Ningning; Xiang, Hui; Su, Yousong; Huang, Yueqi; Zhang, Shengyu; Zhao, Guoqin; Zhou, Rubai; Mao, Ling; Lin, Zhiguang; Fang, Yiru; Zhang, Qinting; Xie, Bin

    2016-01-01

    Glial damage and immune dysfunction are involved in pathogenesis of schizophrenia. However, interaction between glial damage and immune dysfunction in schizophrenia is undefined. This study aims to compare plasma S100 calcium binding protein (S100B) levels between schizophrenia patients and healthy participants, and to determine if immune markers are independently related with concentration of S100B in schizophrenia patients. Forty-one schizophrenia patients and thirty-three healthy volunteers were enrolled. Enzyme-linked immunosorbent assay (ELISA) was used to assess the concentrations of plasma S100B and inflammatory markers. We found that concentrations of S100B were elevated in schizophrenia patients than healthy participants (p < 0.05), and were negatively related with the severity of symptoms (p = 0.046). Receiver operating characteristic (ROC) curve analysis showed that different S100B levels between schizophrenia and healthy participants can be used as a clinical diagnostic factor (predictive value: 0.666, p = 0.015). Multiple linear regression analysis found that length of illness (Beta = -0.161), plasma levels of inflammatory regulation factors (including TGF-β1, logIL-23 and logIL-10) (Beta = 0.119, 0.475, 0.514) were independently associated with concentrations of S100B (Adjusted R(2) = 0.897, p < 0.001). Therefore, our results suggest the possible function of S100B in pathogenesis of schizophrenia, and implicate the important role of autoimmune response and balance to glial dysfunction in patients with schizophrenia. PMID:27279465

  16. Higher Plasma S100B Concentrations in Schizophrenia Patients, and Dependently Associated with Inflammatory Markers

    PubMed Central

    Hong, Wu; Zhao, Min; Li, Haozhe; Peng, Fanglan; Wang, Fan; Li, Ningning; Xiang, Hui; Su, Yousong; Huang, Yueqi; Zhang, Shengyu; Zhao, Guoqin; Zhou, Rubai; Mao, Ling; Lin, Zhiguang; Fang, Yiru; Zhang, Qinting; Xie, Bin

    2016-01-01

    Glial damage and immune dysfunction are involved in pathogenesis of schizophrenia. However, interaction between glial damage and immune dysfunction in schizophrenia is undefined. This study aims to compare plasma S100 calcium binding protein (S100B) levels between schizophrenia patients and healthy participants, and to determine if immune markers are independently related with concentration of S100B in schizophrenia patients. Forty-one schizophrenia patients and thirty-three healthy volunteers were enrolled. Enzyme-linked immunosorbent assay (ELISA) was used to assess the concentrations of plasma S100B and inflammatory markers. We found that concentrations of S100B were elevated in schizophrenia patients than healthy participants (p < 0.05), and were negatively related with the severity of symptoms (p = 0.046). Receiver operating characteristic (ROC) curve analysis showed that different S100B levels between schizophrenia and healthy participants can be used as a clinical diagnostic factor (predictive value: 0.666, p = 0.015). Multiple linear regression analysis found that length of illness (Beta = −0.161), plasma levels of inflammatory regulation factors (including TGF-β1, logIL-23 and logIL-10) (Beta = 0.119, 0.475, 0.514) were independently associated with concentrations of S100B (Adjusted R2 = 0.897, p < 0.001). Therefore, our results suggest the possible function of S100B in pathogenesis of schizophrenia, and implicate the important role of autoimmune response and balance to glial dysfunction in patients with schizophrenia. PMID:27279465

  17. MicroRNA-382 expression is elevated in the olfactory neuroepithelium of schizophrenia patients.

    PubMed

    Mor, Eyal; Kano, Shin-Ichi; Colantuoni, Carlo; Sawa, Akira; Navon, Ruth; Shomron, Noam

    2013-07-01

    Schizophrenia is a common neuropsychiatric disorder that has a strong genetic component. MicroRNAs (miRNAs) have been implicated in neurodevelopmental and psychiatric disorders including schizophrenia, as indicated by their dysregulation in post-mortem brain tissues and in peripheral blood of schizophrenia patients. The olfactory epithelium (OE) is one of the few accessible neural tissues that contain neurons and their stem cells. Previous studies showed that OE-derived tissues and cells can be safely and easily collected from live human subjects and may provide a "window" into neuronal processes involved in disorders such as schizophrenia, while avoiding the limitations of using postmortem brain samples or non-neuronal tissues. In this study, we found that the brain-enriched miR-382 (miR-382-5p) expression was elevated in in vitro cultured olfactory cells, in a cohort of seven schizophrenia patients compared with seven non-schizophrenic controls. MiR-382 elevation was further confirmed in laser-capture microdissected OE neuronal tissue (LCM-OE), enriched for mature olfactory neurons, in a cohort of 18 schizophrenia patients and 18 non-schizophrenic controls. In sharp contrast, miR-382 expression could not be detected in lymphoblastoid cell lines generated from schizophrenic or non-schizophrenic individuals. We further found that miR-382 directly regulates the expression of two genes, FGFR1 and SPRY4, which are downregulated in both the cultured olfactory cells and LCM-OE derived from schizophrenia patients. These genes are involved in the fibroblast growth factor (FGF) signaling pathway, while impairment of this pathway may underlie abnormal brain development and function associated with schizophrenia. Our data suggest that miR-382 elevation detected in patients' OE-derived samples might serve to strengthen current biomarker studies in schizophrenia. This study also illustrates the potential utility of OE-derived tissues and cells as surrogate samples for the

  18. Endurance training in patients with schizophrenia and healthy controls: differences and similarities.

    PubMed

    Keller-Varady, Katriona; Hasan, Alkomiet; Schneider-Axmann, Thomas; Hillmer-Vogel, Ursula; Adomßent, Björn; Wobrock, Thomas; Schmitt, Andrea; Niklas, Andree; Falkai, Peter; Malchow, Berend

    2016-08-01

    The aims were to examine the feasibility of and adaptations to endurance training in persons diagnosed with schizophrenia and to address the question whether the principles and beneficial effects of endurance training established in the healthy population apply also to patients with schizophrenia. In this controlled interventional study, 22 patients with schizophrenia and 22 healthy controls performed a standardized aerobic endurance training on bicycle ergometers over 12 weeks. Another group of 21 patients with schizophrenia played table soccer. Endurance capacity was measured with incremental cycle ergometry before and after the intervention and 3 months later. A specific set of outcome parameters was defined. The training stimuli can be assumed to be similar in both endurance groups. Endurance capacity improved significantly in the endurance groups, but not in the table soccer group. Patients and healthy controls showed comparable adaptations to endurance training, as assessed by physical working capacity and maximal achieved power. Differences were found in changes of performance at a lactate concentration of 3 mmol/l. Endurance training was feasible and effective in both groups. The principles and types of training that are usually applied to healthy controls need to be verified in patients with schizophrenia. Nevertheless, patients benefited from endurance training in terms of improvement of endurance capacity and reduction in the baseline deficit in comparison with healthy controls. Therefore, endurance training should be implemented in future therapy programs. These programs need to pay special attention to the differences between patients with schizophrenia and healthy controls. PMID:26541835

  19. Differential Neurodevelopmental Trajectories in Patients With Early-Onset Bipolar and Schizophrenia Disorders

    PubMed Central

    Arango, Celso

    2014-01-01

    Schizophrenia and bipolar disorders share not only clinical features but also some risk factors such as genetic markers and childhood adversity, while other risk factors such as urbanicity and obstetric complications seem to be specific to schizophrenia. An intriguing question is whether the well-established abnormal neurodevelopment present in many children and adolescents who eventually develop schizophrenia is also present in bipolar patients. The literature on adult bipolar patients is controversial. We report data on a subgroup of patients with pediatric-onset psychotic bipolar disorder who seem to share some developmental trajectories with patients with early-onset schizophrenia. These early-onset psychotic bipolar patients have low intelligence quotient, more neurological signs, reduced frontal gray matter at the time of their first psychotic episode, and greater brain changes than healthy controls in a pattern similar to early-onset schizophrenia cases. However, patients with early-onset schizophrenia seem to have more social impairment, developmental abnormalities (eg, language problems), and lower academic achievement in childhood than early-onset bipolar patients. We suggest that some of these abnormal developmental trajectories are more related to the phenotypic features (eg, early-onset psychotic symptoms) of these 2 syndromes than to categorically defined Diagnostic and Statistical Manual of Mental Disorders disorders. PMID:24371326

  20. Differential neurodevelopmental trajectories in patients with early-onset bipolar and schizophrenia disorders.

    PubMed

    Arango, Celso; Fraguas, David; Parellada, Mara

    2014-03-01

    Schizophrenia and bipolar disorders share not only clinical features but also some risk factors such as genetic markers and childhood adversity, while other risk factors such as urbanicity and obstetric complications seem to be specific to schizophrenia. An intriguing question is whether the well-established abnormal neurodevelopment present in many children and adolescents who eventually develop schizophrenia is also present in bipolar patients. The literature on adult bipolar patients is controversial. We report data on a subgroup of patients with pediatric-onset psychotic bipolar disorder who seem to share some developmental trajectories with patients with early-onset schizophrenia. These early-onset psychotic bipolar patients have low intelligence quotient, more neurological signs, reduced frontal gray matter at the time of their first psychotic episode, and greater brain changes than healthy controls in a pattern similar to early-onset schizophrenia cases. However, patients with early-onset schizophrenia seem to have more social impairment, developmental abnormalities (eg, language problems), and lower academic achievement in childhood than early-onset bipolar patients. We suggest that some of these abnormal developmental trajectories are more related to the phenotypic features (eg, early-onset psychotic symptoms) of these 2 syndromes than to categorically defined Diagnostic and Statistical Manual of Mental Disorders disorders. PMID:24371326

  1. Effects of sentence context on lexical ambiguity resolution in patients with schizophrenia.

    PubMed

    Andreou, Christina; Tsapkini, Kyrana; Bozikas, Vasilis P; Giannakou, Maria; Karavatos, Athanasios; Nimatoudis, Ioannis

    2009-03-01

    Previous research has suggested that a failure in processing contextual information may account for the heterogeneous clinical manifestations and cognitive impairments observed in schizophrenia. In the domain of language, context processing in schizophrenia has been investigated mostly with single-word semantic priming paradigms; however, natural language comprehension depends on more than semantic relations between words. The present study aimed to systematically assess sentence context effects in homonym meaning activation in patients with schizophrenia. Fourteen patients with schizophrenia and 14 normal controls matched to the patients on sex, age, education and parental education, were examined using a cross-modal priming paradigm. Primes were sentences biasing the first, second, or neither meaning of a sentence-final equibiased homonym; targets were related to either the first or the second meaning of the homonym and appeared after an interstimulus interval (ISI) of 0ms or 750ms. Patients with schizophrenia exhibited a trend towards facilitation of both target types following unbiased sentences at ISI=0ms, similar to controls. However, in contrast to the pattern of selective target facilitation exhibited by control subjects following first- or second meaning-biased sentences, no significant target facilitation was observed in patients in the same condition. At ISI=750ms, patients did no longer exhibit significant target facilitation in any sentence context condition. This pattern of results is compatible with the assumption of a combined impairment in lexical (automatic spreading of activation within the semantic network) and extralexical (working memory) processes in patients with schizophrenia. PMID:19162050

  2. Rate of Family Violence Among Patients With Schizophrenia in Japan.

    PubMed

    Kageyama, Masako; Yokoyama, Keiko; Nagata, Satoko; Kita, Sachiko; Nakamura, Yukako; Kobayashi, Sayaka; Solomon, Phyllis

    2015-09-01

    Family violence is a serious concern in the era of deinstitutionalization in Japan. Consequently, we aimed to clarify the rate of family violence among patients with schizophrenia, and differences by sex and relationship to the patient. We asked households belonging to a family group association to complete a self-administered mail survey. Of 350 households that responded, data for 302 were analyzed. The rate of violence toward any family member was 60.9% over the lifetime and 27.2% in the past year. Order of lifetime rates for family members from highest to lowest was 51.0% for mothers, 47.0% for fathers, 30.7% for younger sisters, 23.8% for spouses, 19.5% for younger brothers, 18.2% for older sisters, 17.1% for older brothers, and none for children. Younger sisters were more likely to be victims compared to other siblings. Fathers and older brothers were likely to be victims when patients were male. PMID:26182940

  3. Arrhythmogenic right ventricular cardiomyopathy in a patient with schizophrenia

    PubMed Central

    Kawasaki, Kenta; Miyaji, Kotaro; Kodera, Satoshi; Suzuki, Yoshio; Kanda, Junji; Ikeda, Masayuki

    2015-01-01

    Key Clinical Message People with schizophrenia are at greater risk of cardiovascular morbidity and mortality than the general population. Arrhythmogenic right ventricular cardiomyopathy is a recognized cause of sudden cardiac death in young people. This report discusses the necessity for close cardiac evaluation to reduce incidence of sudden death in people with schizophrenia. PMID:25984311

  4. Prevalence of Antipsychotic Polypharmacy and Associated Factors among Outpatients with Schizophrenia Attending Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

    PubMed Central

    Tesfaye, Siranesh; Debencho, Nigussie; Kisi, Teresa; Tareke, Minale

    2016-01-01

    Background. Despite recommendations by guidelines to avoid combinations of antipsychotics unless after multiple trials of antipsychotic monotherapy, it is quite a common practice to use combinations. This practice leads to unnecessary expenses and exposes the patient to severe drug adverse effects. Methods. An institution based cross-sectional study was conducted from April to May 2014. Systematic random sampling technique was used to select 423 study subjects. Logistic regression analysis was conducted to identify associated factors of antipsychotic polypharmacy among schizophrenia outpatients. Result. The overall prevalence of antipsychotic polypharmacy was found to be 28.2%. Extra pyramidal side effects (AOR = 2.80; 95% CI: 1.38, 5.71), repeated psychiatric hospitalization (AOR = 2.83; 95% CI: 1.45, 5.50), history of substance use (AOR = 2.82; 95% CI: 1.36, 5.88), longer duration of treatment (AOR = 2.10; 95% CI: 1.14, 3.87), and drug nonadherence (AOR = 1.84; 95% CI: 1.14, 2.98) were found to be significantly associated with antipsychotic polypharmacy. Conclusion. Prevalence of antipsychotic polypharmacy was found to be high among the current study participants. Individuals who had extra pyramidal side effects, admission, substance use, duration of treatment, and drug nonadherence were associated with antipsychotic polypharmacy. PMID:26904586

  5. Lack of tolerable treatment options for patients with schizophrenia

    PubMed Central

    Citrome, Leslie; Eramo, Anna; Francois, Clement; Duffy, Ruth; Legacy, Susan N; Offord, Steve J; Krasa, Holly B; Johnston, Stephen S; Guiraud-Diawara, Alice; Kamat, Siddhesh A; Rohman, Patricia

    2015-01-01

    Purpose Atypical antipsychotics (AAs), an effective treatment for schizophrenia, have a range of pharmacologic properties leading to differences in tolerability as well as heterogeneity in treatment response. Individual patient characteristics must be considered when making treatment choices, especially from an adverse event (AE) or tolerability perspective. Despite the availability of numerous AAs, after appraising patient characteristics at the time of treatment selection, physicians may quickly run out of tolerable treatment options. Patients and methods AE risk factors, defined as having either a prior history of an AE or a risk factor for that AE, were determined for Medicaid-insured and Commercially insured patients using database analysis. Patients receiving AA treatment between January 1, 2010 and December 31, 2012 defined the index date of first observed AA prescription during this period. Nine AAs were evaluated for association with AE risk factors as informed by drug prescribing information from the different manufacturers and published meta-analyses. The proportion of patients with pre-index AE risk factors prescribed an AA associated with that risk factor was then determined. Results A high proportion of patients (>80%) were prescribed an AA associated with extrapyramidal symptoms or akathisia despite experiencing extrapyramidal symptoms or akathisia prior to AA treatment initiation. Similar trends were observed among patients with diabetes (>60%) and obesity (>40%). From the nine treatment options available, the number of optimal choices for individual patient segments were limited based on their prior history, including those with cardiometabolic and cardiovascular comorbidities (four); experiencing prolactin elevation-related problems (seven); needing to avoid excessive sedation (four); or at risk of extrapyramidal symptoms or akathisia (two). Options were then further restricted among patients in more than one segment when multiple pre-index AE

  6. Effects of Auricular Acupressure on Body Weight Parameters in Patients with Chronic Schizophrenia

    PubMed Central

    Ching, Han-Yi; Wu, Shang-Liang; Chen, Wen-Chi; Hsieh, Ching-Liang

    2012-01-01

    Auricular acupressure is widely used in complementary and alternative medicine to reduce body weight, but little is known about the effects of auricular acupressure on body weight parameters in patients with chronic schizophrenia. The purpose of this study was to evaluate the effects of auricular acupressure on body weight parameters in patients with chronic schizophrenia. Eighty-six inpatients with schizophrenia were recruited from chronic wards in a psychiatric center. The participants were randomly divided into experimental (acupressure at 4 acupuncture sites: hunger, stomach, shenmen and endocrine) and control groups, and body weight parameters were determined weekly for 8 weeks. There was no significant difference between the experimental and control groups in mean body weight, waist circumference, or body fat percentage at the pretest or during the entire 8-week study period. Therefore, auricular acupressure did not cause body weight reduction in patients with chronic schizophrenia. PMID:22997527

  7. Impaired ability to give a meaning to personally significant events in patients with schizophrenia.

    PubMed

    Berna, Fabrice; Bennouna-Greene, Mehdi; Potheegadoo, Jevita; Verry, Paulina; Conway, Martin A; Danion, Jean-Marie

    2011-09-01

    Schizophrenia is a severe mental illness affecting sense of identity. Autobiographical memory deficits observed in schizophrenia could contribute to this altered sense of identity. The ability to give a meaning to personally significant events (meaning making) is also critical for identity construction and self-coherence. Twenty-four patients with schizophrenia and 24 control participants were asked to recall five self-defining memories. We assessed meaning making in participants' narratives (spontaneous meaning making) and afterwards asked them explicitly to give a meaning to their memories (cued meaning making). We found that both spontaneous and cued meaning making were impaired in patients with schizophrenia. This impairment was correlated with executive dysfunctions and level of negative symptoms. Our results suggest that patients' difficulties in drawing lessons about past experiences could contribute to explain the lack of coherence observed in their life trajectories and their impaired social adjustment abilities. Implications for psychotherapy are also discussed. PMID:21459619

  8. Category fluency performance in patients with schizophrenia and bipolar disorder: The influence of affective categories.

    PubMed

    Rossell, Susan L

    2006-02-28

    Semantic fluency (SF) and phonological fluency (PF) were examined in large groups of schizophrenia patients, bipolar patients and controls. As well as standard SF categories (animals and food), fluency to two affective categories, happy and fear was measured, i.e. participants were asked to produce as many words as they could that resulted in or are associated with fear or happiness. Schizophrenia patients showed SF and PF deficits. Bipolar patients showed PF deficits. Thus, PF is argued to be a good cognitive marker in both disorders. Severity of delusions was related to SF performance in all patients. The patient groups showed different patterns on the affective categories compared to controls: the bipolar patients were better and produced more words, especially to the happiness category, and the schizophrenia patients were impaired and produced less words. The results suggest an interesting interaction between psychotic illnesses, fluency and emotion. PMID:16376054

  9. Patient (customer) expectations in hospitals.

    PubMed

    Bostan, Sedat; Acuner, Taner; Yilmaz, Gökhan

    2007-06-01

    The expectations of patient are one of the determining factors of healthcare service. The purpose of this study is to measure the Patients' Expectations, based on Patient's Rights. This study was done with Likert-Survey in Trabzon population. The analyses showed that the level of the expectations of the patient was high on the factor of receiving information and at an acceptable level on the other factors. Statistical meaningfulness was determined between age, sex, education, health insurance, and the income of the family and the expectations of the patients (p<0.05). According to this study, the current legal regulations have higher standards than the expectations of the patients. The reason that the satisfaction of the patients high level is interpreted due to the fact that the level of the expectation is low. It is suggested that the educational and public awareness studies on the patients' rights must be done in order to increase the expectations of the patients. PMID:17028043

  10. Inefficient DMN Suppression in Schizophrenia Patients with Impaired Cognitive Function but not Patients with Preserved Cognitive Function

    PubMed Central

    Zhou, Li; Pu, Weidan; Wang, Jingjuan; Liu, Haihong; Wu, Guowei; Liu, Chang; Mwansisya, Tumbwene E.; Tao, Haojuan; Chen, Xudong; Huang, Xiaojun; Lv, Dongsheng; Xue, Zhimin; Shan, Baoci; Liu, Zhening

    2016-01-01

    Previous studies have observed reduced suppression of the default mode network (DMN) during cognitive tasks in schizophrenia, suggesting inefficient DMN suppression is critical for the cognitive deficits of schizophrenia. Cognitive function in schizophrenia patients, however, varies from relatively intact to severely impaired. This study, which compared the DMN suppression patterns between first-episode schizophrenia patients with (SZ-Imp) and without (SZ-Pre) impaired cognitive function, may provide further insight into the role of DMN dysfunction in cognitive deficits of schizophrenia. Independent component analysis (ICA) was applied to resting-state fMRI data to identify the DMN in each subject, and then general linear modeling based on the task-fMRI data was used to examine the different DMN activation patterns between groups. We observed that the SZ-Imp group, but not the SZ-Pre group, showed reduced suppression in the medial prefrontal cortex and posterior cingulated cortex when compared to the healthy controls (HC) group. Moreover, less DMN suppression was associated with poorer task performance in both HC and patient groups. Our findings provide the first direct evidence that disrupted DMN activity only exists in schizophrenia patients with impaired cognitive function, supporting the specific neuro-pathological role of inefficient DMN suppression in cognitive deficits of first-episode schizophrenia. PMID:26882844

  11. Inefficient DMN Suppression in Schizophrenia Patients with Impaired Cognitive Function but not Patients with Preserved Cognitive Function.

    PubMed

    Zhou, Li; Pu, Weidan; Wang, Jingjuan; Liu, Haihong; Wu, Guowei; Liu, Chang; Mwansisya, Tumbwene E; Tao, Haojuan; Chen, Xudong; Huang, Xiaojun; Lv, Dongsheng; Xue, Zhimin; Shan, Baoci; Liu, Zhening

    2016-01-01

    Previous studies have observed reduced suppression of the default mode network (DMN) during cognitive tasks in schizophrenia, suggesting inefficient DMN suppression is critical for the cognitive deficits of schizophrenia. Cognitive function in schizophrenia patients, however, varies from relatively intact to severely impaired. This study, which compared the DMN suppression patterns between first-episode schizophrenia patients with (SZ-Imp) and without (SZ-Pre) impaired cognitive function, may provide further insight into the role of DMN dysfunction in cognitive deficits of schizophrenia. Independent component analysis (ICA) was applied to resting-state fMRI data to identify the DMN in each subject, and then general linear modeling based on the task-fMRI data was used to examine the different DMN activation patterns between groups. We observed that the SZ-Imp group, but not the SZ-Pre group, showed reduced suppression in the medial prefrontal cortex and posterior cingulated cortex when compared to the healthy controls (HC) group. Moreover, less DMN suppression was associated with poorer task performance in both HC and patient groups. Our findings provide the first direct evidence that disrupted DMN activity only exists in schizophrenia patients with impaired cognitive function, supporting the specific neuro-pathological role of inefficient DMN suppression in cognitive deficits of first-episode schizophrenia. PMID:26882844

  12. A Novel Approach to Determining Violence Risk in Schizophrenia: Developing a Stepped Strategy in 13,806 Discharged Patients

    PubMed Central

    Singh, Jay P.; Grann, Martin; Lichtenstein, Paul; Långström, Niklas; Fazel, Seena

    2012-01-01

    Clinical guidelines recommend that violence risk be assessed in schizophrenia. Current approaches are resource-intensive as they employ detailed clinical assessments of dangerousness for most patients. An alternative approach would be to first screen out patients at very low risk of future violence prior to more costly and time-consuming assessments. In order to implement such a stepped strategy, we developed a simple tool to screen out individuals with schizophrenia at very low risk of violent offending. We merged high quality Swedish national registers containing information on psychiatric diagnoses, socio-demographic factors, and violent crime. A cohort of 13,806 individuals with hospital discharge diagnoses of schizophrenia was identified and followed for up to 33 years for violent crime. Cox regression was used to determine risk factors for violent crime and construct the screening tool, the predictive validity of which was measured using four outcome statistics. The instrument was calibrated on 6,903 participants and cross-validated using three independent replication samples of 2,301 participants each. Regression analyses resulted in a tool composed of five items: male sex, previous criminal conviction, young age at assessment, comorbid alcohol abuse, and comorbid drug abuse. At 5 years after discharge, the instrument had a negative predictive value of 0.99 (95% CI = 0.98–0.99), meaning that very few individuals who the tool screened out (n = 2,359 out of original sample of 6,903) were subsequently convicted of a violent offence. Screening out patients who are at very low risk of violence prior to more detailed clinical assessment may assist the risk assessment process in schizophrenia. PMID:22359622

  13. A Hospital-based Patient Legal Clinic.

    PubMed

    Bishop, Liz; Shahkhan, Hana; Loff, Bebe

    2016-03-01

    The HeLP Patient Legal Clinic has provided free legal advice to public hospital patients with health-related problems since March 2014. This article reports on the findings of a study of the first six months of HeLP's operation. The study adopted qualitative methods informed by grounded theory and sought to understand patient and social worker experiences of HeLP. Interviews were conducted with 13 patients and 10 next of kin. Focus group discussions were carried out with 19 social workers who referred patients to HeLP. Locating the legal service in the hospital's social work department enabled and expedited access to legal advice; a team-based approach to patient problems emerged that enhanced patient outcomes; and provision of legal advice relieved the anxiety experienced by patients, allowing them to focus better on their health concern. PMID:27323643

  14. DRD2 Schizophrenia-Risk Allele Is Associated With Impaired Striatal Functioning in Unaffected Siblings of Schizophrenia Patients.

    PubMed

    Vink, Matthijs; de Leeuw, Max; Luykx, Jurjen J; van Eijk, Kristel R; van den Munkhof, Hanna E; van Buuren, Mariët; Kahn, René S

    2016-05-01

    A recent Genome-Wide Association Study showed that the rs2514218 single nucleotide polymorphism (SNP) in close proximity to dopamine receptor D2 is strongly associated with schizophrenia. Further, an in silico experiment showed that rs2514218 has a cis expression quantitative trait locus effect in the basal ganglia. To date, however, the functional consequence of this SNP is unknown. Here, we used functional Magnetic resonance imaging to investigate the impact of this risk allele on striatal activation during proactive and reactive response inhibition in 45 unaffected siblings of schizophrenia patients. We included siblings to circumvent the illness specific confounds affecting striatal functioning independent from gene effects. Behavioral analyses revealed no differences between the carriers (n= 21) and noncarriers (n= 24). Risk allele carriers showed a diminished striatal response to increasing proactive inhibitory control demands, whereas overall level of striatal activation in carriers was elevated compared to noncarriers. Finally, risk allele carriers showed a blunted striatal response during successful reactive inhibition compared to the noncarriers. These data are consistent with earlier reports showing similar deficits in schizophrenia patients, and point to a failure to flexibly engage the striatum in response to contextual cues. This is the first study to demonstrate an association between impaired striatal functioning and the rs2514218 polymorphism. We take our findings to indicate that striatal functioning is impaired in carriers of the DRD2 risk allele, likely due to dopamine dysregulation at the DRD2 location. PMID:26598739

  15. Social Motor Coordination in Unaffected Relatives of Schizophrenia Patients: A Potential Intermediate Phenotype

    PubMed Central

    Del-Monte, Jonathan; Capdevielle, Delphine; Varlet, Manuel; Marin, Ludovic; Schmidt, Richard C.; Salesse, Robin N.; Bardy, Benoît G.; Boulenger, Jean Philippe; Gély-Nargeot, Marie Christine; Attal, Jérôme; Raffard, Stéphane

    2013-01-01

    Intermediate endophenotypes emerge as an important concept in the study of schizophrenia. Although research on phenotypes mainly investigated cognitive, metabolic or neurophysiological markers so far, some authors also examined the motor behavior anomalies as a potential trait-marker of the disease. However, no research has investigated social motor coordination despite the possible importance of its anomalies in schizophrenia. The aim of this study was thus to determine whether coordination modifications previously demonstrated in schizophrenia are trait-markers that might be associated with the risk for this pathology. Interpersonal motor coordination in 27 unaffected first-degree relatives of schizophrenia patients and 27 healthy controls was assessed using a hand-held pendulum task to examine the presence of interpersonal coordination impairments in individuals at risk for the disorder. Measures of neurologic soft signs, clinical variables and neurocognitive functions were collected to assess the cognitive and clinical correlates of social coordination impairments in at-risk relatives. After controlling for potential confounding variables, unaffected relatives of schizophrenia patients had impaired intentional interpersonal coordination compared to healthy controls while unintentional interpersonal coordination was preserved. More specifically, in intentional coordination, the unaffected relatives of schizophrenia patients exhibited coordination patterns that had greater variability and in which relatives did not lead the coordination. These results show that unaffected relatives of schizophrenia patients, like the patients themselves, also present deficits in intentional interpersonal coordination. For the first time, these results suggest that intentional interpersonal coordination impairments might be a potential motor intermediate endophenotype of schizophrenia opening new perspectives for early diagnosis. PMID:24106467

  16. Understanding the needs of relatives of patients within a special hospital for mentally disordered offenders: a basis for improved services.

    PubMed

    McCann, G; McKeown, M; Porter, I

    1996-02-01

    This paper outlines one component of a major research study, which will form the basis for a new service for relatives of schizophrenia sufferers within a special hospital. The aim of this initial component has been twofold: firstly to identify and understand the needs of relatives in terms of their present knowledge and understanding of schizophrenia; and secondly to establish what stress the relatives are presently experiencing in maintaining contact with patients and whether this stress may have an impact on the management of schizophrenia at the hospital. A purposive sample of 17 relatives were interviewed using two semi-structured interview protocols. All interviews were audio-taped and later transcribed for analysis. The data have provided an illuminating insight into the thoughts and feelings of relatives and indicate many ways in which a service for relatives could be tailored. It is apparent that many relatives are currently not being supported, involved or allowed to contribute to the care of their family member at Ashworth Hospital. This present situation is stressful for relatives and is likely to have a detrimental effect on the course of schizophrenia in patients at Ashworth Hospital. PMID:8708249

  17. Alterations of Functional and Structural Networks in Schizophrenia Patients with Auditory Verbal Hallucinations

    PubMed Central

    Zhu, Jiajia; Wang, Chunli; Liu, Feng; Qin, Wen; Li, Jie; Zhuo, Chuanjun

    2016-01-01

    Background: There have been many attempts at explaining the underlying neuropathological mechanisms of auditory verbal hallucinations (AVH) in schizophrenia on the basis of regional brain changes, with the most consistent findings being that AVH are associated with functional and structural impairments in auditory and speech-related regions. However, the human brain is a complex network and the global topological alterations specific to AVH in schizophrenia remain unclear. Methods: Thirty-five schizophrenia patients with AVH, 41 patients without AVH, and 50 healthy controls underwent resting-state functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI). The whole-brain functional and structural networks were constructed and analyzed using graph theoretical approaches. Inter-group differences in global network metrics (including small-world properties and network efficiency) were investigated. Results: We found that three groups had a typical small-world topology in both functional and structural networks. More importantly, schizophrenia patients with and without AVH exhibited common disruptions of functional networks, characterized by decreased clustering coefficient, global efficiency and local efficiency, and increased characteristic path length; structural networks of only schizophrenia patients with AVH showed increased characteristic path length compared with those of healthy controls. Conclusion: Our findings suggest that less “small-worldization” and lower network efficiency of functional networks may be an independent trait characteristic of schizophrenia, and regularization of structural networks may be the underlying pathological process engaged in schizophrenic AVH symptom expression. PMID:27014042

  18. A Population-Based Cohort Study on Peripheral Arterial Disease in Patients with Schizophrenia

    PubMed Central

    Hsu, Wen-Yu; Lin, Cheng-Li; Kao, Chia-Hung

    2016-01-01

    Purpose Peripheral arterial disease (PAD) is considered the leading cause of atherosclerotic cardiovascular morbidity. Several risk factors of PAD have been observed in patients with schizophrenia. Therefore, we hypothesize that the incidence of PAD is higher in the schizophrenia population than in the general population. Methods The patients in this population-based cohort study were selected from the Taiwanese National Health Insurance Research Database on the basis of the claims data from 2000 to 2011. We compared the incidence of PAD between schizophrenia and nonschizophrenia cohorts. Cox proportional hazard regression models were employed for analyzing the risk of PAD after adjustment for sex, age, and comorbidities. Results The adjusted hazard ratio (HR) for PAD in the schizophrenia cohort was 1.26-fold higher than that in the nonschizophrenia cohort. Furthermore, patients with schizophrenia using atypical antipsychotics exhibited a high adjusted HR for PAD. Conclusion Compared with the general population, the risk of PAD is higher among patients with schizophrenia. Early diagnosis and intervention can mitigate complications resulting from cardiovascular diseases and lower mortality. PMID:26871697

  19. Cognitive emotion regulation in patients with schizophrenia: Evidence for effective reappraisal and distraction.

    PubMed

    Grezellschak, Sarah; Lincoln, Tania M; Westermann, Stefan

    2015-09-30

    Negative emotions trigger psychotic symptoms, according to a growing body of evidence. Thus, there is a need for effective emotion regulation in schizophrenia. Reappraisal is an effective, cognitive emotion regulation strategy in healthy individuals. However, it is an open research question whether individuals with schizophrenia have difficulties in successfully applying reappraisal. This study experimentally tests the efficacy of reappraisal compared to distraction in patients with schizophrenia and non-clinical controls. An experimental design with group as between-subject factor (non-clinical controls versus patients with schizophrenia) and emotion regulation during anxiety induction as within-subject factor (reappraisal, distraction, no regulation). Seventeen patients with schizophrenia and 27 healthy participants were instructed to respond to anxiety-inducing stimuli by either using reappraisal, distraction or by just watching. Both reappraisal and distraction were effective in down-regulating anxiety, compared to no regulation. The main effect of group and the interaction of emotion regulation condition and group were not significant indicating that the efficacy of both cognitive emotion regulation strategies was independent of group. Patients with schizophrenia are able to apply reappraisal successfully under experimental conditions. Conclusions are limited by the small sample size of this pilot study. Clinical implications for cognitive behavioral therapy for psychosis are discussed. PMID:26231583

  20. Gray Matter Volume Decreases in Elderly Patients with Schizophrenia: A Voxel-based Morphometry Study

    PubMed Central

    Schuster, Caroline; Schuller, Anne Marie; Paulos, Carlos; Namer, Izzie; Pull, Charles; Danion, Jean Marie; Foucher, Jack René

    2012-01-01

    Background: Aged patients (>50 years old) with residual schizophrenic symptoms differ from young patients. They represent a subpopulation with a more unfavorable Kraepelinian course and have an increased risk (up to 30%) for dementia of unknown origin. However, our current understanding of age-related brain changes in schizophrenia is derived from studies that included less than 17% of patients who were older than 50 years of age. This study investigated the anatomical distribution of gray matter (GM) brain deficits in aged patients with ongoing schizophrenia. Methods: Voxel-based morphometry was applied to 3D-T1 magnetic resonance images obtained from 27 aged patients with schizophrenia (mean age of 60 years) and 40 age-matched normal controls. Results: Older patients with schizophrenia showed a bilateral reduction of GM volume in the thalamus, the prefrontal cortex, and in a large posterior region centered on the occipito-temporo-parietal junction. Only the latter region showed accelerated GM volume loss with increasing age. None of these results could be accounted for by institutionalization, antipsychotic medication, or cognitive scores. Conclusions: This study replicated most common findings in patients with schizophrenia with regard to thalamic and frontal GM deficits. However, it uncovered an unexpected large region of GM atrophy in the posterior tertiary cortices. The latter observation may be specific to this aged and chronically symptomatic subpopulation, as atrophy in this region is rarely reported in younger patients and is accelerated with age. PMID:21205677

  1. Magnet Hospitals: Higher Rates of Patient Satisfaction.

    PubMed

    Smith, Sarah A

    2014-06-10

    Patient satisfaction with care is an important indicator of quality of care. As of 2013-2014, 30% of the Value-Based Purchasing score Medicare is using to determine hospital reimbursement is based on patient reports of care. This study determined whether significant relationships exists between Magnet (N = 160), Magnet-in-progress (N = 99), and non-Magnet hospital (N = 1,742) status and the highest ratings on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey questions related to patient satisfaction with care. This study was a secondary analysis of data collected and compiled from three sources (the American Hospital Association, American Nurses Credentialing Center, and HCAHPS databases). Analysis revealed that Magnet and Magnet-in-progress hospitals have significantly (p < .007) higher scores than non-Magnet hospitals on six of the seven questions regarding patient-reported satisfaction with care. The implications of these results for nursing are discussed. PMID:24915864

  2. Premorbid Cognitive Deficits in Young Relatives of Schizophrenia Patients

    PubMed Central

    Keshavan, Matcheri S.; Kulkarni, Shreedhar; Bhojraj, Tejas; Francis, Alan; Diwadkar, Vaibhav; Montrose, Debra M.; Seidman, Larry J.; Sweeney, John

    2009-01-01

    Neurocognitive deficits in schizophrenia (SZ) are thought to be stable trait markers that predate the illness and manifest in relatives of patients. Adolescence is the age of maximum vulnerability to the onset of SZ and may be an opportune “window” to observe neurocognitive impairments close to but prior to the onset of psychosis. We reviewed the extant studies assessing neurocognitive deficits in young relatives at high risk (HR) for SZ and their relation to brain structural alterations. We also provide some additional data pertaining to the relation of these deficits to psychopathology and brain structural alterations from the Pittsburgh Risk Evaluation Program (PREP). Cognitive deficits are noted in the HR population, which are more severe in first-degree relatives compared to second-degree relatives and primarily involve psychomotor speed, memory, attention, reasoning, and social-cognition. Reduced general intelligence is also noted, although its relationship to these specific domains is underexplored. Premorbid cognitive deficits may be related to brain structural and functional abnormalities, underlining the neurobiological basis of this illness. Cognitive impairments might predict later emergence of psychopathology in at-risk subjects and may be targets of early remediation and preventive strategies. Although evidence for neurocognitive deficits in young relatives abounds, further studies on their structural underpinnings and on their candidate status as endophenotypes are needed. PMID:20300465

  3. Bizarre Delusions: A Qualitative Study on Indian Schizophrenia Patients

    PubMed Central

    De, Sreeja; Bhatia, Triptish; Thomas, Pramod; Chakraborty, Satabdi; Prasad, Shiv; Nagpal, Rajesh; Nimgaonkar, Vishwajit L.; Deshpande, Smita N.

    2013-01-01

    Background: Delusions are an important symptom for the diagnosis of schizophrenia (SZ) in both the commonly used international classificatory systems - the Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV - American Psychiatric Association, 2000) and the International Classification of Diseases, X (ICD X - World Health Organization, 1992). Of special significance are “bizarre delusions” the presence of which is alone sufficient for a diagnosis of SZ in DSM IV. In an attempt to find out the frequency, criteria for classification, and other clinical aspects of bizarre delusions and justification of their importance in the diagnostic system, this retrospective study was conducted. Methodology: Records of 1952 Indian patients affected with SZ, recruited for various research projects at one center were included in this study. All had a diagnosis of DSM IV SZ; all symptoms of SZ from the Diagnostic Interview for Genetic Studies were asked regardless of the presence of specific symptoms - like bizarre delusions - sufficient for diagnosis. Results: The prevalence of bizarre delusions was 2.56%. Five themes, identified on analyzing their contents are described. Main themes were unnatural, bodily sensation, change in identity, sexual, and religious. Conclusions: These themes were culture based, but definitely out of context, excessive or extremely odd. Moreover, the rarity of bizarre delusions makes it difficult to include them as a sole criterion for diagnosis. PMID:24249929

  4. Obsessive compulsive symptoms in patients with Schizophrenia on Clozapine and with Obsessive Compulsive disorder: a comparison study.

    PubMed

    Doyle, Mairead; Chorcorain, Aoife Ni; Griffith, Eleanor; Trimble, Tim; O'Callaghan, Eadbard

    2014-01-01

    Obsessive compulsive symptoms are commonly reported in those with schizophrenia. Clozapine has previously been reported to induce, aggravate and alleviate these symptoms. It is unclear if these are similar to the symptoms experienced by those with obsessive compulsive disorder. This study describes the obsessive compulsive symptom profile of a population of patients with schizophrenia treated with clozapine (n = 62) and compares this with patients with Obsessive Compulsive Disorder (n = 35). All participants were attending an outpatient community mental health service. The Obsessive Compulsive Inventory (which measures the frequency and associated distress of a range of "behavioural" and "cognitive" symptoms), the Hospital Anxiety and Depression Scale and a demographic questionnaire were completed. In addition the schizophrenia group treated with clozapine completed the Brief Psychiatric Rating Scale. The OCD group reported significantly more symptoms for all OCI subscales compared to the clozapine group. Overall fourteen (22%) of the schizophrenia treated with clozapine group had clinically significant total OCI scores. Two (3%) had documented OCS pre clozapine. De novo OCS was reported in twelve (19%) cases. Nine (11%) had documented OC symptoms pre-clozapine while only two (3%) had symptoms after clozapine was initiated. In terms of OC symptom profile, the clozapine group scored highest on the Doubting scale, a cognitive symptom whereas the OCD group scored highest on Washing, a behavioural symptom. Both groups reported greater distress with cognitive rather than behavioural symptoms. Medication including clozapine dose was not correlated with symptom severity. Anxiety correlated highly with obsessive compulsive symptoms in the Clozapine group but not the OCD group. Within the Clozapine group, Obsessing correlated highly with Unusual Thought Content. Findings suggest that obsessive compulsive symptoms in the Clozapine group may reflect a subtype of 'schizo

  5. Nonlinear analysis of electroencephalogram at rest and during cognitive tasks in patients with schizophrenia

    PubMed Central

    Carlino, Elisa; Sigaudo, Monica; Pollo, Antonella; Benedetti, Fabrizio; Mongini, Tullia; Castagna, Filomena; Vighetti, Sergio; Rocca, Paola

    2012-01-01

    Background In spite of the large number of studies on schizophrenia, a full understanding of its core pathology still eludes us. The application of the nonlinear theory of electroencephalography (EEG) analysis provides an interesting tool to differentiate between physiologic conditions (e.g., resting state and mathematical task) and normal and pathologic brain activities. The aim of the present study was to investigate nonlinear EEG activity in patients with schizophrenia. Methods We recorded 19-lead EEGs in patients with stable schizophrenia and healthy controls under 4 different conditions: eyes closed, eyes open, forward counting and backward counting. A nonlinear measure of complexity was calculated by means of correlation dimension (D2). Results We included 17 patients and 17 controls in our analysis. Comparing the 2 populations, we observed greater D2 values in the patient group. In controls, increased D2 values were observed during active states (eyes open and the 2 cognitive tasks) compared with baseline conditions. This increase of brain complexity, which can be interpreted as an increase of information processing and integration, was not preserved in the patient population. Limitations Patients with schizophrenia were taking antipsychotic medications, so the presence of medication effects cannot be excluded. Conclusion Our results suggest that patients with schizophrenia present changes in brain activity compared with healthy controls, and this pathologic alteration can be successfully studied with nonlinear EEG analysis. PMID:22353633

  6. Cognitive and structural neuroimaging characteristics of schizophrenia patients with large, rare copy number deletions.

    PubMed

    Kenneth Martin, Andrew; Robinson, Gail; Reutens, David; Mowry, Bryan

    2014-12-30

    Large (>500 Kb), rare (frequency <1%) deletions are associated with risk for schizophrenia. The aim of the study was to characterise patients with these deletions using measures of cognition, grey-matter volume and white-matter integrity. Patients with schizophrenia and large, rare deletions (SZ-del) (n=17) were assessed on a test of intelligence, the Wechsler Abbreviated Scale of Intelligence (WASI), and compared with age- and sex-matched schizophrenia patients without large, rare deletions (SZ-nodel) (n=65), and healthy controls (HCs) (n=50). Regional grey-matter differences were investigated using voxel-based morphometry (SZ-del=9; SZ-nodel=26; HC=19). White-matter integrity was assessed using fractional anisotropy (SZ-del=9; SZ-nodel=24; HC=15). Compared with schizophrenia patients without large, rare deletions, those with large, rare deletions had lower IQ; greater grey-matter volume in clusters with peaks in the left and right cerebellum, left hippocampus, and right rectal gyrus; and increased white-matter anisotropy in the body and genu of the corpus callosum. Compared with healthy controls, patients with large, rare deletions had reduced grey matter volume in the right calcarine gyrus. In sum, patients with large, rare deletions had structural profiles intermediate to those observed in healthy controls and schizophrenia patients without large, rare deletions, but had greater impairment in intelligence. PMID:25453991

  7. The Hyperactivity of Efferent Auditory System in Patients with Schizophrenia: A Transient Evoked Otoacoustic Emissions Study

    PubMed Central

    Wahab, Suzaily; Abdul Rahman, Abdul Hamid; Sidek, Dinsuhaimi; Zakaria, Mohd. Normani

    2016-01-01

    Objective Electrophysiological studies, which are mostly focused on afferent pathway, have proven that auditory processing deficits exist in patients with schizophrenia. Nevertheless, reports on the suppressive effect of efferent auditory pathway on cochlear outer hair cells among schizophrenia patients are limited. The present, case-control, study examined the contralateral suppression of transient evoked otoacoustic emissions (TEOAEs) in patients with schizophrenia. Methods Participants were twenty-three healthy controls and sixteen schizophrenia patients with normal hearing, middle ear and cochlear outer hair cells function. Absolute non-linear and linear TEOAEs were measured in both ears by delivering clicks stimuli at 80 dB SPL and 60 dB SPL respectively. Subsequently, contralateral suppression was determined by subtracting the absolute TEOAEs response obtained at 60 dBpe SPL during the absence and presence of contralateral white noise delivered at 65 dB HL. No attention tasks were conducted during measurements. Results We found no significant difference in absolute TEOAEs responses at 80 dB SPL, in either diagnosis or ear groups (p>0.05). However, the overall contralateral suppression was significantly larger in schizophrenia patients (p<0.05). Specifically, patients with schizophrenia demonstrated significantly increased right ear contralateral suppression compared to healthy control (p<0.05). Conclusion The present findings suggest increased inhibitory effect of efferent auditory pathway especially on the right cochlear outer hair cells. Further studies to investigate increased suppressive effects are crucial to expand the current understanding of auditory hallucination mechanisms in schizophrenia patients. PMID:26766950

  8. Parental age effects on odor sensitivity in healthy subjects and schizophrenia patients.

    PubMed

    Malaspina, Dolores; Walsh-Messinger, Julie; Antonius, Daniel; Dracxler, Roberta; Rothman, Karen; Puthota, Jennifer; Gilman, Caitlin; Feuerstein, Jessica L; Keefe, David; Goetz, Deborah; Goetz, Raymond R; Buckley, Peter; Lehrer, Douglas S; Pato, Michele; Pato, Carlos

    2016-06-01

    A schizophrenia phenotype for paternal and maternal age effects on illness risk could benefit etiological research. As odor sensitivity is associated with variability in symptoms and cognition in schizophrenia, we examined if it was related to parental ages in patients and healthy controls. We tested Leukocyte Telomere Length (LTL) as an explanatory factor, as LTL is associated with paternal age and schizophrenia risk. Seventy-five DSM-IV patients and 46 controls were assessed for detection of PEA, WAIS-III for cognition, and LTL, assessed by qPCR. In healthy controls, but not schizophrenia patients, decreasing sensitivity was monotonically related to advancing parental ages, particularly in sons. The relationships between parental aging and odor sensitivity differed significantly for patients and controls (Fisher's R to Z: χ(2)  = 6.95, P = 0.009). The groups also differed in the association of odor sensitivity with cognition; lesser sensitivity robustly predicted cognitive impairments in patients (<0.001), but these were unassociated in controls. LTL was unrelated to odor sensitivity and did not explain the association of lesser sensitivity with cognitive deficits.Parental aging predicted less sensitive detection in healthy subjects but not in schizophrenia patients. In patients, decreased odor sensitivity strongly predicted cognitive deficits, whereas more sensitive acuity was associated with older parents. These data support separate risk pathways for schizophrenia. A parental age-related pathway may produce psychosis without impairing cognition and odor sensitivity. Diminished odor sensitivity may furthermore be useful as a biomarker for research and treatment studies in schizophrenia. © 2015 Wiley Periodicals, Inc. PMID:26224136

  9. Abnormal medial temporal activity for bound information during working memory maintenance in patients with schizophrenia.

    PubMed

    Luck, David; Danion, Jean-Marie; Marrer, Corrine; Pham, Bich-Tuy; Gounot, Daniel; Foucher, Jack

    2010-08-01

    Alterations of binding in long-term memory in schizophrenia are well established and occur as a result of aberrant activity in the medial temporal lobe (MTL). In working memory (WM), such a deficit is less clear and the pathophysiological bases remain unstudied. Seventeen patients with schizophrenia and 17 matched healthy controls performed a WM binding task while undergoing functional magnetic resonance imaging. Binding was assessed by contrasting two conditions comprising an equal amount of verbal and spatial information (i.e., three letters and three spatial locations), but differing in the absence or presence of a link between them. In healthy controls, MTL activation was observed for encoding and maintenance of bound information but not for its retrieval. Between-group comparisons revealed that patients with schizophrenia showed MTL hypoactivation during the maintenance phase only. In addition, BOLD signals correlated with behavioral performance in controls but not in patients with schizophrenia. Our results confirm the major role that the MTL plays in the pathophysiology of schizophrenia. Short-term and long-term relational memory deficits in schizophrenia may share common cognitive and functional pathological bases. Our results provide additional information about the episodic buffer that represents an integrative interface between WM and long-term memory. PMID:19693783

  10. Aberrant Functional Whole-Brain Network Architecture in Patients With Schizophrenia: A Meta-analysis.

    PubMed

    Kambeitz, Joseph; Kambeitz-Ilankovic, Lana; Cabral, Carlos; Dwyer, Dominic B; Calhoun, Vince D; van den Heuvel, Martijn P; Falkai, Peter; Koutsouleris, Nikolaos; Malchow, Berend

    2016-07-01

    Findings from multiple lines of research provide evidence of aberrant functional brain connectivity in schizophrenia. By using graph-analytical measures, recent studies indicate that patients with schizophrenia exhibit changes in the organizational principles of whole-brain networks and that these changes relate to cognitive symptoms. However, there has not been a systematic investigation of functional brain network changes in schizophrenia to test the consistency of these changes across multiple studies. A comprehensive literature search was conducted to identify all available functional graph-analytical studies in patients with schizophrenia. Effect size measures were derived from each study and entered in a random-effects meta-analytical model. All models were tested for effects of potential moderator variables as well as for the presence of publication bias. The results of a total of n = 13 functional neuroimaging studies indicated that brain networks in patients with schizophrenia exhibit significant decreases in measures of local organization (g = -0.56, P = .02) and significant decreases in small-worldness (g = -0.65, P = .01) whereas global short communication paths seemed to be preserved (g = 0.26, P = .32). There was no evidence for a publication bias or moderator effects. The present meta- analysis demonstrates significant changes in whole brain network architecture associated with schizophrenia across studies. PMID:27460615

  11. Epidemiology of hospitalized burns patients in Taiwan.

    PubMed

    Chien, Wu-Chien; Pai, Lu; Lin, Chao-Cheng; Chen, Heng-Chang

    2003-09-01

    Previous studies based on either single hospital data or sampling of specific groups of hospitalized burns victims in Taiwan have provided only minimal epidemiological information. The study is designed to provide additional data on the epidemiology of hospitalized burns patients in Taiwan. Data were obtained from the Burn Injury Information System (BIIS), which brings together information supplied by 34 contracted hospitals. The study time course spanned a 2-year period from July 1997 to June 1999. Patient characteristics (age, sex, education level, etc.), causes and severity of injuries, and medical care measures were explored. A total of 4741 patients were registered with BIIS over the study period. The majority of hospitalized patients (67%) were male. The age distribution of burns patients showed peaks occurring at the age groups of 0-5 and 35-44 years. Over the time course of a day, burn injuries occurred more frequently from 10:00 to 12:00 h and 16:00 to 18:00 h. Injuries suspected as the result of suicide, homicide or child abuse accounted for 4.8% of hospitalized cases. More than 48% of the burns occurred in the home. The leading type of burn injury was scalding, followed by naked flame, explosion, electrical burns, and chemical burns due to caustic or corrosive substances. The mean percent total body surface area (%TBSA) for adults was 19%, and for young children was 12%. The average length of hospital stay was 18 days. In conclusion, children under 5 years and adults between 35 and 44 years of age are two high-risk groups for burn injuries. Corresponding to meal preparation time, hot substances such as boiling water, hot soup, etc. are the most common agents responsible for scalds. Prevention programs for reducing the risk of burn injuries during cooking and eating are required, especially for parents with young children. PMID:12927984

  12. Adherence and rehospitalizations in patients with schizophrenia: evidence from Japanese claims data

    PubMed Central

    Kuwabara, Hiroyo; Saito, Yoshimichi; Mahlich, Jörg

    2015-01-01

    Background The aim of this study is to analyze if there is a relationship between adherence to antipsychotic medication and rehospitalization for patients diagnosed with schizophrenia in Japan. Methods Based on Japanese claims data, we constructed three patient groups based on their medication possession ratio (MPR). Controlling for potential confounders, a Cox proportional hazard model was employed to assess if medication adherence affects the risk of rehospitalization. Results Patients with good adherence (MPRs from 0.8–1.1) had the lowest rates of admission. Both poor adherence (MPRs <0.8) and overadherence (MPRs >1.1) were associated with a significant higher risk of rehospitalization with hazard ratios of 4.7 and 2.0, respectively. Conclusion The results of this study support the notion that good adherence to antipsychotic medication reduces the risk of rehospitalization of schizophrenia patients. Appropriate measures should be taken to improve adherence of schizophrenia patients. PMID:25897229

  13. Performance of Mini-Mental State Examination (MMSE) in long-stay patients with schizophrenia or schizoaffective disorders in a psychiatric institute.

    PubMed

    Ong, Hui Lin; Subramaniam, Mythily; Abdin, Edimansyah; Wang, Peizhi; Vaingankar, Janhavi Ajit; Lee, Siau Pheng; Shafie, Saleha; Seow, Esmond; Chong, Siow Ann

    2016-07-30

    Studies have found that age and education were associated with cognition in older adults. However, little is known how clinical factors (e.g. age of illness onset, length of hospital stay, type of antipsychotic medications, and duration of illness) are associated with cognitive functioning in patients with schizophrenia. This study aimed to examine the influence of socio-demographic and clinical factors on cognitive domains measured using Mini-Mental State Examination (MMSE) among patients with schizophrenia or schizoaffective disorders residing in a psychiatric institute in Singapore. A single-phase interview was conducted at the Institute of Mental Health (IMH) in patients diagnosed with schizophrenia or schizoaffective disorders (n=110). MMSE was administered to all participants. Data on socio-demographic characteristics, smoking, alcohol consumption, and medical history were collected. Age, gender, and level of education were significantly associated with MMSE scores. After adjusting for all socio-demographic correlates, longer length of hospital stay remained significant in predicting lower MMSE scores. Length of hospital stay was independently associated with cognitive functioning. Early interventions for cognition such as physical and mental exercises should be implemented for better prognosis. PMID:27203153

  14. Selenium, zinc, and copper plasma levels in patients with schizophrenia: relationship with metabolic risk factors.

    PubMed

    Vidović, Bojana; Dorđević, Brižita; Milovanović, Srđan; Škrivanj, Sandra; Pavlović, Zoran; Stefanović, Aleksandra; Kotur-Stevuljević, Jelena

    2013-12-01

    The aim of this study was to determine the plasma selenium (Se), copper (Cu), and zinc (Zn) levels and to evaluate their possible association with metabolic syndrome (MetS) components in patients with schizophrenia. The study group consisted of 60 patients with schizophrenia and 60 sex- and age-matched healthy controls. Anthropometric measurements, blood pressure, and biochemical analysis of fasting blood were performed in all subjects. Patients with schizophrenia had significantly higher plasma Cu concentrations compared with controls (0.97 ± 0.31 vs. 0.77 ± 0.32 mg/L, p = 0.001). The plasma Cu concentration showed a positive correlation with plasma glucose and diastolic blood pressure in the patient groups (r s = 0.263, p < 0.05 and r s = 0.272, p < 0.05, respectively). The plasma Se level correlated positive with MetS score (r s = 0.385, p < 0.01), waist circumference (r s = 0.344, p < 0.05), plasma glucose (r s = 0.319, p < 0.05), and triglyceride concentrations (r s = 0.462, p < 0.001) in patients with schizophrenia. Plasma Zn did not correlate with any of the MetS components. These results suggest that alterations in plasma Cu and Se levels in medicated patients with schizophrenia could be associated with metabolic risk factors. PMID:24150923

  15. [The subjective quality of life of patients with schizophrenia: influence of psychopathology and patients' expectations. A comparative study].

    PubMed

    Salomé, F; Petitjean, F; Germain, C; Demant, J-C

    2004-01-01

    Most studies on the quality of life (Qol) of patients with schizophrenia deal with objective living conditions and how they are perceived by hospitalized patients. The few studies that compare Qol for patients treated in part time services with the Qol of ambulatory patients do not show any significant difference in terms of subjective Qol. Some stu-dies evaluate the influence of psychopathology and needs (or expectations) on the subjective Qol in these groups of patients. Available data indicate that the general well-being is influenced by psychopathology (positive, negative or depressive symptoms) and unmet needs in ambulatory patients. They also show that subjective Qol in certain life domains (social relations, family relations, leisure, health, law and security) is influenced by negative symptoms, anxiety and depression in patients treated in part-time services. The aim of this study is to compare the objective and subjective Qol of patients with schizophrenia treated in part time services (day hospital and day care center) to the Qol of out-patients treated on a purely ambulatory basis (out patient clinic). We studied the Qol of 2 groups of 30 patients with schizophrenia (ICD 10 criteria) treated in various centers. The first group was made of ambulatory patients, the second one was constituted of patients treated in a day hospital or a day care center. Patients were matched for age, duration of illness, number of hospitalizations. The instruments used for rating were the following: Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), Positive And Negative Symptoms Scale (PANSS), Drug Attitude Inventory (DAI-10). The Qol was measured with a french version of the Lancashire Quality Of Life Profile (LQOLP) (Salomé, Germain, Petitjean, Demant and Boyer, 2000). This instrument measures the objective Qol as well as the subjective Qol. It does possess satisfying psychometric properties and offers the possibility to establish Qol profiles. All

  16. Model construction of nursing service satisfaction in hospitalized tumor patients.

    PubMed

    Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients' expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved. PMID:25419410

  17. A review of schizophrenia research in malaysia.

    PubMed

    Chee, K Y; Salina, A A

    2014-08-01

    Research in schizophrenia has advanced tremendously. One hundred and seventy five articles related to Schizophrenia were found from a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. This project aims to examine published research articles, in local and international journals in order to provide a glimpse of the research interest in Malaysia with regards to schizophrenia. Single case study, case series report, reviews and registry reports were not included in this review. Medication trial, unless it concerned a wider scope of psychopharmacology was also excluded from this review. A total of 105 articles were included in this review. Despite numerous genetics studies conducted and published, a definitive conclusion on the aetiology or mechanism underlying schizophrenia remains elusive. The National Mental Health - Schizophrenia Registry (NMHR) proved to be an important platform for many studies and publications. Studies stemmed from NMHR have provided significant insight into the baseline characteristic of patients with schizophrenia, pathway to care, and outcomes of the illness. International and regional collaborations have also encouraged important work involving stigma and discrimination in schizophrenia. Ministry of Health's hospitals (MOH) are the main research sites in the country with regards to schizophrenia research. Numbers of schizophrenia research are still low in relation to the number of universities and hospitals in the country. Some of the weaknesses include duplication of studies, over-emphasising clinical trials and ignoring basic clinical research, and the lack of publications in international and regional journals. PMID:25417951

  18. FDG-PET scans in patients with Kraepelinian and non-Kraepelinian schizophrenia.

    PubMed

    Bralet, Marie-Cécile; Buchsbaum, Monte S; DeCastro, Alex; Shihabuddin, Lina; Mitelman, Serge A

    2016-09-01

    We recruited 14 unmedicated patients with Kraepelinian schizophrenia (12 men and 2 women; mean age = 47 years old), 27 non-Kraepelinian patients (21 men and 6 women; mean age = 36.4 years old) and a group of 56 age- and sex-matched healthy volunteers. FDG positron emission tomography and MRI scans were coregistered for both voxel-by-voxel statistical mapping and stereotaxic regions of interest analysis. While both Kraepelinian and non-Kraepelinian patients showed equally lower uptake than healthy volunteers in the frontal lobe, the temporal lobes (Brodmann areas 20 and 21) showed significantly greater decreases in Kraepelinian than in non-Kraepelinian patients. Kraepelinian patients had lower FDG uptake in parietal regions 39 and 40, especially in the right hemisphere, while non-Kraepelinian patients had similar reductions in the left. Only non-Kraepelinian patients had lower caudate FDG uptake than healthy volunteers. While both patient groups had lower uptake than healthy volunteers in the medial dorsal nucleus of the thalamus, Kraepelinian patients alone had higher uptake in the ventral nuclei of the thalamus. Kraepelinian patients also showed higher metabolic rates in white matter. Our results are consistent with other studies indicating that Kraepelinian schizophrenia is a subgroup of schizophrenia, characterized by temporal and right parietal deficits and normal rather than reduced caudate uptake. It suggests that Kraepelinian schizophrenia may be more primarily characterized by FDG uptake decreased in both the frontal and temporal lobes, while non-Kraepelinian schizophrenia may have deficits more limited to the frontal lobe. This is consistent with some neuropsychological and prognosis reports of disordered sensory information processing in Kraepelinian schizophrenia in addition to deficits in frontal lobe executive functions shared with the non-Kraepelinian subtype. PMID:26370275

  19. Patients with methamphetamine psychosis admitted to a psychiatric hospital in Japan. A preliminary report.

    PubMed

    Iwanami, A; Sugiyama, A; Kuroki, N; Toda, S; Kato, N; Nakatani, Y; Horita, N; Kaneko, T

    1994-06-01

    To examine the clinical characteristics of methamphetamine (MAP) psychosis in Japan, we evaluated 104 patients with MAP psychosis (80 men and 24 women) admitted to the closed psychiatric units of Tokyo Metropolitan Matsuzawa Hospital between 1988 and 1991. There has recently been a steep increase in the number of admissions for MAP psychosis, reflecting the growth of the epidemic of MAP abuse in Japan. Although more than half of the patients were discharged within one month, 16 patients were hospitalized for more than 3 months. Most of the patients showed paranoid psychotic state similar to schizophrenia, consistent with previous reports. Despite the abstinence from MAP and antipsychotic medication, psychotic symptoms tended to persist in some of the patients. The etiological role of MAP psychosis in the development of long-lasting psychotic state was discussed. PMID:8085475

  20. Fronto-striatal dysfunction during reward processing in unaffected siblings of schizophrenia patients.

    PubMed

    de Leeuw, Max; Kahn, René S; Vink, Matthijs

    2015-01-01

    Schizophrenia is a psychiatric disorder that is associated with impaired functioning of the fronto-striatal network, in particular during reward processing. However, it is unclear whether this dysfunction is related to the illness itself or whether it reflects a genetic vulnerability to develop schizophrenia. Here, we examined reward processing in unaffected siblings of schizophrenia patients using functional magnetic resonance imaging. Brain activity was measured during reward anticipation and reward outcome in 27 unaffected siblings of schizophrenia patients and 29 healthy volunteers using a modified monetary incentive delay task. Task performance was manipulated online so that all subjects won the same amount of money. Despite equal performance, siblings showed reduced activation in the ventral striatum, insula, and supplementary motor area (SMA) during reward anticipation compared to controls. Decreased ventral striatal activation in siblings was correlated with sub-clinical negative symptoms. During the outcome of reward, siblings showed increased activation in the ventral striatum and orbitofrontal cortex compared to controls. Our finding of decreased activity in the ventral striatum during reward anticipation and increased activity in this region during receiving reward may indicate impaired cue processing in siblings. This is consistent with the notion of dopamine dysfunction typically associated with schizophrenia. Since unaffected siblings share on average 50% of their genes with their ill relatives, these deficits may be related to the genetic vulnerability for schizophrenia. PMID:25368371

  1. Electrophysiological Neuroimaging using sLORETA Comparing 100 Schizophrenia Patients to 48 Patients with Major Depression

    PubMed Central

    Eugene, Andy R.; Masiak, Jolanta

    2015-01-01

    In this retrospective analysis of electroencephalograms were to identify a surrogate biomarker for the Dopamine D2 receptors in the brain by comparing patients diagnosed with Schizophrenia taking Atypical Antipsychotics to Depressive patients medicated with Selective Serotonin Reuptake Inhibitors. To achieve this, thirty-seconds of resting EEG were spectrally transformed in sLORETA. Three-dimensional statistical non-paramentric maps (SnPM) for the sLORETA Global Field Power within each band were then computed. Our results illustrated that the Right Superior Frontal Gyrus (t=2.049, p=0.007), along the dopamine mesolimbic pathway, had higher neuronal oscillations in the delta frequency band in the 100 Schizophrenia patients as compared to the 32-depressive female patients. The comparisons with both the 48 depressive patient cohort or the sixteen male depressive patient cohort did not yield any statistically significant findings. We conclude that the Superior Frontal Gyrus should be investigated as a possible surrogate biomarker for preclinical and clinical drug discovery in neuropharmacology. PMID:26609423

  2. Coping strategies and self-stigma in patients with schizophrenia-spectrum disorders

    PubMed Central

    Holubova, Michaela; Prasko, Jan; Hruby, Radovan; Latalova, Klara; Kamaradova, Dana; Marackova, Marketa; Slepecky, Milos; Gubova, Terezia

    2016-01-01

    Background Maladaptive coping strategies may adversely disturb the overall functioning of people with mental disorders. Also, self-stigma is considered a maladaptive psychosocial phenomenon that can affect many areas of patient life. It has a negative impact on self-image, and may lead to dysphoria, social isolation, reduced adherence, using of negative coping strategies, and lower quality of life. The objective of this study was to determine the relationship between coping strategies and self-stigma among persons with schizophrenia and related psychotic disorders. Subjects and methods A total of 104 clinically stable outpatients with chronic schizophrenia-spectrum disorders were enrolled in a cross-sectional study. Sociodemographic and clinical data were recorded. Patients were examined by psychiatrists with the Stress Coping Style Questionnaire, the Internalized Stigma of Mental Illness scale, and the Clinical Global Impression scale. Correlation and multiple-regression analyses were performed to discover contributing factors to self-stigma. Results Positive coping strategies were used by patients with schizophrenia-spectrum disorders to the same extent as in the healthy population. Negative coping strategies were overused by these patients. There were significant associations between self-stigma, severity of the disorder, and coping strategies in schizophrenia. The ability to use positive coping strategies was connected with lower self-stigma. Use of negative coping strategies predominantly increased the self-stigma of patients with schizophrenia. Conclusion This study revealed a significant association among self-stigma, severity of the disorder, and coping strategies in individuals suffering from schizophrenia-spectrum disorders. Thinking about coping strategies and self-stigma in practice may play a significant role in understanding people with schizophrenia-spectrum disorders, especially for mental health professionals. PMID:27445463

  3. Model construction of nursing service satisfaction in hospitalized tumor patients

    PubMed Central

    Chen, Yongyi; Liu, Jingshi; Xiao, Shuiyuan; Liu, Xiangyu; Tang, Xinhui; Zhou, Yujuan

    2014-01-01

    This study aims to construct a satisfaction model on nursing service in hospitalized tumor patients. Using questionnaires, data about hospitalized tumor patients’ expectation, quality perception and satisfaction of hospital nursing service were obtained. A satisfaction model of nursing service in hospitalized tumor patients was established through empirical study and by structural equation method. This model was suitable for tumor specialized hospital, with reliability and validity. Patient satisfaction was significantly affected by quality perception and patient expectation. Patient satisfaction and patient loyalty was also affected by disease pressure. Hospital brand was positively correlated with patient satisfaction and patient loyalty, negatively correlated with patient complaint. Patient satisfaction was positively correlated with patient loyalty, patient complaints, and quality perception, and negatively correlated with disease pressure and patient expectation. The satisfaction model on nursing service in hospitalized tumor patients fits well. By this model, the quality of hospital nursing care may be improved. PMID:25419410

  4. Emotional effect on cognitive control in implicit memory tasks in patients with schizophrenia.

    PubMed

    Kim, Gwang-Won; Yang, Jong-Chul; Jeong, Gwang-Woo

    2015-08-01

    The aim of this study was to reveal a potential effect of emotion on cognitive control in the implicit memory task with emotionally neutral and unpleasant words in healthy controls and patients with schizophrenia using a 3.0 T functional MRI (fMRI). A total of 15 patients with schizophrenia and 15 healthy controls underwent the fMRI. fMRI data were obtained while the participants performed the implicit memory tasks with emotionally neutral and unpleasant words. During the implicit memory retrieval with emotionally neutral words, the predominant activation areas observed in patients in contrast to healthy controls included the precuneus, superior parietal gyrus, and dorsolateral prefrontal cortex (dlPFC). In the implicit memory retrieval with unpleasant words, patients with schizophrenia showed dominant activities in the superior and middle temporal gyri, fusiform gyrus, supramarginal gyrus, postcentral gyrus, occipital gyrus, lingual gyrus, parahippocampal gyrus, amygdala, and insula as well as precuneus, superior parietal gyrus, and dlPFC. Blood-oxygen-level-dependent signal changes in the dlPFC were correlated positively with the scores of the negative symptoms under the PANSS during implicit memory retrieval with unpleasant words in patients with schizophrenia. These findings would be useful to understand the neural mechanisms related to general impairment of cognitive and emotional functions commonly observed in schizophrenia. PMID:26103120

  5. Virtual Avatar for Emotion Recognition in Patients with Schizophrenia: A Pilot Study

    PubMed Central

    Marcos-Pablos, Samuel; González-Pablos, Emilio; Martín-Lorenzo, Carlos; Flores, Luis A.; Gómez-García-Bermejo, Jaime; Zalama, Eduardo

    2016-01-01

    Persons who suffer from schizophrenia have difficulties in recognizing emotions in others’ facial expressions, which affects their capabilities for social interaction and hinders their social integration. Photographic images have traditionally been used to explore emotion recognition impairments in schizophrenia patients, but they lack of the dynamism that is inherent to facial expressiveness. In order to overcome those inconveniences, over the last years different authors have proposed the use of virtual avatars. In this work, we present the results of a pilot study that explored the possibilities of using a realistic-looking avatar for the assessment of emotion recognition deficits in patients who suffer from schizophrenia. In the study, 20 subjects with schizophrenia of long evolution and 20 control subjects were invited to recognize a set of facial expressions of emotions showed by both the said virtual avatar and static images. Our results show that schizophrenic patients exhibit recognition deficits in emotion recognition from facial expressions regardless the type of stimuli (avatar or images), and that those deficits are related with the psychopathology. Finally, some improvements in recognition rates (RRs) for the patient group when using the avatar were observed for sadness or surprise expressions, and they even outperform the control group in the recognition of the happiness expression. This leads to conclude that, apart from the dynamism of the shown expression, the RRs for schizophrenia patients when employing animated avatars may depend on other factors which need to be further explored. PMID:27616987

  6. Cortical PGC-1α-Dependent Transcripts Are Reduced in Postmortem Tissue From Patients With Schizophrenia.

    PubMed

    McMeekin, Laura J; Lucas, Elizabeth K; Meador-Woodruff, James H; McCullumsmith, Robert E; Hendrickson, Robert C; Gamble, Karen L; Cowell, Rita M

    2016-07-01

    The transcriptional coactivator peroxisome proliferator-activated receptor-gamma coactivator 1-alpha (PGC-1α) has been linked to multiple neurological and psychiatric disorders including schizophrenia, but its involvement in the pathophysiology of these disorders is unclear. Experiments in mice have revealed a set of developmentally-regulated cortical PGC-1α-dependent transcripts involved in calcium buffering (parvalbumin, PV), synchronous neurotransmitter release (synaptotagmin 2, Syt2; complexin 1, Cplx1) and axonal integrity (neurofilamaent heavy chain, Nefh). We measured the mRNA expression of PGC-1α and these transcripts in postmortem cortical tissue from control and schizophrenia patients and found a reduction in PGC-1α-dependent transcripts without a change in PGC-1α. While control subjects with high PGC-1α expression exhibited high PV and Nefh expression, schizophrenia subjects with high PGC-1α expression did not, suggesting dissociation between PGC-1α expression and these targets in schizophrenia. Unbiased analyses of the promoter regions for PGC-1α-dependent transcripts revealed enrichment of binding sites for the PGC-1α-interacting transcription factor nuclear respiratory factor 1 (NRF-1). NRF-1 mRNA expression was reduced in schizophrenia, and its transcript levels predicted that of PGC-1α-dependent targets in schizophrenia. Interestingly, the positive correlation between PGC-1α and PV, Syt2, or Cplx1 expression was lost in schizophrenia patients with low NRF-1 expression, suggesting that NRF-1 is a critical predictor of these genes in disease. These data suggest that schizophrenia involves a disruption in PGC-1α and/or NRF-1-associated transcriptional programs in the cortex and that approaches to enhance the activity of PGC-1α or transcriptional regulators like NRF-1 should be considered with the goal of restoring normal gene programs and improving cortical function. PMID:26683626

  7. A Questionnaire-based Study of the Views of Schizophrenia Patients and Psychiatric Healthcare Professionals in Japan about the Side Effects of Clozapine

    PubMed Central

    Takeuchi, Ippei; Hanya, Manako; Uno, Junji; Amano, Yuhei; Fukai, Keiko; Fujita, Kiyoshi; Kamei, Hiroyuki

    2016-01-01

    Objective It is well documented that clozapine treatment causes agranulocytosis, but it can also induce drowsiness, constipation, and hypersalivation; however, these symptoms are usually less severe. It has been reported that clozapine-treated patients with schizophrenia and psychiatric healthcare professionals consider different side effects to be important. The aim of this study was to assess current practice related to the side effects of clozapine in clozapine-treated patients with schizophrenia and psychiatric healthcare professionals in Japan. Methods Data were collected from January 2014 to August 2015 in Okehazama Hospital, Kakamigahara Hospital, and Numazu Chuo Hospital. Clozapine-treated patients with schizophrenia and psychiatric healthcare professionals (psychiatrists and pharmacists) were enrolled in this study. Results Of the 106 patients and 120 psychiatric healthcare professionals screened, 100 patients and 104 healthcare professionals were included in this study. We asked the patients what side effects caused them trouble and we asked psychiatric healthcare professionals what side effects caused them concern. The patients and psychiatrists held similarly positive views regarding the efficacy of clozapine. The healthcare professionals were concerned about agranulocytosis (92.4%), blood routines (61.3%). On the other hand, the patients experienced hypersalivation (76.0%), sleepiness (51.0%). A positive correlation (R=0.696) was found between patient satisfaction and DAI-10 score. Conclusion Patients experienced more problems than healthcare professionals expected. However, usage experience of clozapine healthcare professionals tended to have similar results to patients. It is necessary that all healthcare professionals fully understand the efficacy and potential side effects of clozapine. This is very important for promoting clozapine treatment in Japan. PMID:27489383

  8. An evaluation of the use of olanzapine pamoate depot injection in seriously violent men with schizophrenia in a UK high-security hospital

    PubMed Central

    Baruch, Nina; Sharda, Amit; Basu, Amlan; Bajorek, Tom; Ross, Callum C; Sengupta, Samrat; Larkin, Fintan; Young, Susan

    2014-01-01

    Background: Oral olanzapine is a well-established treatment for patients suffering from schizophrenia. Advantages of depot olanzapine may include improved compliance. However, it is expensive, causes metabolic side effects, and carries a risk of postinjection syndrome. Clinical trials have shown olanzapine pamoate to be effective, but further work is needed in this area. This study was a retrospective service evaluation, carried out in a high-security hospital, where the majority of patients have complex, treatment resistant schizophrenia spectrum disorder and a very high propensity for violence. Compliance is a significant problem, both in the high-security setting and on discharge. There has been no previous published work that the authors are aware of evaluating the effects of olanzapine pamoate in this subgroup of patients. Methods: The aim of the study was to evaluate the clinical efficacy of olanzapine pamoate, its effect on violence as well as its side effects, in a high-security setting for the first time. Anonymized patient records were used to identify the main outcome measure and clinical global improvement, and to ascertain secondary outcome measures which included seclusion hours, risk of violence and side effects. Metabolic parameters and number of incidents were also recorded. Eight patients were treated with olanzapine pamoate. Results: Six showed an improvement in symptoms, with an associated decrease in violence and number of incidents. Four showed an associated decrease in seclusion hours. Two showed an increase in body mass index and two showed an increase in glucose. Conclusions: The findings of this study are important in showing that all patients who responded to olanzapine pamoate also showed a decrease in violent behaviour. The potential anti-aggression effects of olanzapine pamoate may represent a very promising area for further work. A depot antipsychotic medication that reduces violence could have significant implications for management

  9. Self-Disturbance in Schizophrenia: A Phenomenological Approach to Better Understand Our Patients

    PubMed Central

    de Vries, Rob; Postmes, Lot; Goedhart, Saskia; Sno, Herman N.; de Haan, Lieuwe

    2013-01-01

    A phenomenological approach explains the apparently unintelligible experiences of patients with schizophrenia as a disruption of the normal self-perception. Patients with schizophrenia suffer from a decline of “me,” the background core of their experiences. Normally tacit experiences intrude into the forefront of their attention, and the sense that inner-world experiences are private diminishes. These patients lose the sense that they are the origin of their thoughts and actions; their self-evident network of meanings and a solid foundation of life disintegrate. Subsequently, their experiential world is transformed, alienated, intruded, and fragmented. In this article, a phenomenological investigation of the self-experiences and actions of 4 patients with schizophrenia is presented. PMID:23724352

  10. Effectiveness of a specific cueing method for improving autobiographical memory recall in patients with schizophrenia.

    PubMed

    Potheegadoo, Jevita; Cordier, Adrian; Berna, Fabrice; Danion, Jean-Marie

    2014-01-01

    Autobiographical memory deficits in schizophrenia have a significant impact on patients' daily life. Our study was aimed at testing the effectiveness of a specific cueing (SC) method for improving autobiographical memory recall in patients with schizophrenia, particularly the phenomenological details of their memories. Twenty-five patients with schizophrenia and 25 comparison participants took part in the study. They recalled 6 specific autobiographical events which occurred during 3 different life periods. After each memory recall, participants were given a general cue which allowed them to add further information to their narration. The SC was then applied by means of a series of specific questions to elicit more precise memory detail. The overall memory specificity as well as the number and richness of 5 categories of memory detail (perceptual/sensory, temporal, contextual, emotional, and cognitive) were assessed before and after the SC phase. Before SC, patients' memories were less specific and less detailed. SC had a beneficial effect on patients' memory recall. The overall memory specificity of patients improved. The gain in the number and richness of memory details was comparable between patients and comparison participants. The difference between groups in terms of the number of memory details was not significant. Richness of details was still lower in patients, except for emotional and cognitive details, which were similarly rich in both groups. The cueing method reduces the autobiographical memory impairment of patients with schizophrenia and paves the way for developing specific cognitive remediation therapies to help patients in their daily life. PMID:24268933

  11. Screening for Depression in Hospitalized Pediatric Patients

    PubMed Central

    ESMAEELI, Mohammad-Reza; ERFANI SAYAR, Reza; SAGHEBI, Ali; ELMI, Saghi; RAHMANI, Shagheyegh; ELMI, Sam; RABBANI JAVADI, Akram

    2014-01-01

    Objective In chronically ill children who are hospitalized, many mood changes occur. For example, in children with cancer or renal failure, prolonged hospitalization and chemotherapy can lead to depression. With the improved survival of childhood malignancies, the effect of treatment on child’s psychosocial well-being becomes increasingly relevant. In this study, we examined the prevalence of depression in hospitalized children with chronic and acute conditions in Dr Sheikh Pediatrics Hospital in Mashhad. Materials & Methods After receiving the approval from the Ethics Committee of Mashhad University of Medical Sciences, we did this cross-sectional descriptive study, from April to June 2012 in Dr Sheikh Pediatric Hospital in Mashhad. Ninety children, between 8 to 16 years, were screened for depression. The sampling method was census. Children with a history of depressive or other mental disorders were excluded. Three groups of children (children with chronic renal disease, malignancy, and acute disease) were evaluated for depression using standard Children Depression Inventory Questionnaire (CDI). Two specifically trained nurses filled out the questionnaires at patients’ bedside under the supervision of a psychiatrist. Depression scores were then analyzed by SPSS software. Results Of 90 children, 43(47.7%) were male and 47(52.2%) were female. The Children’s mean age was 11±2.3 years, and the mean length of hospitalization was 8±5.3 days. Depression was detected in various degrees in 63% of patients (N=57), and 36.6% of children (N=32) had no symptoms of depression. Severe depression was not seen in any of the patients with acute illness. More than half of patients with cancer and chronic kidney disease had moderate to severe depression. There was a significant statistical relationship between the duration of illness and severity of depression. There was also a significant correlation between severity of depression and frequency of hospitalization. Children

  12. [A cognitive behavioural group therapy program for the improvement of the cognitive and social abilities of patients with schizophrenia].

    PubMed

    Efthimiou, K; Rakitzi, S; Roder, V

    2009-07-01

    Pharmacotherapy is the main therapy for the positive and negative symptoms and for the relapse prevention for patients with schizophrenia. The cognitive and behavioural therapy can be combined with other therapies for schizophrenia. Within this frame of reference the cognitive behavioural therapy for schizophrenia and other psychotic syndromes is the first choice for psychiatrists and psychologists in European countries. The National Institute of Clinical Excellence (NICE) has included the cognitive behavioural therapy as a recommended therapy for schizophrenia. The Cognitive Behavioral Therapy includes interventions for the acute phase in an episode (relapse) as well as for the rehabilitation of patients with schizophrenia. The Integrated Psychological Therapy, which is an effective group therapy for the improvement of cognitive and social abilities of patients with schizophrenia, will be represented in the following article. PMID:22218214

  13. Differences among hospitals in Medicare patient mortality.

    PubMed Central

    Chassin, M R; Park, R E; Lohr, K N; Keesey, J; Brook, R H

    1989-01-01

    Using hospital discharge abstract data for fiscal year 1984 for all acute care hospitals treating Medicare patients (age greater than or equal to 65), we measured four mortality rates: inpatient deaths, deaths within 30 days after discharge, and deaths within two fixed periods following admission (30 days, and the 95th percentile length of stay for each condition). The metric of interest was the probability that a hospital would have as many deaths as it did (taking age, race, and sex into account). Differences among hospitals in inpatient death rates were large and significant (p less than .05) for 22 of 48 specific conditions studied and for all conditions together; among these 22 "high-variation" conditions, medical conditions accounted for far more deaths than did surgical conditions. We compared pairs of conditions in terms of hospital rankings by probability of observed numbers of inpatient deaths; we found relatively low correlations (Spearman correlation coefficients of 0.3 or lower) for most comparisons except between a few surgical conditions. When we compared different pairs of the four death measures on their rankings of hospitals by probabilities of the observed numbers of deaths, the correlations were moderate to high (Spearman correlation coefficients of 0.54 to 0.99). Hospitals with low probabilities of the number of observed deaths were not distributed randomly geographically; a small number of states had significantly more than their share of these hospitals (p less than .01). Information from hospital discharge abstract data is insufficient to determine the extent to which differences in severity of illness or quality of care account for this marked variability, so data on hospital death rates cannot now be used to draw inferences about quality of care. The magnitude of variability in death rates and the geographic clustering of facilities with low probabilities, however, both argue for further study of hospital death rates. These data may prove

  14. Hospital dental practice in special patients

    PubMed Central

    Silvestre-Rangil, Javier; Espín-Gálvez, Fernando

    2014-01-01

    Dental patients with special needs are people with different systemic diseases, multiple disorders or severe physical and/or mental disabilities. A Medline search was made, yielding a total of 29 articles that served as the basis for this study, which offers a brief description of the dental intervention protocols in medically compromised patients. Dental treatment in patients with special needs, whether presenting medical problems or disabilities, is sometimes complex. For this reason the hospital should be regarded as the ideal setting for the care of these individuals. Before starting any dental intervention, a correct patient evaluation is needed, based on a correct anamnesis, medical records and interconsultation reports, and with due assessment of the medical risks involved. The hospital setting offers the advantage of access to electronic medical records and to data referred to any complementary tests that may have been made, and we moreover have the possibility of performing treatments under general anesthesia. In this context, ambulatory major surgery is the best approach when considering general anesthesia in patients of this kind. Key words:Hospital dentistry, special patients, medically compromised patients. PMID:24121921

  15. Subjective Symptoms in Euthymic Bipolar Disorder and Remitted Schizophrenia Patients: A Comparative Study

    PubMed Central

    Kumar, Manish; Sinha, Vinod Kumar; Mondal, Anwesha

    2016-01-01

    Background: Subjective experience means subtle, not yet psychotic abnormalities of experience that might be present during remitted phase and also in prodromal phase of schizophrenia and might be accurately efficient in identifying individuals at risk of eminent psychosis (Parnas et al., 2003). Apart from schizophrenic patients, bipolar patients also experience certain subjective symptoms in their euthymic state. They often experience subtle cognitive impairment and functional disturbances during their euthymic states. These subjective experiences may be related to distorted cognitive functions in these patients. These experiences include a great variety of cognitive dysfunction complaints about attention, perception, memory, thinking, language, movement, and emotion. Objective: To measure the experience of subjective symptoms and compare them between euthymic bipolar and remitted schizophrenia patients. Materials and Methods: Thirty euthymic bipolar patients and 30 remitted schizophrenia patients as per International Classification of Diseases Tenth Revision were selected for the purpose of the study. At first, sociodemographic data were collected. And then, the patients were assessed using the scales; positive and negative syndrome scale, Young Mania Rating Scale, Hamilton Depression Rating Scale, Symptom Checklist-90-Revised, and Frankfurt Complaint Questionnaire-24. Results: Both the groups showed significant differences in terms of subjective symptoms. However, no significant correlation has been found between the objective psychopathology and subjective experience in the two groups. Conclusion: It can be suggested that the patients with schizophrenia show significantly higher subjective experience when compared with the patients of bipolar disorder. PMID:27114621

  16. Safety evaluation of saffron stigma (Crocus sativus L.) aqueous extract and crocin in patients with schizophrenia

    PubMed Central

    Mousavi, Bentolhoda; Bathaie, Seyedeh Zahra; Fadai, Farbod; Ashtari, Zabihollah; Ali beigi, Neda; Farhang, Sara; Hashempour, Sara; Shahhamzei, Nasim; Heidarzadeh, Hamid

    2015-01-01

    Objectives: Saffron is the stigma of Crocus sativus L., which has the potentials to play a role in the treatment of many diseases. Although many researches are now going on this precious spice, there are few data on saffron safety in human, especially in patients with chronic mental illnesses. This study aimed to evaluate the short-term safety and tolerability of both saffron and crocin (its major constituent) in adult patients with schizophrenia. Materials and Methods: The capsules of saffron aqueous extract (SAE) and crocin were used to evaluate short-term safety and tolerability in patients with schizophrenia. A double-blind, placebo-controlled study was performed on patients with schizophrenia. The patients were all male and were divided into three 22-patient groups. While receiving their normal treatment, they also received a 12 week treatment with SAE (15 mg twice daily), crocin (15 mg twice daily) or placebo. Results: A total of 61 patients completed the trial; none of them reported a serious side effect. WBC count increased significantly in patients receiving saffron aqua extract (SAE), but it was within the normal range and had no clinical significance. Other hematologic components, markers of thyroid, liver and kidney or inflammation markers had no statistically significant difference among the groups. Conclusion: This study showed that SAE and crocin in doses of 15 mg twice daily were safely tolerated in patients with schizophrenia. PMID:26468460

  17. Reduced fronto–striatal white matter integrity in schizophrenia patients and unaffected siblings: a DTI study

    PubMed Central

    de Leeuw, Max; Bohlken, Marc M; Mandl, René C W; Kahn, René S; Vink, Matthijs

    2015-01-01

    Background: Schizophrenia is characterized by impairments in the fronto–striatal network. Underlying these impairments may be disruptions in anatomical pathways connecting frontal and striatal regions. However, the specifics of these disruptions remain unclear and whether these impairments are related to the genetic vulnerability of schizophrenia is not known. Methods: Here, we investigated fronto–striatal tract connections in 24 schizophrenia patients, 30 unaffected siblings, and 58 healthy controls using diffusion tensor imaging. Mean fractional anisotropy (FA) was calculated for tracts connecting the striatum with frontal cortex regions including the dorsolateral prefrontal cortex (DLPFC), medial orbital frontal cortex, and inferior frontal gyrus. Specifically, the striatum was divided into three subregions (caudate nucleus, putamen, and nucleus accumbens) and mean FA was computed for tracts originating from these striatal subregions. Results: We found no differences between patients, siblings, and controls in mean FA when taking the whole striatum as a seed region. However, subregion analyses showed reduced FA in the tract connecting the left nucleus accumbens and left DLPFC in both patients (P=0.0003) and siblings (P=0.0008) compared with controls. Conclusions: The result of reduced FA in the tract connecting the left nucleus accumbens and left DLPFC indicates a possible reduction of white matter integrity, commonly associated with schizophrenia. As both patients and unaffected siblings show reduced FA, this may represent a vulnerability factor for schizophrenia.

  18. Intact Associative Learning in Patients with Schizophrenia: Evidence from a Go/NoGo Paradigm

    PubMed Central

    Woolard, Austin A.; Kose, Samet; Woodward, Neil D.; Verbruggen, Frederick; Logan, Gordon D.; Heckers, Stephan

    2010-01-01

    Objective Schizophrenia is associated with deficits in executive control and associative learning. In the present study, we investigated the effect of associative learning during a Go/NoGo task in healthy controls subjects and patients with schizophrenia. Methods Thirty patients with schizophrenia and 30 age-and-gender matched healthy control subjects performed 15 blocks of training and 3 blocks of test trials. The trials consisted of responding to words denoting either living or non-living objects. In the training condition, subjects were instructed to respond by pressing the space bar (Go-task) to one of the word types (living or non-living objects), but not the other. In the test phase, the Go/NoGo mapping was reversed. Subjects were instructed to respond as quickly and as accurately as possible. Reaction times (RT) and accuracy were recorded for each trial and all subjects were debriefed upon completion of the test trials. Results Patients with schizophrenia had significantly longer Go RTs when compared to the control group, during both training and test trials. However, the two groups did not differ on any measure of associative learning. Conclusions Our findings suggest that associative learning is intact in schizophrenia patients during the performance of a relational Go/NoGo paradigm. PMID:20226631

  19. Iowa Gambling Task in Schizophrenia: A Review and New Data in Patients with Schizophrenia and Co-Occurring Cannabis Use Disorders

    PubMed Central

    Sevy, Serge; Burdick, Katherine E.; Visweswaraiah, Hema; Abdelmessih, Sherif; Lukin, Meredith; Yechiam, Eldad; Bechara, Antoine

    2007-01-01

    Background: We reviewed previous studies comparing schizophrenia patients and healthy subjects for performance on the Iowa Gambling Task (IGT) (a laboratory task designed to measure emotion-based decision-making), and found mixed results. We hypothesize that deficits in IGT performance in schizophrenia may be more specifically related to concurrent substance use disorders. To test this hypothesis, we compared schizophrenia patients with (SCZ(+)) or without (SCZ(−)) cannabis use disorders, to healthy subjects, on measures of cognition and IGT performance. Methods: A comprehensive battery of cognitive tests and the IGT were administered to three groups of subjects: (1) 13 subjects with DSM-IV diagnosis of schizophrenia and no concurrent substance use disorders (mean age: 28 ± 12 (SD); 54% males); (2) 14 subjects with schizophrenia and concurrent cannabis use disorders (mean age: 29 ± 9 (SD); 71% males); and (3) 20 healthy subjects (mean age 33 ± 10 (SD); 60% males). Results: Compared to the healthy group, both schizophrenia groups were cognitively more impaired, and did worse on IGT performance. There were no differences between SCZ(+) and SCZ(−) patients on most of the cognitive tests, and IGT performance. Conclusions: Schizophrenia patients show widespread impairments in several cognitive domains and emotion-based decision-making. These results are consistent with the evidence that schizophrenia reflects a dorsolateral and orbitofrontal/ventromedial prefrontal cortex dysfunction. More intriguing, it appears that the concurrent abuse of cannabis has no compounding effects on cognition, as well as emotion/affect-based decision-making. PMID:17379482

  20. Effects of endurance training on brain structures in chronic schizophrenia patients and healthy controls.

    PubMed

    Malchow, Berend; Keeser, Daniel; Keller, Katriona; Hasan, Alkomiet; Rauchmann, Boris-Stephan; Kimura, Hiroshi; Schneider-Axmann, Thomas; Dechent, Peter; Gruber, Oliver; Ertl-Wagner, Birgit; Honer, William G; Hillmer-Vogel, Ursula; Schmitt, Andrea; Wobrock, Thomas; Niklas, Andree; Falkai, Peter

    2016-06-01

    The objective of this longitudinal magnetic resonance (MR) imaging study was to examine the effects of endurance training on hippocampal and grey matter volumes in schizophrenia patients and healthy controls. 20 chronic schizophrenia patients and 21 age- and gender-matched healthy controls underwent 3months of endurance training (30min, 3 times per week). 19 additionally recruited schizophrenia patients played table soccer ("foosball" in the USA) over the same period. MR imaging with 3D-volumetric T1-weighted sequences was performed on a 3T MR scanner at baseline, after 6weeks and after the 3-month intervention and 3 additional training-free months. In addition to voxel-based morphometry (VBM), we performed manual and automatic delineation of the hippocampus and its substructures. Endurance capacity and psychopathological symptoms were measured as secondary endpoints. No significant increases in the volumes of the hippocampus or hippocampal substructures were observed in schizophrenia patients or healthy controls. However, VBM analyses displayed an increased volume of the left superior, middle and inferior anterior temporal gyri compared to baseline in schizophrenia patients after the endurance training, whereas patients playing table soccer showed increased volumes in the motor and anterior cingulate cortices. After the additional training-free period, the differences were no longer present. While endurance capacity improved in exercising patients and healthy controls, psychopathological symptoms did not significantly change. The subtle changes in the left temporal cortex indicate an impact of exercise on brain volumes in schizophrenia. Subsequent studies in larger cohorts are warranted to address the question of response variability of endurance training. PMID:25623601

  1. [Respect of patient's dignity in the hospital].

    PubMed

    Duguet, A-M

    2010-12-01

    Every code of ethics of health professionals in France considers the respect of dignity as a fundamental duty. The French 2002 Law on patient rights says that the person has the right to respect of dignity and of private life. After a presentation of the articles of ethics codes regarding dignity, this paper presents recommendations to deliver medical care in situations where dignity might be endangered such as for patients hospitalized in psychiatric services without consent, or for medical examination of prisoners or medical care to vulnerable patients unable to express their will, especially in palliative care or at the end of life. Respect of dignity after death is illustrated by the reflection conducted by the Espace Ethique de l'AP-HP (Paris area hospitals) and in the Chart of the mortuary yard. A survey of the patients' letters of complaint received by the emergency service of the Toulouse University Hospital showed that, in five years, there were 188 letters and 18 pointed out infringements to the dignity of the person. The health professional team is now aware of this obligation, and in the accreditation of the hospitals, the respect of dignity is one of the indicators of the quality of medical care. PMID:21766725

  2. Are housestaff identifying malnourished hospitalized medicine patients?

    PubMed

    Mitchell, Michael A; Duerksen, Donald R; Rahman, Adam

    2014-10-01

    Clinical nutrition and nutritional assessment are often a neglected component of medical school curriculums despite the high prevalence of malnutrition in hospitalized patients. This study found that medical housestaff performed nutritional assessments in only 4% of admitted patients despite a high rate of malnutrition (57%). Survey results show housestaff lack knowledge in the area of malnutrition. Medical schools and training programs must place greater emphasis of providing qualified physician nutrition specialists to implement effective nutrition instruction. PMID:25061765

  3. Prevention of Pulmonary Emboli in Hospitalized Patients

    PubMed Central

    Hubbard, J. C.

    1983-01-01

    The risk of pulmonary infarction in any hospitalized population is high. To decrease this dreaded complication, the high risk population must be identified. These are chiefly elderly patients with a history of previous DVTP, cancer, cardiac disease, trauma to a lower limb or a history of recent surgery. All methods of reducing venous stasis should be used, and most of these patients should be treated prophylactically with subcutaneous heparin. PMID:21283325

  4. Impairments of event-related magnetic fields in schizophrenia patients with predominant negative symptoms.

    PubMed

    Yefet, Keren; Goldstein, Abraham; Rabany, Liron; Levkovitz, Yechiel

    2015-03-30

    Recently there is a growing understanding that patients suffering from negative symptoms of schizophrenia represent a distinct patient population. However, despite the abundance of EEG studies characterizing schizophrenia patients in general, only a handful of studies have focused on the electrophysiological correlates of negative symptoms. The current study examined whether the impairments in event-related magnetic fields (ERFs) commonly reported in heterogeneous groups of patients with mixed positive and negative symptoms also occur in patients with predominantly negative symptoms, and investigated their correlation to clinical symptoms and cognitive deficits. Twenty schizophrenia patients suffering from predominant negative symptoms and 25 healthy subjects underwent neuropsychological and electromagnetic assessments. ERFs were recorded during a three-stimuli novelty oddball and a sensory gating paradigm, and M50, P300m and Novelty-P3m components were investigated. Patients displayed impaired M50 ratios, reduced left P300m and frontal Novelty-P3m amplitudes. These electromagnetic measures correlated significantly with the severity of negative symptoms (SANS scale). The electrophysiological abnormalities which have been proposed as candidate biomarkers for schizophrenia are also manifested in patients with predominantly negative symptoms. PMID:25680554

  5. Localized abnormalities in the cingulum bundle in patients with schizophrenia: A Diffusion Tensor tractography study

    PubMed Central

    Whitford, Thomas J.; Lee, Sun Woo; Oh, Jungsu S.; de Luis-Garcia, Rodrigo; Savadjiev, Peter; Alvarado, Jorge L.; Westin, Carl-Fredrik; Niznikiewicz, Margaret; Nestor, Paul G.; McCarley, Robert W.; Kubicki, Marek; Shenton, Martha E.

    2014-01-01

    The cingulum bundle (CB) connects gray matter structures of the limbic system and as such has been implicated in the etiology of schizophrenia. There is growing evidence to suggest that the CB is actually comprised of a conglomeration of discrete sub-connections. The present study aimed to use Diffusion Tensor tractography to subdivide the CB into its constituent sub-connections, and to investigate the structural integrity of these sub-connections in patients with schizophrenia and matched healthy controls. Diffusion Tensor Imaging scans were acquired from 24 patients diagnosed with chronic schizophrenia and 26 matched healthy controls. Deterministic tractography was used in conjunction with FreeSurfer-based regions-of-interest to subdivide the CB into 5 sub-connections (I1 to I5). The patients with schizophrenia exhibited subnormal levels of FA in two cingulum sub-connections, specifically the fibers connecting the rostral and caudal anterior cingulate gyrus (I1) and the fibers connecting the isthmus of the cingulate with the parahippocampal cortex (I4). Furthermore, while FA in the I1 sub-connection was correlated with the severity of patients' positive symptoms (specifically hallucinations and delusions), FA in the I4 sub-connection was correlated with the severity of patients' negative symptoms (specifically affective flattening and anhedonia/asociality). These results support the notion that the CB is a conglomeration of structurally interconnected yet functionally distinct sub-connections, of which only a subset are abnormal in patients with schizophrenia. Furthermore, while acknowledging the fact that the present study only investigated the CB, these results suggest that the positive and negative symptoms of schizophrenia may have distinct neurobiological underpinnings. PMID:25003032

  6. Localized abnormalities in the cingulum bundle in patients with schizophrenia: a Diffusion Tensor tractography study.

    PubMed

    Whitford, Thomas J; Lee, Sun Woo; Oh, Jungsu S; de Luis-Garcia, Rodrigo; Savadjiev, Peter; Alvarado, Jorge L; Westin, Carl-Fredrik; Niznikiewicz, Margaret; Nestor, Paul G; McCarley, Robert W; Kubicki, Marek; Shenton, Martha E

    2014-01-01

    The cingulum bundle (CB) connects gray matter structures of the limbic system and as such has been implicated in the etiology of schizophrenia. There is growing evidence to suggest that the CB is actually comprised of a conglomeration of discrete sub-connections. The present study aimed to use Diffusion Tensor tractography to subdivide the CB into its constituent sub-connections, and to investigate the structural integrity of these sub-connections in patients with schizophrenia and matched healthy controls. Diffusion Tensor Imaging scans were acquired from 24 patients diagnosed with chronic schizophrenia and 26 matched healthy controls. Deterministic tractography was used in conjunction with FreeSurfer-based regions-of-interest to subdivide the CB into 5 sub-connections (I1 to I5). The patients with schizophrenia exhibited subnormal levels of FA in two cingulum sub-connections, specifically the fibers connecting the rostral and caudal anterior cingulate gyrus (I1) and the fibers connecting the isthmus of the cingulate with the parahippocampal cortex (I4). Furthermore, while FA in the I1 sub-connection was correlated with the severity of patients' positive symptoms (specifically hallucinations and delusions), FA in the I4 sub-connection was correlated with the severity of patients' negative symptoms (specifically affective flattening and anhedonia/asociality). These results support the notion that the CB is a conglomeration of structurally interconnected yet functionally distinct sub-connections, of which only a subset are abnormal in patients with schizophrenia. Furthermore, while acknowledging the fact that the present study only investigated the CB, these results suggest that the positive and negative symptoms of schizophrenia may have distinct neurobiological underpinnings. PMID:25003032

  7. The course of vocational functioning in patients with schizophrenia: Re-examining social drift

    PubMed Central

    Vargas, Gabriela; Strassnig, Martin; Sabbag, Samir; Gould, Felicia; Durand, Dante; Stone, Laura; Patterson, Thomas L.; Harvey, Philip D.

    2014-01-01

    Vocational functioning is markedly impaired in people with schizophrenia. In addition to low rates of employment, people with schizophrenia have been reported to be underachieved compared to other family members. Among the causes of this vocational impairment may be cognitive deficits and other skills deficits, as well as social factors impacting on opportunities for employment. In this study, we examined two separate samples of people with schizophrenia who differed in their educational and social backgrounds. We compared personal and maternal education in people with schizophrenia attending an outpatient rehabilitation facility (n = 57) or receiving outpatient services at a VA medical center (n = 39). The sample as a whole showed evidence of decline in vocational status from their best job to their most recent job. Patients attending a rehabilitation facility had completed less education than their mothers, while the VA patients completed more. Differences between personal and maternal education predicted the difference in status between best and latest jobs in the sample as a whole. VA patients were more likely to be living independently and performed better on a measure of functional capacity than the rehabilitation sample. These data implicate vocational decline in schizophrenia and also suggest that this decline may originate prior to the formal onset of the illness. At the same time, vocational outcomes appear to be related to social opportunities. PMID:25254157

  8. 18F-Fallypride binding potential in patients with schizophrenia compared to healthy controls

    PubMed Central

    Lehrer, Douglas S.; Christian, Bradley T.; Kirbas, Cemil; Chiang, Meicheng; Sidhu, Shawn; Short, Holly; Wang, Binquan; Shi, Bingzhi; Chu, King-Wai; Merrill, Brian; Buchsbaum, Monte S.

    2012-01-01

    Background Molecular imaging of dopaminergic parameters has contributed to the dopamine hypothesis of schizophrenia, expanding our understanding of pathophysiology, clinical phenomenology and treatment. Our aim in this study was to compare 18F-fallypride binding potential BPND in a group of patients with schizophrenia-spectrum illness vs. controls, with a particular focus on the cortex and thalamus. Methods We acquired 18F-fallypride positron emission tomography images on 33 patients with schizophrenia spectrum disorder (28 with schizophrenia; 5 with schizoaffective disorder) and 18 normal controls. Twenty-four patients were absolutely neuroleptic naïve and nine were previously medicated, although only four had a lifetime neuroleptic exposure of greater than two weeks. Parametric images of 18F-fallypride BPND were calculated to compare binding across subjects. Results Decreased BPND was observed in the medial dorsal nucleus of the thalamus, prefrontal cortex, lateral temporal lobe and primary auditory cortex. These findings were most marked in subjects who had never previously received medication. Conclusions The regions with decreased BPND tend to match brain regions previously reported to show alterations in metabolic activity and blood flow and areas associated with the symptoms of schizophrenia. PMID:20655709

  9. Altered Error-Related Activity in Patients with Schizophrenia

    ERIC Educational Resources Information Center

    Koch, Kathrin; Wagner, Gerd; Schultz, Christoph; Schachtzabel, Claudia; Nenadic, Igor; Axer, Martina; Reichenbach, Jurgen R.; Sauer, Heinrich; Schlosser, Ralf G. M.

    2009-01-01

    Deficits in working memory (WM) and executive cognitive control are core features of schizophrenia. However, findings regarding functional activation strengths are heterogeneous, partly due to differences in task demands and behavioral performance. Previous investigators proposed integrating these heterogeneous findings into a comprehensive model…

  10. Hyperintentionality during automatic perception of naturalistic cooperative behavior in patients with schizophrenia.

    PubMed

    Backasch, Bianca; Straube, Benjamin; Pyka, Martin; Klöhn-Saghatolislam, Farahnaz; Müller, Matthias J; Kircher, Tilo T J; Leube, Dirk T

    2013-01-01

    Social cognition and the corresponding functionality of involved brain networks are essential for effortless social interaction. Patients with schizophrenia exhibit impaired social functioning. In this study, we focused on the neural networks involved in the automatic perception of cooperative behavior and their alterations in schizophrenia. We performed a functional magnetic resonance imaging study of 19 schizophrenia patients and 19 healthy matched controls. Participants watched a set of short videos with two actors manipulating objects, either with (C+) or without cooperation (C-). Additionally, we assessed delusional symptoms in patients using the Scales for the Assessment of Positive Symptoms and psychosis proneness in healthy controls using the brief schizotypal personality questionnaire. The observed group-by-condition interaction revealed a contrasting activation pattern for patients versus healthy controls in the medial and lateral prefrontal cortex, the middle cingulate cortex, and the left angular gyrus. Furthermore, increased activation of the middle prefrontal areas, left angular gyrus, and the posterior sulcus temporalis superior in response to the noncooperative condition (C-) was positively correlated with delusional symptoms in patients. Our findings suggest an overactivated "theory of mind" network in patients for the processing of noncooperative behavior. Thus, "overmentalizing" might be based on delusions and altered processing of cooperative behavior in patients with schizophrenia. PMID:23895223

  11. Social priming enhances interpersonal synchronization and feeling of connectedness towards schizophrenia patients

    PubMed Central

    Raffard, Stéphane; Salesse, Robin N.; Marin, Ludovic; Del-Monte, Jonathan; Schmidt, Richard C.; Varlet, Manuel; Bardy, Benoit G.; Boulenger, Jean-Philippe; Capdevielle, Delphine

    2015-01-01

    What leads healthy individuals to abnormal feelings of contact with schizophrenia patients remains obscure. Despite recent findings that human bonding is an interactive process influenced by coordination dynamics, the spatiotemporal organization of the bodily movements of schizophrenia patients when interacting with other people is poorly understood. Interpersonal motor coordination between dyads of patients (n = 45) or healthy controls (n = 45), and synchronization partners (n = 90), was assessed with a hand-held pendulum task following implicit exposure to pro-social, non-social, or anti-social primes. We evaluated the socio-motor competence and the feeling of connectedness between participants and their synchronization partners with a measure of motor coordination stability. Immediately after the coordination task, all participants were also asked to rate the likeableness of their interacting partner. Our results showed greater stability during interpersonal synchrony in schizophrenia patients who received pro-social priming, inducing in their synchronization partner greater feelings of connectedness towards patients. This greater feeling of connectedness was positively correlated with stronger motor synchronization between participants suggesting that motor coordination partly underlies patients' social interactions and feelings of contact with others. Pro-social priming can have a pervasive effect on abnormal social interactions in schizophrenia patients. PMID:25640605

  12. Field visual perspective during autobiographical memory recall is less frequent among patients with schizophrenia.

    PubMed

    Potheegadoo, Jevita; Berna, Fabrice; Cuervo-Lombard, Christine; Danion, Jean-Marie

    2013-10-01

    There is growing interest in clinical research regarding the visual perspective adopted during memory retrieval, because it reflects individuals' self-attitude towards their memories of past personal events. Several autobiographical memory deficits, including low specificity of personal memories, have been identified in schizophrenia, but visual perspective during autobiographical memory retrieval has not yet been investigated in patients. The aim of this study was therefore to investigate the visual perspective with which patients visualize themselves when recalling autobiographical memories and to assess the specificity of their memories which is a major determinant of visual perspective. Thirty patients with schizophrenia and 30 matched controls recalled personal events from 4 life periods. After each recall, they were asked to report their visual perspective (Field or Observer) associated with the event. The specificity of their memories was assessed by independent raters. Our results showed that patients reported significantly fewer Field perspectives than comparison participants. Patients' memories, whether recalled with Field or Observer perspectives, were less specific and less detailed. Our results indicate that patients with schizophrenia adopt Field perspectives less frequently than comparison participants, and that this may contribute to a weakened sense of the individual of being an actor of his past events, and hence to a reduced sense of self. They suggest that this may be related to low specificity of memories and that all the important aspects involved in re-experiencing autobiographical events are impaired in patients with schizophrenia. PMID:23932447

  13. Development of a recovery manual for suicidal patients with schizophrenia: consumer feedback.

    PubMed

    Kasckow, J; Appelt, C; Haas, G L; Huegel, S; Fox, L; Gurklis, J; Zickmund, S; Daley, D

    2012-10-01

    A recovery-oriented manual was developed for patients with schizophrenia and suicidality. It included psychoeducational information, vignettes, "workbook" sections and was reviewed by experts in suicidology, recovery, patient education, manual development and psychosocial interventions. The revised version was tested in 22 consumers with schizophrenia and a history of suicidality. Consumer-based focus groups yielded five key themes which were used to further refine the manual. A satisfaction survey indicated that 85% stated the manual was 'somewhat easy', 'easy' or 'very easy to read.' All stated it was 'very useful', 'useful' or 'somewhat useful. Thus, the manual appears to be acceptable and useful. PMID:22187086

  14. Schizophrenia patient-derived olfactory neurosphere-derived cells do not respond to extracellular reelin

    PubMed Central

    Tee, Jing Yang; Sutharsan, Ratneswary; Fan, Yongjun; Mackay-Sim, Alan

    2016-01-01

    Reelin expression is reduced in various regions in the post-mortem brain of schizophrenia patients but the exact role of reelin function in the neurobiology of schizophrenia remains elusive. Absence of reelin in knockout mouse causes inverted lamination of the neocortex due to aberrant neuronal migration. The aim of this study was to utilize patient-derived olfactory neurosphere-derived (ONS) cells to investigate whether extracellular reelin alters cell motility in schizophrenia patient-derived cells. ONS cells from nine patients were compared with cells from nine matched healthy controls. Automated high-throughput imaging and analysis were used to track motility of individual living cells on reelin-coated surfaces produced from reelin secreted into the medium by HEK293FT cells transfected with the full-length reelin plasmid pCrl. Automated assays were used to quantify intracellular cytoskeleton composition, cell morphology, and focal adhesions. Expression of reelin and components of the reelin signaling pathway were measured by western blot and flow cytometry. Reelin inhibited the motility of control cells but not patient cells, and increased the number and size of focal adhesions in control cells but not patient cells. Patient and control cells expressed similar levels of the reelin receptors and the reelin signaling protein, Dab1, but patient cells expressed less reelin. Patient cells were smaller than control cells and had less actin and acetylated α-tubulin, components of the cytoskeleton. These findings are the first direct evidence that cellular responses to reelin are impaired in schizophrenia and are consistent with the role of reelin in cytoarchitectural deficits observed in schizophrenia patient brains. PMID:27602387

  15. Schizophrenia patient-derived olfactory neurosphere-derived cells do not respond to extracellular reelin.

    PubMed

    Tee, Jing Yang; Sutharsan, Ratneswary; Fan, Yongjun; Mackay-Sim, Alan

    2016-01-01

    Reelin expression is reduced in various regions in the post-mortem brain of schizophrenia patients but the exact role of reelin function in the neurobiology of schizophrenia remains elusive. Absence of reelin in knockout mouse causes inverted lamination of the neocortex due to aberrant neuronal migration. The aim of this study was to utilize patient-derived olfactory neurosphere-derived (ONS) cells to investigate whether extracellular reelin alters cell motility in schizophrenia patient-derived cells. ONS cells from nine patients were compared with cells from nine matched healthy controls. Automated high-throughput imaging and analysis were used to track motility of individual living cells on reelin-coated surfaces produced from reelin secreted into the medium by HEK293FT cells transfected with the full-length reelin plasmid pCrl. Automated assays were used to quantify intracellular cytoskeleton composition, cell morphology, and focal adhesions. Expression of reelin and components of the reelin signaling pathway were measured by western blot and flow cytometry. Reelin inhibited the motility of control cells but not patient cells, and increased the number and size of focal adhesions in control cells but not patient cells. Patient and control cells expressed similar levels of the reelin receptors and the reelin signaling protein, Dab1, but patient cells expressed less reelin. Patient cells were smaller than control cells and had less actin and acetylated α-tubulin, components of the cytoskeleton. These findings are the first direct evidence that cellular responses to reelin are impaired in schizophrenia and are consistent with the role of reelin in cytoarchitectural deficits observed in schizophrenia patient brains. PMID:27602387

  16. Clinical characteristics in schizophrenia patients with or without suicide attempts and non-suicidal self-harm - a cross-sectional study

    PubMed Central

    2013-01-01

    Background To investigate whether schizophrenia patients with both suicide attempts and non-suicidal self-harm have earlier age of onset of psychotic and depressive symptoms and higher levels of clinical symptoms compared to patients with only suicide attempts or without suicide attempt. Methods Using a cross-sectional design, 251 patients (18–61 years old, 58% men) with schizophrenia treated at hospitals in Oslo and Innlandet Hospital Trust, Norway, were assessed with a comprehensive clinical research protocol and divided into three groups based on their history of suicide attempts and non-suicidal self-harm. Results Suicide attempts were present in 88 patients (35%); 52 had suicide attempts only (29%) and 36 had both suicide attempts and non-suicidal self-harm (14%). When compared with nonattempters and those with suicide attempts without non-suicidal self-harm, patients with both suicide attempts and non-suicidal self-harm were more frequently women, younger at the onset of psychotic symptoms, had longer duration of untreated psychosis, and had higher levels of current impulsivity/aggression and depression. Patients with both suicide attempts and non-suicidal self-harm were more likely to repeat suicide attempts than patients with suicide attempts only. Conclusions Patients with both suicide attempts and non-suicidal self-harm had different illness history and clinical characteristics compared to patients with only suicide attempts or patients without suicidal behavior. Our study suggests that patients with both suicide attempts and non-suicidal self-harm represent a distinct subgroup among patients with schizophrenia and suicidal behavior with their early onset of psychotic symptoms, high rate of repeated suicidal behavior and significant treatment delay. PMID:24106884

  17. Oscillatory Underpinnings of Mismatch Negativity and Their Relationship with Cognitive Function in Patients with Schizophrenia

    PubMed Central

    Lawrence, Phil; Miller, Sam; Dodds, Chris; Croft, Rodney; Dudas, Robert B.; Zaman, Rashid; Fernandez-Egea, Emilio; Müller, Ulrich; Dean, Anna; Bullmore, Edward T.; Nathan, Pradeep J.

    2013-01-01

    Background Impairments in mismatch negativity (MMN) generation have been consistently reported in patients with schizophrenia. However, underlying oscillatory activity of MMN deficits in schizophrenia and the relationship with cognitive impairments have not been investigated in detail. Time-frequency power and phase analyses can provide more detailed measures of brain dynamics of MMN deficits in schizophrenia. Method 21 patients with schizophrenia and 21 healthy controls were tested with a roving frequency paradigm to generate MMN. Time-frequency domain power and phase-locking (PL) analysis was performed on all trials using short-time Fourier transforms with Hanning window tapering. A comprehensive battery (CANTAB) was used to assess neurocognitive functioning. Results Mean MMN amplitude was significantly lower in patients with schizophrenia (95% CI 0.18 - 0.77). Patients showed significantly lower EEG power (95% CI -1.02 - -0.014) in the ~4-7 Hz frequency range (theta band) between 170 and 210 ms. Patients with schizophrenia showed cognitive impairment in multiple domains of CANTAB. However, MMN impairments in amplitude and power were not correlated with clinical measures, medication dose, social functioning or neurocognitive performance. Conclusion The findings from this study suggested that while MMN may be a useful marker to probe NMDA receptor mediated mechanisms and associated impairments in gain control and perceptual changes, it may not be a useful marker in association with clinical or cognitive changes. Trial-by-trial EEG power analysis can be used as a measure of brain dynamics underlying MMN deficits which also can have implications for the use of MMN as a biomarker for drug discovery. PMID:24358266

  18. Distinguishing familiarity-based from source-based memory performance in patients with schizophrenia

    PubMed Central

    Weiss, Anthony P.; Goff, Donald C.; Duff, Margaret; Roffman, Joshua L.; Schacter, Daniel L.

    2008-01-01

    Background There is substantial current interest in the cognitive deficits associated with schizophrenia, particularly those in the realm of memory. Yet the exact nature of these deficits remains a matter of some debate. This study sought to examine performance on two distinct aspects of memory performance: familiarity-based and source-based memory processes. Methods Eighteen medicated outpatients with schizophrenia and eighteen healthy adult control subjects performed an external source memory task. Key measures included the ability to distinguish old (previously experienced) items from new items, the ability to correctly identify the source (male voice or female voice) of previously experienced items, and the reaction time associated with these responses. Results Patients with schizophrenia showed an impaired ability to distinguish old from new items, but intact performance in correctly identifying the source of items recognized as old. Whereas control subjects showed a rapid response to items deemed unfamiliar, particularly in rejecting novel items, these responses were slowed in patients with schizophrenia. This was not attributable to a generalized diminution in processing speed, as reaction times to correctly recognized old items (regardless of source accuracy) did not differ between the two groups. Conclusions Patients with schizophrenia demonstrated impaired familiarity-based and intact source-based memory performance. In addition, the reaction time for novelty detection, an important component of familiarity-based memory, was significantly delayed in patients compared to controls, while the response times for source-based decisions were completely overlapping. Considered together, these findings suggest a deficit in the familiarity-based aspect of episodic memory in at least some patients with schizophrenia. PMID:17629463

  19. Managing patients for zoonotic disease in hospitals

    PubMed Central

    Warwick, Clifford; Corning, Susan

    2013-01-01

    Zoonoses involve infections and infestations transmissible from animals to humans. Zoonoses are a major global threat. Exposure to zoonotic pathogens exists in various settings including encroachment on nature; foreign travel; pet keeping; bushmeat consumption; attendance at zoological parks, petting zoos, school ‘animal contact experiences’, wildlife markets, circuses, and domesticated and exotic animal farms. Under-ascertainment is believed to be common and the frequency of some zoonotic disease appears to be increasing. Zoonoses include direct, indirect and aerosolized transmission. Improved awareness of zoonoses in the hospital environment may be important to the growing need for prevention and control. We reviewed relevant literature for the years 2000 to present and identified a significant need for the promotion of awareness and management of zoonoses in the hospital environment. This article provides a new decision-tree, as well as staff and patient guidance on the prevention and control of zoonoses associated with hospitals. PMID:24040497

  20. Specific vulnerability of face perception to noise: A similar effect in schizophrenia patients and healthy individuals

    PubMed Central

    Chen, Yue; McBain, Ryan; Norton, Daniel

    2014-01-01

    Face perception plays a foundational role in the social world. This perceptual ability is deficient in schizophrenia. A noise-filtering mechanism is essential for perceptual processing. It remains unclear as to whether a specific noise-filtering mechanism is implicated in the face perception problem or a general noise-filtering mechanism is involved which also mediates non-face visual perception problems associated with this psychiatric disorder. This study examined and compared the effects of external noise on the performance of face discrimination and car discrimination in schizophrenia patients (n=25) and healthy controls (n=27). Superimposing the external visual noise on face or car stimuli elevated perceptual thresholds (i.e. degraded performance levels) for both face and car discrimination. However, the effect of noise was significantly larger on face than on car discrimination, both in patients and controls. This pattern of results suggests specific vulnerability of face processing to noise in healthy individuals and those with schizophrenia. PMID:25500350

  1. Effect of perceived intimacy on social decision-making in patients with schizophrenia.

    PubMed

    Park, Sunyoung; Shin, Jung Eun; Han, Kiwan; Shin, Yu-Bin; Kim, Jae-Jin

    2014-01-01

    Social dysfunctions including emotional perception and social decision-making are common in patients with schizophrenia. The aim of this study was to determine the level of intimacy formation and the effect of intimacy on social decision in patients with schizophrenia using virtual reality tasks, which simulate complicated social situations. Twenty-seven patients with schizophrenia and 30 healthy controls performed the 2 virtual social tasks: the intimacy task and the social decision task. The first one was to estimate repeatedly how intimate participants felt with each avatar after listening to what avatars said. The second one was to decide whether or not participants accepted the requests of easy, medium, or hard difficulty by the intimate or distant avatars. During the intimacy task, the intimacy rating scores for intimate avatars were not significantly different between groups, but those for distant avatars were significantly higher in patients than in controls. During the social decision task, the difference in the acceptance rate between intimate and distant avatars was significantly smaller in patients than in controls. In detail, a significant group difference in the acceptance rate was found only for the hard requests, but not for the easy and medium difficulty requests. These results suggest that patients with schizophrenia have a deficit in emotional perception and social decision-making. Various factors such as a peculiarity of emotional deficits, motivational deficits, concreteness, and paranoid tendency may contribute to these abnormalities. PMID:25505397

  2. Effect of Perceived Intimacy on Social Decision-Making in Patients with Schizophrenia

    PubMed Central

    Park, Sunyoung; Shin, Jung Eun; Han, Kiwan; Shin, Yu-Bin; Kim, Jae-Jin

    2014-01-01

    Social dysfunctions including emotional perception and social decision-making are common in patients with schizophrenia. The aim of this study was to determine the level of intimacy formation and the effect of intimacy on social decision in patients with schizophrenia using virtual reality tasks, which simulate complicated social situations. Twenty-seven patients with schizophrenia and 30 healthy controls performed the 2 virtual social tasks: the intimacy task and the social decision task. The first one was to estimate repeatedly how intimate participants felt with each avatar after listening to what avatars said. The second one was to decide whether or not participants accepted the requests of easy, medium, or hard difficulty by the intimate or distant avatars. During the intimacy task, the intimacy rating scores for intimate avatars were not significantly different between groups, but those for distant avatars were significantly higher in patients than in controls. During the social decision task, the difference in the acceptance rate between intimate and distant avatars was significantly smaller in patients than in controls. In detail, a significant group difference in the acceptance rate was found only for the hard requests, but not for the easy and medium difficulty requests. These results suggest that patients with schizophrenia have a deficit in emotional perception and social decision-making. Various factors such as a peculiarity of emotional deficits, motivational deficits, concreteness, and paranoid tendency may contribute to these abnormalities. PMID:25505397

  3. Distribution of Active and Resting Periods in the Motor Activity of Patients with Depression and Schizophrenia

    PubMed Central

    Hauge, Erik; Berle, Jan Øystein; Dilsaver, Steven; Oedegaard, Ketil J.

    2016-01-01

    Objective Alterations of activity are prominent features of the major functional psychiatric disorders. Motor activity patterns are characterized by bursts of activity separated by periods with inactivity. The purpose of the present study has been to analyze such active and inactive periods in patients with depression and schizophrenia. Methods Actigraph registrations for 12 days from 24 patients with schizophrenia, 23 with depression and 29 healthy controls. Results Patients with schizophrenia and depression have distinctly different profiles with regard to the characterization and distribution of active and inactive periods. The mean duration of active periods is lowest in the depressed patients, and the duration of inactive periods is highest in the patients with schizophrenia. For active periods the cumulative probability distribution, using lengths from 1 to 35 min, follows a straight line on a log-log plot, suggestive of a power law function, and a similar relationship is found for inactive periods, using lengths from 1 to 20 min. For both active and inactive periods the scaling exponent is higher in the depressed compared to the schizophrenic patients. Conclusion The present findings add to previously published results, with other mathematical methods, suggesting there are important differences in control systems regulating motor behavior in these two major groups of psychiatric disorders. PMID:26766953

  4. The validity of Psychosis Proneness Scales as vulnerability indicators in recent-onset schizophrenia patients.

    PubMed

    Horan, William P; Reise, Steven P; Subotnik, Kenneth L; Ventura, Joseph; Nuechterlein, Keith H

    2008-03-01

    The Psychosis Proneness Scales developed by the Chapmans and colleagues [Chapman, J.P., Chapman, L.J., Kwapil, T.R. Scales for the measurement of schizotypy. In: Raine., A., Lencz, T., Mednick, S.A., (Eds.). Schizotypal Personality. New York: Cambridge University Press, 1995. pp. 79-109] are widely used to identify non-patient individuals who are hypothesized to possess heightened vulnerability to schizophrenia and related psychopathology. Yet surprisingly little is known about whether schizophrenia patients themselves show abnormalities on these scales across different clinical states, as would be expected for vulnerability indicators. Scores on four of the Psychosis Proneness Scales were evaluated at three assessment points over a 15-month period in healthy controls (n=54) and in recent-onset schizophrenia patients (n=72) who experienced symptom fluctuations across assessments. Patients showed steady elevations on the Physical Anhedonia Scale across time and clinical state, consistent with a stable vulnerability indicator. Patients had higher scores on the Perceptual Aberration and Magical Ideation Scales than controls throughout the follow-up period but scores also changed across clinical states, consistent with a mediating vulnerability indicator. Patients had higher scores on the Impulsive Non-Conformity Scale than controls only during a psychotic state, reflecting an episode indicator. The longitudinal characteristics of these scales in people who are actually diagnosed with schizophrenia provide key evidence for the validity of three commonly used psychometric indicators of vulnerability to psychosis. PMID:18221857

  5. Neural substrate of quality of life in patients with schizophrenia: a magnetisation transfer imaging study

    PubMed Central

    Catherine, Faget-Agius; Boyer, Laurent; Jonathan, Wirsich; Jean-Philippe, Ranjeva; Raphaelle, Richieri; Elisabeth, Soulier; Sylviane, Confort-Gouny; Pascal, Auquier; Maxime, Guye; Christophe, Lançon

    2015-01-01

    The aim of this study was to investigate the neural substrate underlying quality of life (QoL) and to demonstrate the microstructural abnormalities associated with impaired QoL in a large sample of patients with schizophrenia, using magnetisation transfer imaging. A total of 81 right-handed men with a diagnosis of schizophrenia and 25 age- and sex-similar healthy controls were included and underwent a 3T MRI with magnetization transfer ratio (MTR) to detect microstructural abnormalities. Compared with healthy controls, patients with schizophrenia had grey matter (GM) decreased MTR values in the temporal lobe (BA21, BA37 and BA38), the bilateral insula, the occipital lobe (BA17, BA18 and BA19) and the cerebellum. Patients with impaired QoL had lower GM MTR values relative to patients with preserved QoL in the bilateral temporal pole (BA38), the bilateral insula, the secondary visual cortex (BA18), the vermis and the cerebellum. Significant correlations between MTR values and QoL scores (p < 0.005) were observed in the GM of patients in the right temporal pole (BA38), the bilateral insula, the vermis and the right cerebellum. Our study shows that QoL impairment in patients with schizophrenia is related to the microstructural changes in an extensive network, suggesting that QoL is a bio-psychosocial marker. PMID:26632639

  6. Social Alienation in Schizophrenia Patients: Association with Insula Responsiveness to Facial Expressions of Disgust

    PubMed Central

    Lindner, Christian; Dannlowski, Udo; Walhöfer, Kirsten; Rödiger, Maike; Maisch, Birgit; Bauer, Jochen; Ohrmann, Patricia; Lencer, Rebekka; Zwitserlood, Pienie; Kersting, Anette; Heindel, Walter; Arolt, Volker

    2014-01-01

    Introduction Among the functional neuroimaging studies on emotional face processing in schizophrenia, few have used paradigms with facial expressions of disgust. In this study, we investigated whether schizophrenia patients show less insula activation to macro-expressions (overt, clearly visible expressions) and micro-expressions (covert, very brief expressions) of disgust than healthy controls. Furthermore, departing from the assumption that disgust faces signal social rejection, we examined whether perceptual sensitivity to disgust is related to social alienation in patients and controls. We hypothesized that high insula responsiveness to facial disgust predicts social alienation. Methods We used functional magnetic resonance imaging to measure insula activation in 36 schizophrenia patients and 40 healthy controls. During scanning, subjects passively viewed covert and overt presentations of disgust and neutral faces. To measure social alienation, a social loneliness scale and an agreeableness scale were administered. Results Schizophrenia patients exhibited reduced insula activation in response to covert facial expressions of disgust. With respect to macro-expressions of disgust, no between-group differences emerged. In patients, insula responsiveness to covert faces of disgust was positively correlated with social loneliness. Furthermore, patients' insula responsiveness to covert and overt faces of disgust was negatively correlated with agreeableness. In controls, insula responsiveness to covert expressions of disgust correlated negatively with agreeableness. Discussion Schizophrenia patients show reduced insula responsiveness to micro-expressions but not macro-expressions of disgust compared to healthy controls. In patients, low agreeableness was associated with stronger insula response to micro- and macro-expressions of disgust. Patients with a strong tendency to feel uncomfortable with social interactions appear to be characterized by a high sensitivity for

  7. Antipsychotic Medication Prescribing Practices Among Adult Patients Discharged From State Psychiatric Inpatient Hospitals

    PubMed Central

    HOLLEN, VERA; SCHACHT, LUCILLE

    2016-01-01

    Objectives: The goal of this study was to explore antipsychotic medication prescribing practices in a sample of 86,034 patients discharged from state psychiatric inpatient hospitals and to find the prevalence of patients discharged with no antipsychotic medications, on antipsychotic monotherapy, and on antipsychotic polypharmacy. For patients discharged on antipsychotic polypharmacy, the study explored the adjusted rates of antipsychotic polypharmacy, the reasons patients were discharged on antipsychotic polypharmacy, the proportion of antipsychotic polypharmacy by mental health disorder, and the characteristics associated with being discharged on antipsychotic polypharmacy. Methods: This cross-sectional study analyzed all discharges for adult patients (18 to 64 y of age) from state psychiatric inpatient hospitals between January 1 and December 31, 2011. The relationship among variables was explored using χ2, t test, and analysis of variance. Logistic regression was used to determine predictors of antipsychotic polypharmacy. Results: The prevalence of antipsychotic polypharmacy was 12%. Of the discharged patients receiving at least 1 antipsychotic medication (adjusted rate), 18% were on antipsychotic polypharmacy. The strongest predictors of antipsychotic polypharmacy being prescribed were having a diagnosis of schizophrenia and a length of stay of 90 days or more. Patients were prescribed antipsychotic polypharmacy primarily to reduce their symptoms. Conclusions: Antipsychotic polypharmacy continues at a high enough rate to affect nearly 10,000 patients with a diagnosis of schizophrenia each year in state psychiatric inpatient hospitals. Further analysis of the clinical presentation of these patients may highlight particular aspects of the illness and its previous treatment that are contributing to practices outside the best-practice guideline. An increased understanding of trend data, patient characteristics, and national benchmarks provides an opportunity for

  8. Project Among African-Americans to Explore Risks for Schizophrenia (PAARTNERS): Evidence for Impairment and Heritability of Neurocognitive Functioning in Families of Schizophrenia Patients

    PubMed Central

    Calkins, Monica E.; Tepper, Ping; Gur, Ruben C.; Ragland, J. Daniel; Klei, Lambertus; Wiener, Howard W.; Richard, Jan; Savage, Robert M.; Allen, Trina B.; O'Jile, Judith; Devlin, Bernie; Kwentus, Joseph; Aliyu, Muktar H.; Bradford, L. DiAnne; Edwards, Neil; Lyons, Paul D.; Nimgaonkar, Vishwajit L.; Santos, Alberto B.; Go, Rodney C.P.; Gur, Raquel E.

    2015-01-01

    Objective Neurocognitive impairments in schizophrenia are well replicated and widely regarded as candidate endophenotypes that may facilitate understanding of schizophrenia genetics and pathophysiology. The Project Among African-Americans to Explore Risks for Schizophrenia (PAARTNERS) aims to identify genes underlying liability to schizophrenia. The unprecedented size of its study group (N=1,872), made possible through use of a computerized neurocognitive battery, can help further investigation of the genetics of neurocognition. The current analysis evaluated two characteristics not fully addressed in prior research: 1) heritability of neurocognition in African American families and 2) relationship between neurocognition and psychopathology in families of African American probands with schizophrenia or schizoaffective disorder. Method Across eight data collection sites, patients with schizophrenia or schizoaffective disorder (N=610), their biological relatives (N=928), and community comparison subjects (N=334) completed a standardized diagnostic evaluation and the computerized neurocognitive battery. Performance accuracy and response time (speed) were measured separately for 10 neurocognitive domains. Results The patients with schizophrenia or schizoaffective disorder exhibited less accuracy and speed in most neurocognitive domains than their relatives both with and without other psychiatric disorders, who in turn were more impaired than comparison subjects in most domains. Estimated trait heritability after inclusion of the mean effect of diagnostic status, age, and sex revealed significant heritabilities for most neurocognitive domains, with the highest for accuracy of abstraction/ flexibility, verbal memory, face memory, spatial processing, and emotion processing and for speed of attention. Conclusions Neurocognitive functions in African American families are heritable and associated with schizophrenia. They show potential for gene-mapping studies. PMID:20194479

  9. Psychopathology and treatment responsiveness of patients with first-episode schizophrenia.

    PubMed

    Cesková, Eva; Prikryl, Radovan; Kaspárek, Tomás; Ondrusová, Marta

    2005-06-01

    One hundred and four male patients hospitalized for the first time with the diagnosis of first-episode schizophrenia were comprehensively assessed on admission and discharge. Psychopathology, treatment response, and remission rates were evaluated (based on the Positive and Negative Syndrome Scale (PANSS), severity of symptoms only). On admission, the most frequently observed symptoms were lack of judgment and insight (87.6%), suspiciousness/feelings of persecution (82.3%), delusions (77%), poor attention (70%), disturbance of volition (65.4%), conceptual disorganization (64.7%), and active social avoidance (64%). Except for delusions and hallucinations, the positive items of the PANSS correlated significantly with negative symptoms, and conceptual disorganization correlated with the greatest number of negative symptoms. Individual negative symptoms were present in about half the patients. At discharge, the most frequent symptoms were again lack of judgment and insight (in 55.7%), and for negative symptoms they were blunted affect (22.1%), emotional withdrawal (21.2%), and passive/apathetic social withdrawal (19.5%). The positive symptoms of suspiciousness/feelings of persecution and grandiosity persisted in 20.6% of patients. On average, all symptoms were significantly reduced 44 days after admission. The negative symptoms improved less, compared with the positive ones. At discharge there was a high rate of responders (response defined as minimal 30% reduction of total PANSS): 73% and 74% of patients fulfilled the criteria for remission. On admission, the responders (n = 76) had significantly higher scores of most symptoms, both positive and negative ones than nonresponders (n = 28). PMID:18568064

  10. Dysregulated 14-3-3 Family in Peripheral Blood Leukocytes of Patients with Schizophrenia

    PubMed Central

    Qing, Ying; Sun, Liya; Yang, Chao; Jiang, Jie; Yang, Xuhan; Hu, Xiaowen; Cui, Donghong; Xu, Yifeng; He, Lin; Han, Dongmei; Wan, Chunling

    2016-01-01

    The 14-3-3 family, which is composed of seven distinct members in humans, plays important roles in the cell cycle, apoptosis, synaptic plasticity and neuronal differentiation and migration. Previous genetic and post-mortem gene expression studies have linked this family to schizophrenia. However, the direction of gene expression changes in these studies has been inconsistent, and reports of 14-3-3 gene expression in living schizophrenic patients are still lacking. Here, we assessed 14-3-3 gene and protein expression levels in peripheral blood leukocytes from drug-naïve first-episode schizophrenic patients and matched controls. mRNA and protein expression levels were quantified by qRT-PCR and UPLC-MRM/MS, respectively. Expression analysis revealed four downregulated and one upregulated mRNA transcripts as well as five downregulated protein levels of 14-3-3 isoforms in schizophrenia. Moreover, significant positive correlations between 14-3-3 mRNA and protein expression levels were found in schizophrenia, and we also identified negative correlations between ε, θ and ζ isoform expression levels and positive symptoms of schizophrenia. Our results suggest that gene and protein expression levels for the 14-3-3 family are dysregulated in schizophrenia, perhaps owing to specific regulatory mechanisms, and we also suggest that expression of the 14-3-3ε, θ and ζ isoform genes could be useful indicators of disease severity. PMID:27030512

  11. Early-Course Unmedicated Schizophrenia Patients Exhibit Elevated Prefrontal Connectivity Associated with Longitudinal Change

    PubMed Central

    Anticevic, Alan; Hu, Xinyu; Xiao, Yuan; Hu, Junmei; Li, Fei; Bi, Feng; Cole, Michael W.; Savic, Aleksandar; Yang, Genevieve J.; Repovs, Grega; Murray, John D.; Wang, Xiao-Jing; Huang, Xiaoqi; Lui, Su; Krystal, John H.

    2015-01-01

    Strong evidence implicates prefrontal cortex (PFC) as a major source of functional impairment in severe mental illness such as schizophrenia. Numerous schizophrenia studies report deficits in PFC structure, activation, and functional connectivity in patients with chronic illness, suggesting that deficient PFC functional connectivity occurs in this disorder. However, the PFC functional connectivity patterns during illness onset and its longitudinal progression remain uncharacterized. Emerging evidence suggests that early-course schizophrenia involves increased PFC glutamate, which might elevate PFC functional connectivity. To test this hypothesis, we examined 129 non-medicated, human subjects diagnosed with early-course schizophrenia and 106 matched healthy human subjects using both whole-brain data-driven and hypothesis-driven PFC analyses of resting-state fMRI. We identified increased PFC connectivity in early-course patients, predictive of symptoms and diagnostic classification, but less evidence for “hypoconnectivity.” At the whole-brain level, we observed “hyperconnectivity” around areas centered on the default system, with modest overlap with PFC-specific effects. The PFC hyperconnectivity normalized for a subset of the sample followed longitudinally (n = 25), which also predicted immediate symptom improvement. Biologically informed computational modeling implicates altered overall connection strength in schizophrenia. The initial hyperconnectivity, which may decrease longitudinally, could have prognostic and therapeutic implications. PMID:25568120

  12. Neuroimaging findings from childhood onset schizophrenia patients and their non-psychotic siblings.

    PubMed

    Ordóñez, Anna E; Luscher, Zoe I; Gogtay, Nitin

    2016-06-01

    Childhood onset schizophrenia (COS), with onset of psychosis before age 13, is a rare form of schizophrenia that represents a more severe and chronic form of the adult onset illness. In this review we examine structural and functional magnetic resonance imaging (MRI) studies of COS and non-psychotic siblings of COS patients in the context of studies of schizophrenia as a whole. Studies of COS to date reveal progressive loss of gray matter volume and cortical thinning, ventricular enlargement, progressive decline in cerebellar volume and a significant but fixed deficit in hippocampal volume. COS is also associated with a slower rate of white matter growth and disrupted local connectivity strength. Sibling studies indicate that non-psychotic siblings of COS patients share many of these brain abnormalities, including decreased cortical thickness and disrupted white matter growth, yet these abnormalities normalize with age. Cross-sectional and longitudinal neuroimaging studies remain some of the few methods for assessing human brain function and play a pivotal role in the quest for understanding the neurobiology of schizophrenia as well as other psychiatric disorders. Parallel studies in non-psychotic siblings provide a unique opportunity to understand both risk and resilience in schizophrenia. PMID:25819937

  13. Poor performance in smooth pursuit and antisaccadic eye-movement tasks in healthy siblings of patients with schizophrenia.

    PubMed

    Karoumi, B; Saoud, M; d'Amato, T; Rosenfeld, F; Denise, P; Gutknecht, C; Gaveau, V; Beaulieu, F E; Daléry, J; Rochet, T

    2001-04-15

    This study examines the area of eye movement dysfunctions as an indicator of vulnerability to schizophrenia. Eye movement performance was investigated with three different paradigms: Smooth Pursuit Eye Movements (SPEM); Visually Guided Saccades (VGS); and Antisaccades (AS) in 21 clinically stable patients with schizophrenia, 21 of their healthy, biological full siblings and 21 healthy control subjects. The three groups did not differ on VGS performance, whereas both patients and their siblings showed lower SPEM gain, an increased catch-up Saccades (CUS) rate, reduced AS accuracy and an increased number of AS errors in comparison to control subjects. In addition, patients with schizophrenia exhibited increased AS latency. Among the patients with schizophrenia, eye movement abnormalities did not correlate with age, gender, clinical state or duration of illness. These data suggest that abnormalities of SPEM and AS may represent neurobiological markers of the vulnerability to schizophrenia in individuals at high genetic risk for the disease. PMID:11311924

  14. Sexual obsessions and suicidal behaviors in patients with mood disorders, panic disorder and schizophrenia

    PubMed Central

    2012-01-01

    Background The topic of sexual obsessions as a psychiatric symptom has not been well investigated. The aim of this study was twofold: 1) to explore the presence of sexual obsessions in patients with mood disorders (n=156), panic disorder (n=54) and schizophrenia (n=79), with respect to non-psychiatric subjects (n=100); 2) to investigate the relationship between sexual obsessions and suicidal behaviors, taking into account socio-demographic variables ad mental disorders. Methods 289 psychiatric patients with mood disorders, panic disorder or schizophrenia, were recruited at the Italian University departments of psychiatry along with 100 non-psychiatric subjects, who presented for a routine eye exam at the ophthalmology department of the same Universities. The assessments included: the Structured Clinical Interview for DSM-IV-TR, the Brief Psychiatric Rating Scale (BPRS), the Obsessive-Compulsive Spectrum Self-Report (OBS-SR), for sexual obsession, and the Mood Spectrum-Self Report lifetime version (MOODS-SR). Suicidality was assessed by means of 6 items of the MOODS-SR. Results Sexual obsessions were more frequent in schizophrenia (54.4%), followed by mood disorders (35.9%). Among schizophrenia patients, males reported more sexual obsessions than females (P<0.01). Subjects who were more likely to report suicidal behaviors (suicidal ideation, plans and attempts) were female (adjusted OR=1.99), patients with mental disorders, specifically mood disorders (adjusted OR=11.5), schizophrenia (adjusted OR=3.7) or panic disorder (adjusted OR=2.9), and subjects who reported lifetime sexual obsessions (adjusted OR= 3.6). Sexual obsessions remained independently associated with all aspects of suicidal behaviors. Age, education, marital and employment status were not related to suicidal behaviors. Conclusions Special attention should be given to investigate and establish effective strategies of treatment for sexual obsessions, especially those with comorbid mood disorders or

  15. Neural correlates of out-group bias predict social impairment in patients with schizophrenia

    PubMed Central

    Blackford, JU; Williams, LE; Heckers, S

    2015-01-01

    Background Social impairments are a hallmark feature of schizophrenia and are a key predictor of functional disability. Deficits in social information processing likely underlie social impairment; however, this relationship is understudied. We previously demonstrated that patients with schizophrenia fail to habituate to neutral faces, providing evidence for an alteration in basic social information processing. It remains unknown whether patients with schizophrenia also show deficits in processing of more complex social information. Out-group bias provides an excellent opportunity to test complex social information processing because the bias requires basic face processing skills, the ability to discriminate between groups, as well as the ability to categorize oneself into a salient social group. Methods Study participants were 23 patients with schizophrenia and 21 controls. Using functional magnetic resonance imaging, habituation of response to 120 seconds of repeated presentations of faces was assessed in participants who viewed either same-gender faces or opposite-gender faces. The interaction between face gender (same/opposite) and group was examined in three key regions: amygdala, hippocampus, and visual cortex. Social impairment was measured using the PANSS and correlations between social impairment and out-group effect (main effect of face type) were performed in patients. Results Patients with schizophrenia had aberrant neural responses to opposite-gender faces (interaction, p < .05 corrected). Healthy controls showed an immediate heightened response to opposite-gender faces relative to same-gender faces; but in patients this effect was substantially delayed (~ 70 seconds). In patients with schizophrenia, the out-group bias was significantly correlated with social impairment. Patients with no social impairment showed a heightened neural response to opposite-gender faces after 30 seconds, whereas patients with mild-moderate social impairment failed to ever

  16. Dietary Intake in Body Mass Index Differences in Community-Based Japanese Patients with Schizophrenia

    PubMed Central

    ITO, Haruyuki; KUMAGAI, Takako; KIMURA, Midori; KOIKE, Shotaro; SHIMIZU, Takeshi

    2015-01-01

    Background: Patients with schizophrenia reportedly have a high prevalence of obesity. One of the reasons is a poor choice of diet. The goal of this study was to clarify characteristics of the dietary intake across the strata of the body mass index (BMI) and to compare the general population and patients with schizophrenia in Japan. Methods: This is a cross-sectional study of 51 patients with schizophrenia residing in rural areas in 2011. Anthropometric indices (of height, weight, body mass index) were measured at the commencement of the survey. Intakes of energy, protein, fat, carbohydrate, calcium, phosphorus, vitamins, total fiber, and salt were noted through a 3-day dietary recording. The nutrient intake was estimated using Excel add-in software (Excel Eiyou-kun Ver. 6.0, Kenpakusha Co., Ltd.). Patients were divided into two groups: those with a BMI ≥25 kg/m2 and with a BMI <25 kg/m2, and the differences in their nutrition intake were analyzed. To compare these patients with the general population, the results of the National Health and Nutrition Survey, 2010 (NHNS) were used (the NHNS group). For statistical analysis, an unpaired t-test was performed with P < 0.05. Results: Patients with a BMI ≥25 kg/m2 had the higher intakes than those with a BMI <25 kg/m2 of energy, fat and phosphorus and salt. Patients with schizophrenia showed higher intakes of energy, carbohydrate, fat, calcium, phosphorus and salt than the NHNS group. Conclusion: The characteristics of the dietary intake in patients with schizophrenia were suggested the food constitution that is likely to increase the body weight. PMID:26284204

  17. Decreased DNA Methylation in the Shati/Nat8l Promoter in Both Patients with Schizophrenia and a Methamphetamine-Induced Murine Model of Schizophrenia-Like Phenotype

    PubMed Central

    Uno, Kyosuke; Kikuchi, Yuu; Iwata, Mina; Uehara, Takashi; Matsuoka, Tadasu; Sumiyoshi, Tomiki; Okamoto, Yoshinori; Jinno, Hideto; Takada, Tatsuyuki; Furukawa-Hibi, Yoko; Nabeshima, Toshitaka; Miyamoto, Yoshiaki

    2016-01-01

    The number of patients with schizophrenia has increased over the past decade. Previously, many studies have been performed to establish its diagnostic criteria, prophylactic methods, and effective therapies. In this study, we analyzed whether the ratios of DNA methylation in CpG islands of the Shati/Nat8l is decreased in model mice of schizophrenia-like phenotype using genomic DNA collected from brain regions and peripheral blood, since the mouse model of schizophrenia-like phenotype, mice treated repeatedly with methamphetamine showed increase of Shati/Nat8l mRNA expression in our previous experiment. The ratios of Shati/Nat8l CpG island methylation were significantly decreased in both the nucleus accumbens and the peripheral blood of model mice compared with those of control mice. We also investigated Shati/Nat8l methylation in the blood of patients with schizophrenia. We found that Shati/Nat8l CpG island methylation ratios were lower in the patients with schizophrenia than in the healthy controls, which is consistent with our findings in the mice model. To our knowledge, this is the first study to show similar alterations in methylation status of a particular genomic DNA site in both the brain and peripheral blood of mice. Furthermore, the same phenomenon was observed in corresponding human genomic sequences of the DNA extracted from the peripheral blood of patients with schizophrenia. Based on our findings, DNA methylation profiles of the CpG island of Shati/Nat8l might be a diagnostic biomarker of schizophrenia. PMID:27348532

  18. Decreased DNA Methylation in the Shati/Nat8l Promoter in Both Patients with Schizophrenia and a Methamphetamine-Induced Murine Model of Schizophrenia-Like Phenotype.

    PubMed

    Uno, Kyosuke; Kikuchi, Yuu; Iwata, Mina; Uehara, Takashi; Matsuoka, Tadasu; Sumiyoshi, Tomiki; Okamoto, Yoshinori; Jinno, Hideto; Takada, Tatsuyuki; Furukawa-Hibi, Yoko; Nabeshima, Toshitaka; Miyamoto, Yoshiaki; Nitta, Atsumi

    2016-01-01

    The number of patients with schizophrenia has increased over the past decade. Previously, many studies have been performed to establish its diagnostic criteria, prophylactic methods, and effective therapies. In this study, we analyzed whether the ratios of DNA methylation in CpG islands of the Shati/Nat8l is decreased in model mice of schizophrenia-like phenotype using genomic DNA collected from brain regions and peripheral blood, since the mouse model of schizophrenia-like phenotype, mice treated repeatedly with methamphetamine showed increase of Shati/Nat8l mRNA expression in our previous experiment. The ratios of Shati/Nat8l CpG island methylation were significantly decreased in both the nucleus accumbens and the peripheral blood of model mice compared with those of control mice. We also investigated Shati/Nat8l methylation in the blood of patients with schizophrenia. We found that Shati/Nat8l CpG island methylation ratios were lower in the patients with schizophrenia than in the healthy controls, which is consistent with our findings in the mice model. To our knowledge, this is the first study to show similar alterations in methylation status of a particular genomic DNA site in both the brain and peripheral blood of mice. Furthermore, the same phenomenon was observed in corresponding human genomic sequences of the DNA extracted from the peripheral blood of patients with schizophrenia. Based on our findings, DNA methylation profiles of the CpG island of Shati/Nat8l might be a diagnostic biomarker of schizophrenia. PMID:27348532

  19. Nonverbal Synchrony in Social Interactions of Patients with Schizophrenia Indicates Socio-Communicative Deficits

    PubMed Central

    Kupper, Zeno; Ramseyer, Fabian; Hoffmann, Holger; Tschacher, Wolfgang

    2015-01-01

    Background Disordered interpersonal communication can be a serious problem in schizophrenia. Recent advances in computer-based measures allow reliable and objective quantification of nonverbal behavior. Research using these novel measures has shown that objective amounts of body and head movement in patients with schizophrenia during social interactions are closely related to the symptom profiles of these patients. In addition to and above mere amounts of movement, the degree of synchrony, or imitation, between patients and normal interactants may be indicative of core deficits underlying various problems in domains related to interpersonal communication, such as symptoms, social competence, and social functioning. Methods Nonverbal synchrony was assessed objectively using Motion Energy Analysis (MEA) in 378 brief, videotaped role-play scenes involving 27 stabilized outpatients diagnosed with paranoid-type schizophrenia. Results Low nonverbal synchrony was indicative of symptoms, low social competence, impaired social functioning, and low self-evaluation of competence. These relationships remained largely significant when correcting for the amounts of patients‘ movement. When patients showed reduced imitation of their interactants’ movements, negative symptoms were likely to be prominent. Conversely, positive symptoms were more prominent in patients when their interaction partners’ imitation of their movements was reduced. Conclusions Nonverbal synchrony can be an objective and sensitive indicator of the severity of patients’ problems. Furthermore, quantitative analysis of nonverbal synchrony may provide novel insights into specific relationships between symptoms, cognition, and core communicative problems in schizophrenia. PMID:26716444

  20. Irony and proverb comprehension in schizophrenia: do female patients "dislike" ironic remarks?

    PubMed

    Rapp, Alexander M; Langohr, Karin; Mutschler, Dorothee E; Wild, Barbara

    2014-01-01

    Difficulties in understanding irony and sarcasm are part of the social cognition deficits in patients with schizophrenia. A number of studies have reported higher error rates during comprehension in patients with schizophrenia. However, the relationships of these impairments to schizotypal personality traits and other language deficits, such as the comprehension of proverbs, are unclear. We investigated irony and proverb comprehension in an all-female sample of 20 schizophrenia patients and 27 matched controls. Subjects indicated if a statement was intended to be ironic, literal, or meaningless and furthermore rated the meanness and funniness of the stimuli and certainty of their decision. Patients made significantly more errors than controls did. Globally, there were no overall differences in the ratings. However, patients rated the subgroup of stimuli with answers given incorrectly as having significantly less meanness and in case of an error indicated a significantly higher certainty than controls. Across all of the study participants, performances in irony (r = -0.51) and proverb (r = 0.56) comprehension were significantly correlated with schizotypal personality traits, suggesting a continuum of nonliteral language understanding. Because irony is so frequent in everyday conversations, this makes irony an especially promising candidate for social cognition training in schizophrenia. PMID:24991434

  1. Regional gray matter abnormalities in patients with schizophrenia determined with optimized voxel-based morphometry

    NASA Astrophysics Data System (ADS)

    Guo, XiaoJuan; Yao, Li; Jin, Zhen; Chen, Kewei

    2006-03-01

    This study examined regional gray matter abnormalities across the whole brain in 19 patients with schizophrenia (12 males and 7 females), comparing with 11 normal volunteers (7 males and 4 females). The customized brain templates were created in order to improve spatial normalization and segmentation. Then automated preprocessing of magnetic resonance imaging (MRI) data was conducted using optimized voxel-based morphometry (VBM). The statistical voxel based analysis was implemented in terms of two-sample t-test model. Compared with normal controls, regional gray matter concentration in patients with schizophrenia was significantly reduced in the bilateral superior temporal gyrus, bilateral middle frontal and inferior frontal gyrus, right insula, precentral and parahippocampal areas, left thalamus and hypothalamus as well as, however, significant increases in gray matter concentration were not observed across the whole brain in the patients. This study confirms and extends some earlier findings on gray matter abnormalities in schizophrenic patients. Previous behavior and fMRI researches on schizophrenia have suggested that cognitive capacity decreased and self-conscious weakened in schizophrenic patients. These regional gray matter abnormalities determined through structural MRI with optimized VBM may be potential anatomic underpinnings of schizophrenia.

  2. White-matter connectivity related to paliperidone treatment response in patients with schizophrenia.

    PubMed

    Kim, Min-Kyoung; Kim, Borah; Lee, Kang Soo; Kim, Chan Mo; Bang, Seong Yun; Choi, Tai Kiu; Lee, Sang-Hyuk

    2016-03-01

    The objective of this study was to examine whether white-matter (WM) connectivity of patients with schizophrenia at early stage of treatment is related to treatment response after paliperidone extended-release (ER) treatment. Forty-one patients with schizophrenia and 17 age- and sex-matched healthy control subjects were included in this study. Brain magnetic resonance scans at 3 Tesla were conducted at early stage of treatment. Voxel-wise statistical analysis of the fractional anisotropy (FA) data was performed using Tract-Based Spatial Statistics. At baseline and eight weeks after paliperidone treatment, patients were assessed using the Positive and Negative Syndrome Scale, the Scale for the Assessment of Positive Symptoms and the Scale for the Assessment of Negative Symptoms. Among the patients with schizophrenia, the FA values of the corpus callosum, corona radiata, internal capsule, external capsule, superior longitudinal fasciculus and fronto-temporal WM regions showed significant negative correlations with scores of the treatment response. The current study suggests that the treatment response after paliperidone ER treatment may be associated with the fronto-temporo-limbic WM connectivity at early stage of treatment in patients with schizophrenia, and it could be used as a predictor of treatment response to paliperidone ER treatment after studies with large samples verify these results. PMID:26755544

  3. Increased serum levels of apoptosis in deficit syndrome schizophrenia patients: a preliminary study

    PubMed Central

    Beyazyüz, Murat; Küfeciler, Tarkan; Bulut, Leyla; Ünsal, Cüneyt; Albayrak, Yakup; Akyol, Esra Soydaş; Baykal, Saliha; Kuloglu, Murat; Hashimoto, Kenji

    2016-01-01

    Background Schizophrenia is a chronic and debilitating disorder, the etiology of which remains unclear. Apoptosis is a programmed cell death mechanism that might be implicated in neuropsychiatric disorders, including schizophrenia. In this study, we aimed to compare the serum levels of apoptosis among deficit schizophrenia (DS) syndrome patients, nondeficit schizophrenia (NDS) patients, and healthy controls (HCs). Patients and methods After the inclusion and exclusion criteria were applied, 23 DS patients, 46 NDS patients, and 33 HCs were included in the study. The serum apoptosis levels were measured using a quantitative sandwich enzyme immunoassay with human monoclonal antibodies directed against DNA and histones. Results There was a significant difference among the three groups in terms of the levels of apoptosis (F2,96=16.58; P<0.001). The serum apoptosis levels in the DS and NDS groups were significantly higher than those in the HC group. Furthermore, the serum apoptosis levels in the DS group were significantly higher than the levels in the NDS group. Conclusion This study suggests that increased levels of apoptosis may be implicated in the pathophysiology of DS syndrome. However, further studies are needed to support the role of apoptosis in DS. PMID:27307738

  4. Patient falls in hospitals: an increasing problem.

    PubMed

    Weil, Thomas P

    2015-01-01

    Despite six decades of worldwide efforts that include publishing virtually hundreds of related epidemiological-type studies, there has been an increase (estimated to be 46% per 1000 patient days from 1954-6 to 2006-10) in the number of patient falls in hospitals and other health care facilities. These still occur most frequently near the bedside or in the bathroom, among mentally confused or physically impaired patients, and often involve those with greater comorbidity. The reasons that hospitals during the past half century have demonstrated a significant increase in patient falls per discharge or per patient days are numerous, are not completely surprising, and are certainly interrelated: improved accident reporting systems; on the average older, more impaired, more acutely ill, and more heavily sedated patients; and, less time spent by nursing personnel at the bedside. Most safety committees are not as effective as they should be, since they have difficulty in implementing a long-term, aggressive, facility-wide prevention program. Within that context, it may be worthwhile to discuss the advantages of nursing leadership rather than a representative of the facility's management staff to chair these safety committees. PMID:26304626

  5. Head movements during conversational speech in patients with schizophrenia

    PubMed Central

    Park, Bert; Khana, Priya; DiMambro, Ben

    2013-01-01

    Background: Motor abnormalities are frequently described in schizophrenia, and work by Altorfer and colleagues suggests that measuring head movements during conversational speech shows differences at the level of the individual. We wished to see whether their findings, conducted using computer analysis of video obtained in motion capture suites, could be replicated using compact, portable movement sensors, in a case–control study comparing the mean amplitude of head movements during general conversation. Methods: A referred sample of inpatients and outpatients with a diagnosis of paranoid schizophrenia was identified from case note information. Movement sensors, mounted in a baseball cap worn by subjects, transmitted data via Bluetooth to a laptop, which simultaneously captured audio to identify who was speaking. Subjects also completed a series of rating scales. Results: Data from the final 11 cases and 11 controls demonstrated a substantial group difference in mean amplitude of head movement velocity during speech (p < 0.0001), although this was not significant at the level of the individual. Conclusions: Movement sensors proved well suited to capturing head movements, demonstrating a large effect size in subjects with schizophrenia. PMID:23983990

  6. Decreased calcineurin immunoreactivity in the postmortem brain of a patient with schizophrenia who had been prescribed the calcineurin inhibitor, tacrolimus, for leukemia

    PubMed Central

    Wada, Akira; Kunii, Yasuto; Matsumoto, Jyunya; Hino, Mizuki; Nagaoka, Atsuko; Niwa, Shin-ichi; Yabe, Hirooki

    2016-01-01

    Background The calcineurin (CaN) inhibitor, tacrolimus, is widely used in patients undergoing allogeneic organ transplantation and in those with certain allergic diseases. Recently, several reports have suggested that CaN is also associated with schizophrenia. However, little data are currently available on the direct effect of tacrolimus on the human brain. Case A 23-year-old Japanese female experienced severe delusion of persecution, delusional mood, suspiciousness, aggression, and excitement. She visited our hospital and was diagnosed with schizophrenia. When she was 27 years old, she had severe general fatigue, persistent fever, systemic joint pain, gingival bleeding, and breathlessness and was diagnosed with acute myelomonocytic leukemia. Later she underwent bone marrow transplantation (BMT), she was administered methotrexate and cyclosporin A to prevent graft versus host disease (GVHD). Three weeks after BMT, she showed initial symptoms of GVHD and was prescribed tacrolimus instead of cyclosporin A. Seven months after BMT at the age of 31 years, she died of progression of GVHD. Pathological anatomy was examined after her death, including immunohistochemical analysis of her brain using anti-CaN antibodies. For comparison, we used our previous data from both a schizophrenia group and a healthy control group. No significant differences were observed in the percentage of CaN-immunoreactive neurons among the schizophrenia group, healthy control group, and the tacrolimus case (all P>0.5, analysis of covariance). Compared with the healthy control group and schizophrenia group, the percentages of CaN-immunoreactive neurons in layers III–VI of the BA46 and the putamen tended to be lower in the tacrolimus case. Conclusion Tacrolimus may decrease CaN immunoreactivity in some regions of the human brain. Thus, tacrolimus may introduce side effects such as cognitive dysfunction and extrapyramidal symptoms. In addition, we also found that the effect of tacrolimus on Ca

  7. Abnormal synchrony and effective connectivity in patients with schizophrenia and auditory hallucinations

    PubMed Central

    de la Iglesia-Vaya, Maria; Escartí, Maria José; Molina-Mateo, Jose; Martí-Bonmatí, Luis; Gadea, Marien; Castellanos, Francisco Xavier; Aguilar García-Iturrospe, Eduardo J.; Robles, Montserrat; Biswal, Bharat B.; Sanjuan, Julio

    2014-01-01

    Auditory hallucinations (AH) are the most frequent positive symptoms in patients with schizophrenia. Hallucinations have been related to emotional processing disturbances, altered functional connectivity and effective connectivity deficits. Previously, we observed that, compared to healthy controls, the limbic network responses of patients with auditory hallucinations differed when the subjects were listening to emotionally charged words. We aimed to compare the synchrony patterns and effective connectivity of task-related networks between schizophrenia patients with and without AH and healthy controls. Schizophrenia patients with AH (n = 27) and without AH (n = 14) were compared with healthy participants (n = 31). We examined functional connectivity by analyzing correlations and cross-correlations among previously detected independent component analysis time courses. Granger causality was used to infer the information flow direction in the brain regions. The results demonstrate that the patterns of cortico-cortical functional synchrony differentiated the patients with AH from the patients without AH and from the healthy participants. Additionally, Granger-causal relationships between the networks clearly differentiated the groups. In the patients with AH, the principal causal source was an occipital–cerebellar component, versus a temporal component in the patients without AH and the healthy controls. These data indicate that an anomalous process of neural connectivity exists when patients with AH process emotional auditory stimuli. Additionally, a central role is suggested for the cerebellum in processing emotional stimuli in patients with persistent AH. PMID:25379429

  8. Abnormal synchrony and effective connectivity in patients with schizophrenia and auditory hallucinations.

    PubMed

    de la Iglesia-Vaya, Maria; Escartí, Maria José; Molina-Mateo, Jose; Martí-Bonmatí, Luis; Gadea, Marien; Castellanos, Francisco Xavier; Aguilar García-Iturrospe, Eduardo J; Robles, Montserrat; Biswal, Bharat B; Sanjuan, Julio

    2014-01-01

    Auditory hallucinations (AH) are the most frequent positive symptoms in patients with schizophrenia. Hallucinations have been related to emotional processing disturbances, altered functional connectivity and effective connectivity deficits. Previously, we observed that, compared to healthy controls, the limbic network responses of patients with auditory hallucinations differed when the subjects were listening to emotionally charged words. We aimed to compare the synchrony patterns and effective connectivity of task-related networks between schizophrenia patients with and without AH and healthy controls. Schizophrenia patients with AH (n = 27) and without AH (n = 14) were compared with healthy participants (n = 31). We examined functional connectivity by analyzing correlations and cross-correlations among previously detected independent component analysis time courses. Granger causality was used to infer the information flow direction in the brain regions. The results demonstrate that the patterns of cortico-cortical functional synchrony differentiated the patients with AH from the patients without AH and from the healthy participants. Additionally, Granger-causal relationships between the networks clearly differentiated the groups. In the patients with AH, the principal causal source was an occipital-cerebellar component, versus a temporal component in the patients without AH and the healthy controls. These data indicate that an anomalous process of neural connectivity exists when patients with AH process emotional auditory stimuli. Additionally, a central role is suggested for the cerebellum in processing emotional stimuli in patients with persistent AH. PMID:25379429

  9. Eye Movement Dysfunction in First-Degree Relatives of Patients with Schizophrenia: A Meta-Analytic Evaluation of Candidate Endophenotypes

    ERIC Educational Resources Information Center

    Calkins, Monica E.; Iacono, William G.; Ones, Deniz S.

    2008-01-01

    Several forms of eye movement dysfunction (EMD) are regarded as promising candidate endophenotypes of schizophrenia. Discrepancies in individual study results have led to inconsistent conclusions regarding particular aspects of EMD in relatives of schizophrenia patients. To quantitatively evaluate and compare the candidacy of smooth pursuit,…

  10. Cognitive correlates of gray matter abnormalities in adolescent siblings of patients with childhood-onset schizophrenia

    PubMed Central

    Wagshal, Dana; Knowlton, Barbara Jean; Cohen, Jessica Rachel; Bookheimer, Susan Yost; Bilder, Robert Martin; Fernandez, Vindia Gisela; Asarnow, Robert Franklin

    2015-01-01

    Patients with childhood onset schizophrenia (COS) display widespread gray matter (GM) structural brain abnormalities. Healthy siblings of COS patients share some of these structural abnormalities, suggesting that GM abnormalities are endophenotypes for schizophrenia. Another possible endophenotype for schizophrenia that has been relatively unexplored is corticostriatal dysfunction. The corticostriatal system plays an important role in skill learning. Our previous studies have demonstrated corticostriatal dysfunction in COS siblings with a profound skill learning deficit and abnormal pattern of brain activation during skill learning. This study investigated whether structural abnormalities measured using volumetric brain morphometry (VBM) were present in siblings of COS patients and whether these were related to deficits in cognitive skill learning. Results revealed smaller GM volume in COS siblings relative to controls in a number of regions, including occipital, parietal, and subcortical regions including the striatum, and greater GM volume relative to controls in several subcortical regions. Volume in the right superior frontal gyrus and cerebellum were related to performance differences between groups on the weather prediction task, a measure of cognitive skill learning. Our results support the idea that corticostriatal and cerebellar impairment in unaffected siblings of COS patients are behaviorally relevant and may reflect genetic risk for schizophrenia. PMID:25541139

  11. Facial emotion perception impairments in schizophrenia patients with comorbid antisocial personality disorder.

    PubMed

    Tang, Dorothy Y Y; Liu, Amy C Y; Lui, Simon S Y; Lam, Bess Y H; Siu, Bonnie W M; Lee, Tatia M C; Cheung, Eric F C

    2016-02-28

    Impairment in facial emotion perception is believed to be associated with aggression. Schizophrenia patients with antisocial features are more impaired in facial emotion perception than their counterparts without these features. However, previous studies did not define the comorbidity of antisocial personality disorder (ASPD) using stringent criteria. We recruited 30 participants with dual diagnoses of ASPD and schizophrenia, 30 participants with schizophrenia and 30 controls. We employed the Facial Emotional Recognition paradigm to measure facial emotion perception, and administered a battery of neurocognitive tests. The Life History of Aggression scale was used. ANOVAs and ANCOVAs were conducted to examine group differences in facial emotion perception, and control for the effect of other neurocognitive dysfunctions on facial emotion perception. Correlational analyses were conducted to examine the association between facial emotion perception and aggression. Patients with dual diagnoses performed worst in facial emotion perception among the three groups. The group differences in facial emotion perception remained significant, even after other neurocognitive impairments were controlled for. Severity of aggression was correlated with impairment in perceiving negative-valenced facial emotions in patients with dual diagnoses. Our findings support the presence of facial emotion perception impairment and its association with aggression in schizophrenia patients with comorbid ASPD. PMID:26778631

  12. Abnormalities in large scale functional networks in unmedicated patients with schizophrenia and effects of risperidone

    PubMed Central

    Kraguljac, Nina Vanessa; White, David Matthew; Hadley, Jennifer Ann; Visscher, Kristina; Knight, David; ver Hoef, Lawrence; Falola, Blessing; Lahti, Adrienne Carol

    2015-01-01

    Objective To describe abnormalities in large scale functional networks in unmedicated patients with schizophrenia and to examine effects of risperidone on networks. Material and methods 34 unmedicated patients with schizophrenia and 34 matched healthy controls were enrolled in this longitudinal study. We collected resting state functional MRI data with a 3T scanner at baseline and six weeks after they were started on risperidone. In addition, a group of 19 healthy controls were scanned twice six weeks apart. Four large scale networks, the dorsal attention network, executive control network, salience network, and default mode network were identified with seed based functional connectivity analyses. Group differences in connectivity, as well as changes in connectivity over time, were assessed on the group's participant level functional connectivity maps. Results In unmedicated patients with schizophrenia we found resting state connectivity to be increased in the dorsal attention network, executive control network, and salience network relative to control participants, but not the default mode network. Dysconnectivity was attenuated after six weeks of treatment only in the dorsal attention network. Baseline connectivity in this network was also related to clinical response at six weeks of treatment with risperidone. Conclusions Our results demonstrate abnormalities in large scale functional networks in patients with schizophrenia that are modulated by risperidone only to a certain extent, underscoring the dire need for development of novel antipsychotic medications that have the ability to alleviate symptoms through attenuation of dysconnectivity. PMID:26793436

  13. Normalization of Cortical Gray Matter Deficits in Nonpsychotic Siblings of Patients with Childhood-Onset Schizophrenia

    ERIC Educational Resources Information Center

    Mattai, Anand A.; Weisinger, Brian; Greenstein, Deanna; Stidd, Reva; Clasen, Liv; Miller, Rachel; Tossell, Julia W.; Rapoport, Judith L.; Gogtay, Nitin

    2011-01-01

    Objective: Cortical gray matter (GM) abnormalities in patients with childhood-onset schizophrenia (COS) progress during adolescence ultimately localizing to prefrontal and temporal cortices by early adult age. A previous study of 52 nonpsychotic siblings of COS probands had significant prefrontal and temporal GM deficits that appeared to…

  14. [Neurophysiological Features of Perception of Emotional Stimuli in Health and in Patients with Paranoid Schizophrenia].

    PubMed

    Arkhipov, A Yu; Strelets, V B

    2015-01-01

    Cognitive and emotional disorders, as far as is known, are the main syndromes of schizophrenia. Disorders of these functions are mainly determined by the clinical picture, as well as by psychophysiological correlates. The purpose of our study was to identify some psychophysiological factors which cause perceptual and emotional disturbances in patients with schizophrenia. These disorders of mental functions form the first rank (top) syndrome in patients with schizophrenia [1]. The studied patients had acute psychosis with a predominance of paranoid hallucinatory syndrome and did not receive antipsychotic therapy; i.e., the disturbances of sensory perception were most pronounced. The analysis of early component P100 and intermediate one N170 of event related potentials (ERPs) in the control group showed an increased level of excitation in response to emotionally threatening stimuli; the amplitude increased and the latency decreased in all leads. In contrast the analysis of components P100 and N170 in the group of patients with schizophrenia showed the increased latency and decreased amplitude. The obtained data provide evidence of pathological inhibition in the passive perception of emotionally significant stimuli. PMID:26485786

  15. Manic Symptoms during a Switch from Paliperidone ER to Paliperidone Palmitate in a Patient with Schizophrenia

    PubMed Central

    Demirci, Kadir; Keleş, Süleyman; Demirdaş, Arif; Korucu, Cafer Çağrı

    2015-01-01

    Some antipsychotic drugs have treatment efficacy for mania and bipolar disorder. However, these drugs may rarely cause manic symptoms in some schizophrenic patients. We hereby report a 22-year-old female patient with schizophrenia who experienced a manic episode during a switch from paliperidone ER to paliperidone palmitate. This case is an important reminder that an abrupt switch from oral paliperidone to paliperidone palmitate may predispose certain patients to hypomanic or manic symptoms. PMID:26539300

  16. Plasma metabonomics study of first-Episode schizophrenia treated with olanzapine in female patients.

    PubMed

    Qiao, Ying; Zhang, Lei; He, Shen; Wen, Hui; Yu, Yi-Min; Cao, Chun-Hua; Li, Hua-Fang

    2016-03-23

    Schizophrenia is a persistent chronic mental illness with an unknown pathogenic mechanism; no empirical laboratory-based tests are available to support the diagnosis of schizophrenia or to identify biomarkers correlated with the therapeutic effect of olanzapine. For this study, 15 female first-episode, drug-naïve patients with schizophrenia and 15 healthy female volunteers were recruited. Tests for blood glucose and lipids were conducted at baseline and after 4 weeks of treatment with olanzapine. UPLC-MS based metabonomic analysis was performed on both case and control groups to identify biomarkers of schizophrenia at baseline and to explore which biomarkers correlated with the therapeutic effect of olanzapine after a 4-week treatment. Compared with the control group, the case group showed significant changes in plasma metabolites. Thirteen distinct metabolites were identified. Among all the therapeutically effective cases, levels of these metabolites appeared to shift towards the normal trend; 8 of the identified 13 metabolites changed dramatically. The metabolites that we found are potential biomarkers for the diagnosis and treatment of schizophrenia. PMID:26924724

  17. Optimized mismatch negativity paradigm reflects deficits in schizophrenia patients. A combined EEG and MEG study.

    PubMed

    Thönnessen, H; Zvyagintsev, M; Harke, K C; Boers, F; Dammers, J; Norra, Ch; Mathiak, K

    2008-02-01

    Mismatch negativity (MMN) and its neuromagnetic analog (MMNm) are event-related brain responses elicited by changes in a sequence of auditory events and indexes early cognitive processing. It consistently detects neural processing deficits in schizophrenia. So far MMN is assessed with different methods (electroencephalography, EEG; magnetoencephalography, MEG) and with different paradigms: the "traditional" oddball design with rare deviants (20%) or the "optimum" design with 50% deviants varying in one of five parameters each. These MMN measures may not reflect one unitary mechanism which is equally affected in schizophrenia. We compared both designs in 12 patients with schizophrenia and controls using MEG and EEG. Automated, observer-independent data analysis rendered the procedures suitable for clinical applications. The optimum design was fastest to detect MMN and MEG had the best signal-to-noise ratio. In addition MMN was mostly reduced in schizophrenia if measured with MEG in the optimum paradigm. Optimized paradigms improve sensitivity and speed for the detection of schizophrenia endophenotypes. Dysfunctions in this disorder may lie primarily in the fast and automatic encoding of stimulus features at the auditory cortex. PMID:18060677

  18. Inefficient Preparatory fMRI-BOLD Network Activations Predict Working Memory Dysfunctions in Patients with Schizophrenia.

    PubMed

    Baenninger, Anja; Diaz Hernandez, Laura; Rieger, Kathryn; Ford, Judith M; Kottlow, Mara; Koenig, Thomas

    2016-01-01

    Patients with schizophrenia show abnormal dynamics and structure of temporally -coherent networks (TCNs) assessed using fMRI, which undergo adaptive shifts in preparation for a cognitively demanding task. During working memory (WM) tasks, patients with schizophrenia show persistent deficits in TCNs as well as EEG indices of WM. Studying their temporal relationship during WM tasks might provide novel insights into WM performance deficits seen in schizophrenia. Simultaneous EEG-fMRI data were acquired during the performance of a verbal Sternberg WM task with two load levels (load 2 and load 5) in 17 patients with schizophrenia and 17 matched healthy controls. Using covariance mapping, we investigated the relationship of the activity in the TCNs before the memoranda were encoded and EEG spectral power during the retention interval. We assessed four TCNs - default mode network (DMN), dorsal attention network (dAN), left and right working memory networks (WMNs) - and three EEG bands - theta, alpha, and beta. In healthy controls, there was a load-dependent inverse relation between DMN and frontal midline theta power and an anti-correlation between DMN and dAN. Both effects were not significantly detectable in patients. In addition, healthy controls showed a left-lateralized load-dependent recruitment of the WMNs. Activation of the WMNs was bilateral in patients, suggesting more resources were recruited for successful performance on the WM task. Our findings support the notion of schizophrenia patients showing deviations in their neurophysiological responses before the retention of relevant information in a verbal WM task. Thus, treatment strategies as neurofeedback -targeting prestates could be beneficial as task performance relies on the preparatory state of the brain. PMID:27047395

  19. Inefficient Preparatory fMRI-BOLD Network Activations Predict Working Memory Dysfunctions in Patients with Schizophrenia

    PubMed Central

    Baenninger, Anja; Diaz Hernandez, Laura; Rieger, Kathryn; Ford, Judith M.; Kottlow, Mara; Koenig, Thomas

    2016-01-01

    Patients with schizophrenia show abnormal dynamics and structure of temporally ­coherent networks (TCNs) assessed using fMRI, which undergo adaptive shifts in preparation for a cognitively demanding task. During working memory (WM) tasks, patients with schizophrenia show persistent deficits in TCNs as well as EEG indices of WM. Studying their temporal relationship during WM tasks might provide novel insights into WM performance deficits seen in schizophrenia. Simultaneous EEG-fMRI data were acquired during the performance of a verbal Sternberg WM task with two load levels (load 2 and load 5) in 17 patients with schizophrenia and 17 matched healthy controls. Using covariance mapping, we investigated the relationship of the activity in the TCNs before the memoranda were encoded and EEG spectral power during the retention interval. We assessed four TCNs – default mode network (DMN), dorsal attention network (dAN), left and right working memory networks (WMNs) – and three EEG bands – theta, alpha, and beta. In healthy controls, there was a load-dependent inverse relation between DMN and frontal midline theta power and an anti-correlation between DMN and dAN. Both effects were not significantly detectable in patients. In addition, healthy controls showed a left-lateralized load-dependent recruitment of the WMNs. Activation of the WMNs was bilateral in patients, suggesting more resources were recruited for successful performance on the WM task. Our findings support the notion of schizophrenia patients showing deviations in their neurophysiological responses before the retention of relevant information in a verbal WM task. Thus, treatment strategies as neurofeedback ­targeting prestates could be beneficial as task performance relies on the preparatory state of the brain. PMID:27047395

  20. Overview of short- and long-term tolerability and safety of brexpiprazole in patients with schizophrenia.

    PubMed

    Kane, John M; Skuban, Aleksandar; Hobart, Mary; Ouyang, John; Weiller, Emmanuelle; Weiss, Catherine; U Correll, Christoph

    2016-07-01

    Second-generation antipsychotics have demonstrated efficacy for patients with schizophrenia but are associated with wide-ranging side effects. Brexpiprazole, a serotonin-dopamine activity modulator, has demonstrated efficacy in adult patients with schizophrenia. This paper provides an overview of the safety and tolerability of brexpiprazole in patients with schizophrenia through examination of pooled safety data from one Phase 2 and two Phase 3 6-week, short-term studies, and two open-label, 52-week, long-term studies. In the short-term studies, there were no reports of treatment-emergent adverse events (TEAEs) with an incidence≥5% and twice that of placebo in patients treated with brexpiprazole 2-4mg. In the long-term studies, TEAEs reported by ≥5% of patients were schizophrenia (10.7%), insomnia (8.0%), weight increase (7.7%), headache (6.0%), and agitation (5.2%). Akathisia rates were low in the short- (5.8%, pooled brexpiprazole group) and long-term studies (4.6%). Sedation rates were low in the short- (2.3%, pooled brexpiprazole group) and long-term studies (0.9%). Mean body weight increase was 1.1kg in both short- and long-term studies. For all studies, changes from baseline to last visit in laboratory parameters, electrocardiogram values, and vital signs were small and not clinically relevant. Changes in lipid profiles or other metabolic parameters were also small. Collectively, these studies suggest that brexpiprazole was well tolerated, with a favorable safety profile that does not exhibit significant rates of important adverse events that can be seen with existing antipsychotics (akathisia, sedation, weight gain, or QTc prolongation), and therefore may provide a useful treatment option for patients with schizophrenia. ClinicalTrials.gov: NCT00905307; NCT01396421; NCT01393613; NCT01649557; NCT01397786. PMID:27188270

  1. Gastric dysmotility in healthy first-degree relatives of patients with schizophrenia.

    PubMed

    Berger, Sandy; Hocke, Michael; Bär, Karl-Jürgen

    2010-10-01

    Gastric dysmotility has been reported in patients suffering from major depression or schizophrenia. An increased sympathetic activity modulating the gastric pacemaker located in the antrum of the stomach has been suggested as the underlying pathology. Similar to patients suffering from schizophrenia, their first-degree relatives showed alterations in cardiac autonomic modulation. Here we aimed to investigate gastric myoelectrical activity in healthy relatives of patients suffering from paranoid schizophrenia. Electrogastrography (EGG) was performed before and after test meal ingestion in 20 patients with paranoid schizophrenia, 20 of their first-degree relatives and 20 healthy matched controls. Autonomic and abdominal symptoms were assessed by the autonomic symptom score as previously reported. Autonomic parameters were correlated with the positive and negative syndrome scale (PANSS). Only minimal differences were observed before test meal ingestion between relatives and controls. In contrast, after test meal ingestion we observed a significantly increased tachygastria within the signal of the gastric pacemaker in relatives compared to controls, whereas normogastria was reduced. Significant difference between relatives and controls were also found for postprandial ICDF (instability coefficient of dominant frequency) and slow wave, which represents the dominant frequency of gastric pacemaker activity, indicating gastric dysmotility in relatives. Between relatives and patients just a difference for ICDP (instability coefficient of dominant power) was observed. After stimulation of the enteric nervous system we have observed an increased sympathetic modulation in first-degree relatives of patients suffering from schizophrenia. This result adds evidence to an ongoing debate on the genetic influence of autonomic dysfunction in the disease. PMID:20654673

  2. Neural Basis of Anhedonia and Amotivation in Patients with Schizophrenia: The role of Reward System

    PubMed Central

    Lee, Jung Suk; Jung, Suwon; Park, Il Ho; Kim, Jae-Jin

    2015-01-01

    Anhedonia, the inability to feel pleasure, and amotivation, the lack of motivation, are two prominent negative symptoms of schizophrenia, which contribute to the poor social and occupational behaviors in the patients. Recently growing evidence shows that anhedonia and amotivation are tied together, but have distinct neural correlates. It is important to note that both of these symptoms may derive from deficient functioning of the reward network. A further analysis into the neuroimaging findings of schizophrenia shows that the neural correlates overlap in the reward network including the ventral striatum, anterior cingulate cortex and orbitofrontal cortex. Other neuroimaging studies have demonstrated the involvement of the default mode network in anhedonia. The identification of a specific deficit in hedonic and motivational capacity may help to elucidate the mechanisms behind social functioning deficits in schizophrenia, and may also lead to more targeted treatment of negative symptoms. PMID:26630955

  3. Neural Basis of Anhedonia and Amotivation in Patients with Schizophrenia: The Role of Reward System.

    PubMed

    Lee, Jung Suk; Jung, Suwon; Park, Il Ho; Kim, Jae-Jin

    2015-01-01

    Anhedonia, the inability to feel pleasure, and amotivation, the lack of motivation, are two prominent negative symptoms of schizophrenia, which contribute to the poor social and occupational behaviors in the patients. Recently growing evidence shows that anhedonia and amotivation are tied together, but have distinct neural correlates. It is important to note that both of these symptoms may derive from deficient functioning of the reward network. A further analysis into the neuroimaging findings of schizophrenia shows that the neural correlates overlap in the reward network including the ventral striatum, anterior cingulate cortex and orbitofrontal cortex. Other neuroimaging studies have demonstrated the involvement of the default mode network in anhedonia. The identification of aspecific deficit in hedonic and motivational capacity may help to elucidate the mechanisms behind social functioning deficits in schizophrenia, and may also lead to more targeted treatment of negative symptoms. PMID:26630955

  4. Relationship between insulin resistance, dyslipidaemia and positive symptom in Chinese antipsychotic-naive first-episode patients with schizophrenia.

    PubMed

    Chen, Song; Broqueres-You, Dong; Yang, Guigang; Wang, Zhiren; Li, Yanli; Wang, Ning; Zhang, Xiangyang; Yang, Fude; Tan, Yunlong

    2013-12-30

    Controversial results concerning insulin resistance and lipid metabolism have been reported in antipsychotic-naive first-episode psychosis (AN-FEP) patients with schizophrenia of different countries. We aimed at determining whether schizophrenia-related psychopathology was associated with insulin resistance and/or dyslipidaemia in Chinese patients with AN-FEP schizophrenia. A cross-sectional study was performed in Chinese patients newly diagnosed with schizophrenia (n = 49, antipsychotic-naïve or antipsychotic medications< 2 weeks) and healthy volunteers (n = 30). The serum levels of insulin and triglyceride levels as well as homeostasis model of assessment-insulin resistance (HOMA-IR) index were significantly increased in AN-FEP patients, when compared with healthy volunteers. The gender difference had a significant impact on the insulin resistance and dyslipidaemia in these AN-FEP subjects. Multiple linear regression analysis demonstrated that the severity of positive symptoms of schizophrenia was negatively related to insulin resistance. No difference of serum glucose level, total cholesterol content, body mass index (BMI) and smoking status was detected between patients with schizophrenia and healthy controls. In conclusion, Chinese AN-FEP patients were more prone to insulin resistance and dyslipidaemia as compared to the healthy population, which is negatively correlated to positive symptoms. The results may contribute to the understanding of the relationship between the glucose/lipidaemia metabolic dysfunction and the psychopathology in patients with schizophrenia. PMID:24113122

  5. Phenomenological correlates of metabolic activity in 18 patients with chronic schizophrenia

    SciTech Connect

    Volkow, N.D.; Wolf, A.P.; Van Gelder, P.; Brodie, J.D.; Overall, J.E.; Cancro, R.; Gomez-Mont, F.

    1987-02-01

    Using (11C)-deoxy-D-glucose and positron emission tomography (PET), the authors measured brain metabolism in 18 patients with chronic schizophrenia to assess which of the metabolic measures from two test conditions was more closely related to the patients' differing clinical characteristics. The two conditions were resting and activation, and an eye tracking task was used. Patients with more negative symptoms showed lower global metabolic rates and more severe hypofrontality than did the patients with fewer negative symptoms. Differences among the patients were distinguished by the task: sicker patients failed to show a metabolic activation response. These findings suggest that cerebral metabolic patterns reflect clinical characteristics of schizophrenic patients.

  6. Supernatural beliefs, aetiological models and help seeking behaviour in patients with schizophrenia

    PubMed Central

    Kate, Natasha; Grover, Sandeep; Kulhara, Parmanand; Nehra, Ritu

    2012-01-01

    Background: Few studies have evaluated the supernatural beliefs of patients with schizophrenia. This study aimed to study the personal beliefs, aetiological models and help seeking behaviour of patients with schizophrenia using a self-rated questionnaire. Materials and Methods: Seventy three patients returned the completed supernatural Attitude questionnaire. Results: 62% of patients admitted that people in their community believed in sorcery and other magico-religious phenomena. One fourth to half of patients believed in ghosts/evil spirit (26%), spirit intrusion (28.8%) and sorcery (46.6%). Two-third patients believed that mental illness can occur either due to sorcery, ghosts/evil spirit, spirit intrusion, divine wrath, planetary/astrological influences, dissatisfied or evil spirits and bad deeds of the past. 40% of the subjects attributed mental disorders to more than one of these beliefs. About half of the patients (46.6%) believed that only performance of prayers was sufficient to improve their mental status. Few patients (9.6%) believed that magico-religious rituals were sufficient to improve their mental illness but about one-fourth (24.7%) admitted that during recent episode either they or their caregivers performed magico-religious rituals. Conclusion: Supernatural beliefs are common in patients with schizophrenia and many of them attribute the symptoms of mental disorders to these beliefs. PMID:23766578

  7. Patient Safety Outcomes in Small Urban and Small Rural Hospitals

    ERIC Educational Resources Information Center

    Vartak, Smruti; Ward, Marcia M.; Vaughn, Thomas E.

    2010-01-01

    Purpose: To assess patient safety outcomes in small urban and small rural hospitals and to examine the relationship of hospital and patient factors to patient safety outcomes. Methods: The Nationwide Inpatient Sample and American Hospital Association annual survey data were used for analyses. To increase comparability, the study sample was…

  8. The Relationship between Language Ability and Cognitive Function in Patients with Schizophrenia

    PubMed Central

    Kim, Sung-Jin; Shim, Joo-Cheol; Kong, Bo-Geum; Kang, Je-Wook; Moon, Jung-Joon; Jeon, Dong-Wook; Jung, Sung-Soo; Seo, Beom-Joo; Jung, Do-Un

    2015-01-01

    Objective Cognitive dysfunction is common in people with schizophrenia, and language disability is one of the most notable cognitive deficits. This study assessed the use and comprehension ability of the Korean language in patients with schizophrenia and the correlations between language ability and cognitive function. Methods Eighty-six patients with schizophrenia and a group of 29 healthy controls were recruited. We assessed both clinical symptoms and cognitive functions including Korean language ability. For clinical symptoms, the Positive and Negative Syndrome Scale, Clinical Global Impression-Schizophrenia Scale, and Social and Occupational Functioning Assessment Scale were used. For the Korean language ability assessment, a portion of the Korean Broadcasting System (KBS) Korean Language Test was used. The Short-form of Korean-Wechsler Adult Intelligence Scale, the Korean version of the University of California San Diego (UCSD) Performance-based Skills Assessment (K-UPSA), and the Wisconsin Card Sorting Test (WCST) were used to assess cognitive functions. Results Schizophrenic patients had significantly lower scores in the language and cognitive function tests both in the total and subscale scores. Various clinical scores had negative correlations with reading comprehension ability of the KBS Korean Language Test. The WCST and a part of the K-UPSA had positive correlations with multiple domains of the language test. Conclusion A significant difference was found between schizophrenic patients and controls in language ability. Correlations between Korean language ability and several clinical symptoms and cognitive functions were demonstrated in patients with schizophrenia. Tests of cognitive function had positive correlations with different aspects of language ability. PMID:26598588

  9. Clonidine Normalizes Levels of P50 Gating in Patients With Schizophrenia on Stable Medication

    PubMed Central

    Oranje, Bob; Glenthøj, Birte Y.

    2014-01-01

    Background: Sensory gating deficits are among the core features of schizophrenia. Recently, we reported significantly increased sensorimotor gating following additional administration of single dosages of clonidine to the treatment of stably medicated patients with schizophrenia who, in spite of their medication, showed gating deficits. In the current study, we investigated whether this result is generalizable to filtering of sensory information as a whole, by examining clonidine’s effect on P50 suppression in the same group of patients. Methods: In a double-blind, placebo-controlled, randomized yet balanced cross-over design, 20 male schizophrenia patients on stable medication were assessed in a psychophysiological test battery, including a sensory gating paradigm on 5 occasions: once after oral administration of placebo and after single doses of 25, 50, 75, and 150 µg of clonidine. Their results were compared with 20 age-matched healthy male volunteers, who received no treatment. Results: Patients showed significantly reduced levels of P50 suppression in the placebo session compared with controls. All dosages of clonidine significantly diminished these deficits to such levels that they no longer differed significantly from the healthy controls (except the highest dose). Conclusions: This is the first study to show that even a single low dose of clonidine administered to stably medicated patients with schizophrenia not only significantly increases their levels of P50 suppression but also normalizes them. The results indicate that α2-noradrenergic agonists are capable of normalizing levels of P50 gating, which has a potentially high clinical relevance for the medical treatment of schizophrenia. PMID:24106334

  10. Blood Levels of Monoamine Precursors and Smoking in Patients with Schizophrenia

    PubMed Central

    Mathai, Ashwin Jacob; Kanwar, Jyoti; Okusaga, Olaoluwa; Fuchs, Dietmar; Lowry, Christopher A.; Peng, Xiaoqing; Giegling, Ina; Hartmann, Annette M.; Konte, Bettina; Friedl, Marion; Gragnoli, Claudia; Reeves, Gloria M.; Groer, Maureen W.; Rosenthal, Richard N.; Rujescu, Dan; Postolache, Teodor T.

    2016-01-01

    Smoking is highly prevalent in patients with schizophrenia and exerts a negative impact on cardiovascular mortality in these patients. Smoking has complex interactions with monoamine metabolism through the ability of cigarette smoke to suppress Type 1 T helper cell (Th1) type immunity, the immunophenotype that is implicated in phenylalanine hydroxylase (PAH) dysfunction and tryptophan (Trp) breakdown to kynurenine (Kyn) via indoleamine 2,3-dioxygenase. Nicotine also induces tyrosine hydroxylase (TH) gene expression, leading to increased synthesis of catecholamines. Furthermore, there is evidence for PAH dysfunction in schizophrenia. This study aimed to compare the plasma levels of selected monoamine precursors and their metabolites in smokers vs. non-smokers in a large sample of patients with schizophrenia. We measured plasma phenylalanine (Phe), tyrosine (Tyr), Trp, and Kyn levels using high-performance liquid chromatography and calculated Phe:Tyr and Kyn:Trp ratios in 920 patients with schizophrenia. Analysis of variance and linear regression analyses were used to compare these endpoints between three groups of patients with schizophrenia: (1) current smokers, (2) past smokers, and (3) non-smokers. There were significant differences among the three groups with regards to Tyr levels [F(2,789) = 3.77, p = 0.02], with current smokers having lower Tyr levels when compared with non-smokers (p = 0.02). Kyn levels and Kyn:Trp ratio were different among the three groups [F(2,738) = 3.17, p = 0.04, F(2,738) = 3.61, p = 0.03] with current smokers having lower Kyn levels (p = 0.04) and higher Kyn:Trp ratio (p = 0.02) when compared with past smokers. These findings need to be replicated with protocols that include healthy controls to further elucidate the neurobiological underpinnings of altered Tyr and Kyn levels in smokers. Results do suggest potential molecular links between schizophrenia and smoking that may represent biomarkers and

  11. Blood Levels of Monoamine Precursors and Smoking in Patients with Schizophrenia.

    PubMed

    Mathai, Ashwin Jacob; Kanwar, Jyoti; Okusaga, Olaoluwa; Fuchs, Dietmar; Lowry, Christopher A; Peng, Xiaoqing; Giegling, Ina; Hartmann, Annette M; Konte, Bettina; Friedl, Marion; Gragnoli, Claudia; Reeves, Gloria M; Groer, Maureen W; Rosenthal, Richard N; Rujescu, Dan; Postolache, Teodor T

    2016-01-01

    Smoking is highly prevalent in patients with schizophrenia and exerts a negative impact on cardiovascular mortality in these patients. Smoking has complex interactions with monoamine metabolism through the ability of cigarette smoke to suppress Type 1 T helper cell (Th1) type immunity, the immunophenotype that is implicated in phenylalanine hydroxylase (PAH) dysfunction and tryptophan (Trp) breakdown to kynurenine (Kyn) via indoleamine 2,3-dioxygenase. Nicotine also induces tyrosine hydroxylase (TH) gene expression, leading to increased synthesis of catecholamines. Furthermore, there is evidence for PAH dysfunction in schizophrenia. This study aimed to compare the plasma levels of selected monoamine precursors and their metabolites in smokers vs. non-smokers in a large sample of patients with schizophrenia. We measured plasma phenylalanine (Phe), tyrosine (Tyr), Trp, and Kyn levels using high-performance liquid chromatography and calculated Phe:Tyr and Kyn:Trp ratios in 920 patients with schizophrenia. Analysis of variance and linear regression analyses were used to compare these endpoints between three groups of patients with schizophrenia: (1) current smokers, (2) past smokers, and (3) non-smokers. There were significant differences among the three groups with regards to Tyr levels [F (2,789) = 3.77, p = 0.02], with current smokers having lower Tyr levels when compared with non-smokers (p = 0.02). Kyn levels and Kyn:Trp ratio were different among the three groups [F (2,738) = 3.17, p = 0.04, F (2,738) = 3.61, p = 0.03] with current smokers having lower Kyn levels (p = 0.04) and higher Kyn:Trp ratio (p = 0.02) when compared with past smokers. These findings need to be replicated with protocols that include healthy controls to further elucidate the neurobiological underpinnings of altered Tyr and Kyn levels in smokers. Results do suggest potential molecular links between schizophrenia and smoking that may represent biomarkers and

  12. Adverse childhood experiences influence white matter microstructure in patients with schizophrenia.

    PubMed

    Poletti, Sara; Mazza, Elena; Bollettini, Irene; Locatelli, Clara; Cavallaro, Roberto; Smeraldi, Enrico; Benedetti, Francesco

    2015-10-30

    Integrity of brain white matter (WM) tracts in adulthood could be detrimentally affected by exposure to adverse childhood experiences (ACE). Changes of diffusion tensor imaging (DTI) measures suggesting WM disruption have been reported in patients with schizophrenia together with a history of childhood maltreatment. We therefore hypothesized that ACE could be associated with altered DTI measures of WM integrity in patients with schizophrenia. We tested this hypothesis in 83 schizophrenia patients using whole brain tract-based spatial statistics in the WM skeleton with threshold-free cluster enhancement of DTI measures of WM microstructure: axial, radial, and mean diffusivity (MD), and fractional anisotropy (FA). We observed an inverse correlation between severity of ACE and DTI measures of FA, and a positive correlation with MD in several WM tracts including corona radiata, thalamic radiations, corpus callosum, cingulum bundle, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus. Lower FA and higher MD are indexes of a reduction in fibre coherence and integrity. The association of ACE to reduced FA and increased MD in key WM tracts contributing to the functional integrity of the brain suggests that ACE might contribute to the pathophysiology of schizophrenia through a detrimental action on structural connectivity in critical cortico-limbic networks. PMID:26341951

  13. Emotions, Ideas and Experiences of Caregivers of Patients With Schizophrenia About "Family to Family Support Program".

    PubMed

    Bademli, Kerime; Duman, Zekiye Çetinkaya

    2016-06-01

    "Family to Family Support Program" is a significant intervention program to assist families by informing them about treatment procedures and coping strategies, increasing their functionality, helping them to overcome the challenges of the disease. This study was particularly designed to investigate the emotions, thoughts, and experiences of caregivers of schizophrenia patients who participated in "Family to Family Support Program." The study was conducted with one of the qualitative research methods, phenomenological method. The study sample included caregivers who care for schizophrenia patients and participated in the "Family to Family Support Program". Twenty caregivers were included in the sample. The study was carried out in İzmir Schizophrenia Support Association. The study data were collected with four open ended questions. The average age of the participants was 56,77 ± 72,89, 10 male caregivers and 10 female caregivers, 9 caregivers were fathers, 6 caregivers were mothers, and 5 of them were siblings. The thematic analysis indicated that the emotions, thoughts and experiences of caregivers can be categorized in four groups: "I learned to deal with my problems", "I am conscious in my interaction with the patient and I know and I am not alone", "I feel much better", and "Schizophrenia is not the end of the road, knowledge sorts things out." Caregivers who participated in "Family to Family Support Program" expressed their satisfaction that they were benefited from the program, their coping skills were improved, they experienced less challenges when providing care, they understood the disease better, and it felt comfortable. PMID:27256937

  14. Increased density of DISC1-immunoreactive oligodendroglial cells in fronto-parietal white matter of patients with paranoid schizophrenia.

    PubMed

    Bernstein, Hans-Gert; Jauch, Esther; Dobrowolny, Henrik; Mawrin, Christian; Steiner, Johann; Bogerts, Bernhard

    2016-09-01

    Profound white matter abnormalities have repeatedly been described in schizophrenia, which involve the altered expression of numerous oligodendrocyte-associated genes. Transcripts of the disrupted-in-schizophrenia 1 (DISC1) gene, a key susceptibility factor in schizophrenia, have recently been shown to be expressed by oligodendroglial cells and to negatively regulate oligodendrocyte differentiation and maturation. To learn more about the putative role(s) of oligodendroglia-associated DISC1 in schizophrenia, we analyzed the density of DISC1-immunoreactive oligodendrocytes in the fronto-parietal white matter in postmortem brains of patients with schizophrenia. Compared with controls (N = 12) and cases with undifferentiated/residual schizophrenia (N = 6), there was a significantly increased density of DISC1-expressing glial cells in paranoid schizophrenia (N = 12), which unlikely resulted from neuroleptic treatment. Pathophysiologically, over-expression of DISC1 protein(s) in white matter oligodendrocytes might add to the reduced levels of two myelin markers, 2',3'-cyclic-nucleotide 3'-phosphodiesterase and myelin basic protein in schizophrenia. Moreover, it might significantly contribute to cell cycle abnormalities as well as to deficits in oligodendroglial cell differentiation and maturation found in schizophrenia. PMID:26315603

  15. The neural basis of a deficit in abstract thinking in patients with schizophrenia.

    PubMed

    Oh, Jooyoung; Chun, Ji-Won; Joon Jo, Hang; Kim, Eunseong; Park, Hae-Jeong; Lee, Boreom; Kim, Jae-Jin

    2015-10-30

    Abnormal abstract thinking is a major cause of social dysfunction in patients with schizophrenia, but little is known about its neural basis. In this study, we aimed to determine the characteristic abstract thinking-related brain responses in patients using a task reflecting social situations. We conducted functional magnetic resonance imaging while 16 patients with schizophrenia and 16 healthy controls performed a theme-identification task, in which various emotional pictures depicting social situations were presented. Compared with healthy controls, the patients showed significantly decreased activity in the left frontopolar and right orbitofrontal cortices during theme identification. Activity in these two regions correlated well in the controls, but not in patients. Instead, the patients exhibited a close correlation between activity in both sides of the frontopolar cortex, and a positive correlation between the right orbitofrontal cortex activity and degrees of theme identification. Reduced activity in the left frontopolar and right orbitofrontal cortices and the underlying aberrant connectivity may be implicated in the patients' deficits in abstract thinking. These newly identified features of the neural basis of abnormal abstract thinking are important as they have implications for the impaired social behavior of patients with schizophrenia during real-life situations. PMID:26329118

  16. Analysis of the Complexity Measures in the EEG of Schizophrenia Patients.

    PubMed

    Akar, S Akdemir; Kara, S; Latifoğlu, F; Bilgiç, V

    2016-03-01

    Complexity measures have been enormously used in schizophrenia patients to estimate brain dynamics. However, the conflicting results in terms of both increased and reduced complexity values have been reported in these studies depending on the patients' clinical status or symptom severity or medication and age status. The objective of this study is to investigate the nonlinear brain dynamics of chronic and medicated schizophrenia patients using distinct complexity estimators. EEG data were collected from 22 relaxed eyes-closed patients and age-matched healthy controls. A single-trial EEG series of 2 min was partitioned into identical epochs of 20 s intervals. The EEG complexity of participants were investigated and compared using approximate entropy (ApEn), Shannon entropy (ShEn), Kolmogorov complexity (KC) and Lempel-Ziv complexity (LZC). Lower complexity values were obtained in schizophrenia patients. The most significant complexity differences between patients and controls were obtained in especially left frontal (F3) and parietal (P3) regions of the brain when all complexity measures were applied individually. Significantly, we found that KC was more sensitive for detecting EEG complexity of patients than other estimators in all investigated brain regions. Moreover, significant inter-hemispheric complexity differences were found in the frontal and parietal areas of schizophrenics' brain. Our findings demonstrate that the utilizing of sensitive complexity estimators to analyze brain dynamics of patients might be a useful discriminative tool for diagnostic purposes. Therefore, we expect that nonlinear analysis will give us deeper understanding of schizophrenics' brain. PMID:26762866

  17. Anemia in hospitalized patients with pulmonary tuberculosis*

    PubMed Central

    Oliveira, Marina Gribel; Delogo, Karina Neves; de Oliveira, Hedi Marinho de Melo Gomes; Ruffino-Netto, Antonio; Kritski, Afranio Lineu; Oliveira, Martha Maria

    2014-01-01

    OBJECTIVE: To describe the prevalence of anemia and of its types in hospitalized patients with pulmonary tuberculosis. METHODS: This was a descriptive, longitudinal study involving pulmonary tuberculosis inpatients at one of two tuberculosis referral hospitals in the city of Rio de Janeiro, Brazil. We evaluated body mass index (BMI), triceps skinfold thickness (TST), arm muscle area (AMA), ESR, mean corpuscular volume, and red blood cell distribution width (RDW), as well as the levels of C-reactive protein, hemoglobin, transferrin, and ferritin. RESULTS: We included 166 patients, 126 (75.9%) of whom were male. The mean age was 39.0 ± 10.7 years. Not all data were available for all patients: 18.7% were HIV positive; 64.7% were alcoholic; the prevalences of anemia of chronic disease and iron deficiency anemia were, respectively, 75.9% and 2.4%; and 68.7% had low body weight (mean BMI = 18.21 kg/m2). On the basis of TST and AMA, 126 (78.7%) of 160 patients and 138 (87.9%) of 157 patients, respectively, were considered malnourished. Anemia was found to be associated with the following: male gender (p = 0.03); low weight (p = 0.0004); low mean corpuscular volume (p = 0.03);high RDW (p = 0; 0003); high ferritin (p = 0.0005); and high ESR (p = 0.004). We also found significant differences between anemic and non-anemic patients in terms of BMI (p = 0.04), DCT (p = 0.003), and ESR (p < 0.001). CONCLUSIONS: In this sample, high proportions of pulmonary tuberculosis patients were classified as underweight and malnourished, and there was a high prevalence of anemia of chronic disease. In addition, anemia was associated with high ESR and malnutrition. PMID:25210963

  18. The effect of aerobic exercise on cortical architecture in patients with chronic schizophrenia: a randomized controlled MRI study.

    PubMed

    Falkai, Peter; Malchow, Berend; Wobrock, Thomas; Gruber, Oliver; Schmitt, Andrea; Honer, William G; Pajonk, Frank-Gerald; Sun, Frank; Cannon, Tyrone D

    2013-09-01

    Via influencing brain plasticity, aerobic exercise could contribute to the treatment of schizophrenia patients. As previously shown, physical exercise increases hippocampus volume and improves short-term memory. We now investigated gray matter density and brain surface expansion in this sample using MRI-based cortical pattern matching methods. Comparing schizophrenia patients to healthy controls before and after 3 months of aerobic exercise training (cycling) plus patients playing table football yielded gray matter density increases in the right frontal and occipital cortex merely in healthy controls. However, respective exercise effects might be attenuated in chronic schizophrenia, which should be verified in a larger sample. PMID:23161338

  19. Is abnormal non-high-density lipoprotein cholesterol a gender-specific predictor for metabolic syndrome in patients with schizophrenia taking second-generation antipsychotics?

    PubMed

    Lin, Esther Ching-Lan; Shao, Wen-Chuan; Yang, Hsin-Ju; Yen, Miaofen; Lee, Sheng-Yu; Wu, Pei-Chun; Lu, Ru-Band

    2015-02-01

    Evidence supports an association between metabolic syndrome (MetS) and schizophrenia. However, specific risk factors for MetS and gender differences in patients with schizophrenia taking second-generation antipsychotics (SGAs) have not been well explored. A cross-sectional cohort of 329 Han Chinese patients was recruited in a psychiatric hospital in central Taiwan. Using the definitions of the International Diabetes Federation for Chinese, the prevalence of MetS was 23.7% (men: 25.7%; women: 21.2%). Logistic regression analyses showed that patients with a BMI ≥ 24 and an abnormal non-high-density lipoprotein cholesterol (non-HDL-C) were significantly (p < 0.001) more likely to develop MetS. A BMI ≥ 24 was a significant risk factor in men (OR: 6.092, p < 0.001) and women (OR: 5.886, p < 0.001). An abnormal non-HDL-C was a significant specific risk factor for men with MetS (OR: 4.127, p < 0.001), but not for women. This study supports a greater prevalence of MetS in patients with schizophrenia taking SGAs than in the general population. Abnormal BMI and non-HDL-C were significantly associated with developing MetS, and an abnormal non-HDL-C was a specific risk factor for men. Future development of specific interventions and regular monitoring for MetS is imperative for early identification and prevention. PMID:25034455

  20. Standardized Mortality Ratio in Patients with Schizophrenia — Findings from Thirthahalli: A Rural South Indian Community

    PubMed Central

    Bagewadi, Virupakshappa Irappa; Kumar, C. Naveen; Thirthalli, Jagadisha; Rao, Girish N.; Suresha, K. K.; Gangadhar, B. N.

    2016-01-01

    Background: Schizophrenia is associated with excess mortality experience than the general population. Though this is one of the important outcome measures, it has not been adequately explored especially in rural community dwelling patients in India. We describe the standardized mortality ratio (SMR) of a cohort of schizophrenia patients of Thirthahalli, one such rural taluk of South India. Materials and Methods: SMRs for the years 2009-2011 were calculated. A number of patients in the cohort were 301, 317, and 325 for those consecutive years, respectively. Observed deaths among the patients were noted for these years separately. Crude death rates (CDRs) of the general population of Shimoga district were obtained from the Statistics Department of the Government of Karnataka. CDR (per 1000) was multiplied by the number of patients in each year to get the expected deaths. Then, observed deaths were divided by the expected deaths to get the SMR. Results: There were totally 12 deaths among the patients in these 3 years. SMRs for the years 2009, 2010, and 2011 were respectively 1.4, 1.8, and 2.2. Six had died out of natural (medical) causes. Four had committed suicide, and one died from an accident. Cause from one death remained unknown. There was no statistically significant difference between the alive and deceased patients in any of the demographic or clinical variables. Conclusions: Mortality among schizophrenia patients in this rural cohort is considerably lower than patients from developed countries. Nevertheless, nearly two-fold excess mortality in schizophrenia calls for attention to their medical and psychosocial needs. PMID:27335514

  1. Can Exercise Increase Fitness and Reduce Weight in Patients with Schizophrenia and Depression?

    PubMed Central

    Krogh, Jesper; Speyer, Helene; Nørgaard, Hans Christian Brix; Moltke, Ane; Nordentoft, Merete

    2014-01-01

    Background: Psychiatric patients have a reduced life expectancy of 15–20 years compared with the general population. Most years of lost life are due to the excess mortality from somatic diseases. Sedentary lifestyle and medication is partly responsible for the high frequency of metabolic syndrome in this patient group and low levels of physical activity is associated with increased risk of cardiovascular disease, diabetes, and all-cause mortality. This study aimed to review trials allocating patients with either schizophrenia or depression to exercise interventions for effect on cardiovascular fitness, strength, and weight. Methods: We searched PubMed, Embase, and PsycINFO including randomized clinical trial allocating patients with either schizophrenia or depression to isolated exercise interventions. Results: We identified five trials including patients with schizophrenia (n = 94) and found little evidence that exercise could increase cardiovascular fitness or decrease weight. Nine exercise trials for patients with depression (n = 892) were identified increasing cardiovascular fitness by 11–30% and strength by 33–37%. No evidence in favor of exercise for weight reduction was found. Conclusion: Based on the current evidence isolated exercise interventions are unlikely to improve cardiovascular fitness or induce weight loss in patients with schizophrenia. In patients with depression, exercise interventions are likely to induce clinically relevant short term effects, however, due to lack of reporting, little is known about the effect on weight reduction and cardiovascular fitness. Future exercise trials regarding patients with mental illness should preferably measure changes in cardiovascular strength, repetition maximum, and anthropometric outcomes. Ideally, participants should be assessed beyond the intervention to identify long lasting effects. PMID:25120495

  2. Electrophysiological Neuroimaging using sLORETA Comparing 22 Age Matched Male and Female Schizophrenia Patients

    PubMed Central

    Eugene, Andy R.; Masiak, Jolanta; Kapica, Jacek; Masiak, Marek

    2015-01-01

    Introduction The purpose of this electrophysiological neuroimaging study was to provide a deeper mechanistic understanding of both olanzapine and risperidone pharmacodynamics relative to gender. In doing so, we age-matched 22 men and women and evaluated their resting-state EEG recordings and later used standard low resolution brain Electrotomography to visualize the differences in brain activity amongst the two patient groups. Methods In this investigation, electroencephalogram (EEG) data were analyzed from male and female schizophrenia patients treated with either olanzapine or risperidone, both atypical antipsychotics, during their in-patient stay at the Department of Psychiatry. Twenty-two males and females were age-matched and EEG recordings were analyzed from 19 Ag/AgCl electrodes. Thirty-seconds of resting EEG were spectrally transformed in standardized low resolution electromagnetic tomography (sLORETA). 3D statistical non-paramentric maps for the sLORETA Global Field Power within each band were finally computed. Results The results indicated that, relative to males patients, females schizophrenia patients had increased neuronal synchronization in delta frequency, slow-wave, EEG band located in the dorsolateral prefrontal cortex, within the middle frontal gyrus (t= -2.881, p < 0.03580). These findings suggest that females experience greater dopamine (D2) receptor and serotonin (5-HT2) receptor neuronal blockade relative to age-matched males. Further, our finding provided insight to the pharmacodynamics of second-generation antipsychotics olanzapine and risperidone. Conclusion When compared to male patients, female patients, suffering from schizophrenia, have D2 and 5-HT2 receptors that are blocked more readily than age-matched male schizophrenia patients. Clinically, this may translate into a quicker time to treatment-response in females as compared to male patients. PMID:26617679

  3. Relationship between lifetime suicide attempts and schizotypal traits in patients with schizophrenia.

    PubMed

    Teraishi, Toshiya; Hori, Hiroaki; Sasayama, Daimei; Matsuo, Junko; Ogawa, Shintaro; Ishida, Ikki; Nagashima, Anna; Kinoshita, Yukiko; Ota, Miho; Hattori, Kotaro; Kunugi, Hiroshi

    2014-01-01

    Patients with schizophrenia are at increased risk for suicide. Various risk factors for suicide have been reported in schizophrenia; however, few studies have examined the association between personality traits and suicidal behavior. We administered the Schizotypal Personality Questionnaire (SPQ) to 87 Japanese patients with schizophrenia (49 males; mean age 38.1 ± 10.6 years) with and without a history of suicide attempts (SA and nSA groups, respectively), and 322 controls (158 males; mean age 40.8 ± 13.9 years). As expected, an analysis of covariance (ANCOVA) controlling for age and sex showed that all SPQ indices (total SPQ score and all three factors, i.e., cognitive-perceptual, interpersonal, and disorganized) were significantly higher in patients with schizophrenia (SA+nSA groups), than controls (p<0.001 for all comparisons). Furthermore, there were significant differences in the total score and the interpersonal and disorganized factors between the SA and nSA groups (nSApatients with schizophrenia. PMID:25226584

  4. Neurocognition, psychopathology, and subjective disturbances in schizophrenia: a comparison between short-term and remitted patients.

    PubMed

    Comparelli, Anna; De Carolis, Antonella; Corigliano, Valentina; Romano, Silvia; Kotzalidis, Giorgio; Brugnoli, Roberto; Tamorri, Stefano; Curto, Martina; Tatarelli, Roberto; Ferracuti, Stefano; Girardi, Paolo

    2012-10-01

    Patients with schizophrenia present deficits in multiple domains of cognition. The study of the relationship between cognitive performance and symptoms of schizophrenia has yielded heterogeneous results. The purposes of this study were to examine the extent of the relationship between psychopathologic symptoms, cognitive function, and subjective disturbances in a group of patients affected by schizophrenia spectrum disorders and to compare short-term with remitted patients. Seventy-nine patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria for schizophrenia, schizophreniform disorder, and schizoaffective disorder were assessed through the Positive and Negative Syndrome Scale, the Frankfurt Complaint Questionnaire, and a neuropsychologic battery exploring the 7 Measurement and Treatment Research to improve Cognition in Schizophrenia cognitive domains (speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition) plus executive control. Neuropsychologic and psychopathologic variables were compared and correlated. Treatment groups did not differ in neuropsychologic and psychopathologic measures. The cognitive factor of the Positive and Negative Syndrome Scale correlated with worse performance on cognitive tasks and with higher scores on the Frankfurt Complaint Questionnaire 24 in the short-term, remitted, and combined groups. Subjective disturbances correlated with impaired executive control, reasoning and problem solving, and social cognition but not during the short-term phase. Both "objective" and subjective psychopathology are intertwined with cognitive function, suggesting some common underlying neural bases. The condition of being in a short-term or a remitted phase of the illness influences this interrelationship, regardless of the type of antipsychotic medication taken. PMID:22444951

  5. Coping patterns as a valid presentation of the diversity of coping responses in schizophrenia patients.

    PubMed

    Ritsner, Michael S; Gibel, Anatoly; Ponizovsky, Alexander M; Shinkarenko, Evgeny; Ratner, Yael; Kurs, Rena

    2006-11-15

    This study aimed to identify coping patterns used by schizophrenia inpatients in comparison with those used by healthy individuals, and to explore their association with selected clinical and psychosocial variables. The Coping Inventory for Stressful Situations (CISS) was used to assess coping strategies among 237 inpatients who met DSM-IV criteria for schizophrenia and 175 healthy individuals. Severity of psychopathology and distress, insight into illness, feelings of self-efficacy and self-esteem (self-construct variables), social support, and quality of life were also examined. Factor analysis, analysis of covariance and correlations were used to examine the relationships between the parameters of interest. Using dimensional measures, we found that emotion-oriented coping style and emotional distress were significantly higher in the schizophrenia group, whereas the task-oriented coping style, self-efficacy, perceived social support and satisfaction with quality of life were lower compared with controls. When eight CISS coping patterns were defined, the results revealed that patients used emotion coping patterns 5.5 times more frequently, and task and task-avoidance coping patterns significantly less often than healthy subjects. Coping patterns have different associations with current levels of dysphoric mood and emotional distress, self-construct variables, and satisfaction with quality of life. Thus, the identified coping patterns may be an additional useful presentation of the diversity of coping strategies used by schizophrenia patients. Coping patterns may be considered an important source of knowledge for patients who struggle with the illness and for mental health professionals who work with schizophrenia patients. PMID:17011633

  6. Relationship between Lifetime Suicide Attempts and Schizotypal Traits in Patients with Schizophrenia

    PubMed Central

    Teraishi, Toshiya; Hori, Hiroaki; Sasayama, Daimei; Matsuo, Junko; Ogawa, Shintaro; Ishida, Ikki; Nagashima, Anna; Kinoshita, Yukiko; Ota, Miho; Hattori, Kotaro; Kunugi, Hiroshi

    2014-01-01

    Patients with schizophrenia are at increased risk for suicide. Various risk factors for suicide have been reported in schizophrenia; however, few studies have examined the association between personality traits and suicidal behavior. We administered the Schizotypal Personality Questionnaire (SPQ) to 87 Japanese patients with schizophrenia (49 males; mean age 38.1±10.6 years) with and without a history of suicide attempts (SA and nSA groups, respectively), and 322 controls (158 males; mean age 40.8±13.9 years). As expected, an analysis of covariance (ANCOVA) controlling for age and sex showed that all SPQ indices (total SPQ score and all three factors, i.e., cognitive-perceptual, interpersonal, and disorganized) were significantly higher in patients with schizophrenia (SA+nSA groups), than controls (p<0.001 for all comparisons). Furthermore, there were significant differences in the total score and the interpersonal and disorganized factors between the SA and nSA groups (nSApatients with schizophrenia. PMID:25226584

  7. Belief Revision and Delusions: How Do Patients with Schizophrenia Take Advice?

    PubMed Central

    Kaliuzhna, Mariia; Chambon, Valérian; Franck, Nicolas; Testud, Bérangère; Van der Henst, Jean-Baptiste

    2012-01-01

    The dominant cognitive model that accounts for the persistence of delusional beliefs in schizophrenia postulates that patients suffer from a general deficit in belief revision. It is generally assumed that this deficit is a consequence of impaired reasoning skills. However, the possibility that such inflexibility affects the entire system of a patient's beliefs has rarely been empirically tested. Using delusion-neutral material in a well-documented advice-taking task, the present study reports that patients with schizophrenia: 1) revise their beliefs, 2) take into account socially provided information to do so, 3) are not overconfident about their judgments, and 4) show less egocentric advice-discounting than controls. This study thus shows that delusional patients' difficulty in revising beliefs is more selective than had been previously assumed. The specificities of the task and the implications for a theory of delusion formation are discussed. PMID:22536329

  8. How specific are emotional deficits? A comparison of empathic abilities in schizophrenia, bipolar and depressed patients.

    PubMed

    Derntl, Birgit; Seidel, Eva-Maria; Schneider, Frank; Habel, Ute

    2012-12-01

    Empathy is a rather elaborated human ability and several recent studies highlight significant impairments in patients suffering from psychiatric disorders, such as schizophrenia, bipolar disorder or major depression. Therefore, the present study aimed at comparing behavioral empathy performance in schizophrenia, bipolar and depressed patients with healthy controls. All subjects performed three tasks tapping the core components of empathy: emotion recognition, emotional perspective taking and affective responsiveness. Groups were matched for age, gender, and verbal intelligence. Data analysis revealed three main findings: First, schizophrenia patients showed the strongest impairment in empathic performance followed by bipolar patients while depressed patients performed similar to controls in most tasks, except for affective responsiveness. Second, a significant association between clinical characteristics and empathy performance was only apparent in depression, indicating worse affective responsiveness with stronger symptom severity and longer duration of illness. Third, self-report data indicate that particularly bipolar patients describe themselves as less empathic, reporting less empathic concern and less perspective taking. Taken together, this study constitutes the first approach to directly compare specificity of empathic deficits in severe psychiatric disorders. Our results suggest disorder-specific impairments in emotional competencies that enable better characterization of the patient groups investigated and indicate different psychotherapeutic interventions. PMID:23116884

  9. Preserved memory monitoring but impaired memory control during episodic encoding in patients with schizophrenia.

    PubMed

    Bacon, Elisabeth; Izaute, Marie; Danion, Jean-Marie

    2007-03-01

    Metamemory awareness refers to the ability to monitor and control how well information is processed depending on the loads and needs of the task at hand. There is some evidence that metamemory functions are impaired in schizophrenia at the time of memory retrieval. This study investigated whether patients with schizophrenia exhibit metamemory abnormalities during the encoding of new information. The frequency of item presentation was varied. Both memory control and memory monitoring were assessed using study-time allocation and Judgments of Learning (JOL), respectively. Repeated items were recalled better by both groups, but memory performance was lower in patients than controls. Patients' behavior patterns were abnormal in terms of the study-time allocated for each item according to presentation frequency. Patients' JOLs were lower than those of controls but remained sensitive to item repetition. Patients' predictive values on memory accuracy were no different to those measured in controls. In addition, none of the patients reported using efficient strategies to help memorize target items. The results show a dissociation between memory control, which was impaired, and memory monitoring, which was spared, in patients with schizophrenia during encoding of new information. PMID:17286879

  10. Targeted training modifies oscillatory brain activity in schizophrenia patients

    PubMed Central

    Popov, Tzvetan G.; Carolus, Almut; Schubring, David; Popova, Petia; Miller, Gregory A.; Rockstroh, Brigitte S.

    2015-01-01

    Effects of both domain-specific and broader cognitive remediation protocols have been reported for neural activity and overt performance in schizophrenia (SZ). Progress is limited by insufficient knowledge of relevant neural mechanisms. Addressing neuronal signal resolution in the auditory system as a mechanism contributing to cognitive function and dysfunction in schizophrenia, the present study compared effects of two neuroplasticity-based training protocols targeting auditory–verbal or facial affect discrimination accuracy and a standard rehabilitation protocol on magnetoencephalographic (MEG) oscillatory brain activity in an auditory paired-click task. SZ were randomly assigned to either 20 daily 1-hour sessions over 4 weeks of auditory–verbal training (N = 19), similarly intense facial affect discrimination training (N = 19), or 4 weeks of treatment as usual (TAU, N = 19). Pre-training, the 57 SZ showed smaller click-induced posterior alpha power modulation than did 28 healthy comparison participants, replicating Popov et al. (2011b). Abnormally small alpha decrease 300–800 ms around S2 improved more after targeted auditory–verbal training than after facial affect training or TAU. The improvement in oscillatory brain dynamics with training correlated with improvement on a measure of verbal learning. Results replicate previously reported effects of neuroplasticity-based psychological training on oscillatory correlates of auditory stimulus differentiation, encoding, and updating and indicate specificity of cortical training effects. PMID:26082889

  11. Reward System Dysfunction as a Neural Substrate of Symptom Expression Across the General Population and Patients With Schizophrenia.

    PubMed

    Simon, Joe J; Cordeiro, Sheila A; Weber, Marc-André; Friederich, Hans-Christoph; Wolf, Robert C; Weisbrod, Matthias; Kaiser, Stefan

    2015-11-01

    Dysfunctional patterns of activation in brain reward networks have been suggested as a core element in the pathophysiology of schizophrenia. However, it remains unclear whether this dysfunction is specific to schizophrenia or can be continuously observed across persons with different levels of nonclinical and clinical symptom expression. Therefore, we sought to investigate whether the pattern of reward system dysfunction is consistent with a dimensional or categorical model of psychosis-like symptom expression. 23 patients with schizophrenia and 37 healthy control participants with varying levels of psychosis-like symptoms, separated into 3 groups of low, medium, and high symptom expression underwent event-related functional magnetic resonance imaging while performing a Cued Reinforcement Reaction Time task. We observed lower activation in the ventral striatum during the expectation of high vs no reward to be associated with higher symptom expression across all participants. No significant difference between patients with schizophrenia and healthy participants with high symptom expression was found. However, connectivity between the ventral striatum and the medial orbitofrontal cortex was specifically reduced in patients with schizophrenia. Dysfunctional local activation of the ventral striatum depends less on diagnostic category than on the degree of symptom expression, therefore showing a pattern consistent with a psychosis continuum. In contrast, aberrant connectivity in the reward system is specific to patients with schizophrenia, thereby supporting a categorical view. Thus, the results of the present study provide evidence for both continuous and discontinuous neural substrates of symptom expression across patients with schizophrenia and the general population. PMID:26006262

  12. Clinical diagnosis of hyposalivation in hospitalized patients

    PubMed Central

    BERTI-COUTO, Soraya de Azambuja; COUTO-SOUZA, Paulo Henrique; JACOBS, Reinhilde; NACKAERTS, Olivia; RUBIRA-BULLEN, Izabel Regina Fischer; WESTPHALEN, Fernando Henrique; MOYSÉS, Samuel Jorge; IGNÁCIO, Sérgio Aparecido; da COSTA, Maitê Barroso; TOLAZZI, Ana Lúcia

    2012-01-01

    Objective The aim of this study was to evaluate the effectiveness of clinical criteria for the diagnosis of hyposalivation in hospitalized patients. Material and Methods A clinical study was carried out on 145 subjects (48 males; 97 females; aged 20 to 90 years). Each subject was clinically examined, in the morning and in the afternoon, along 1 day. A focused anamnesis allowed identifying symptoms of hyposalivation, like xerostomia complaints (considered as a reference symptom), chewing difficulty, dysphagia and increased frequency of liquid intake. Afterwards, dryness of the mucosa of the cheecks and floor of the mouth, as well as salivary secretion during parotid gland stimulation were assessed during oral examination. Results Results obtained with Chi-square tests showed that 71 patients (48.9%) presented xerostomia complaints, with a significant correlation with all hyposalivation symptoms (p<0.05). Furthermore, xerostomia was also significantly correlated with all data obtained during oral examination in both periods of evaluation (p<0.05). Conclusion Clinical diagnosis of hyposalivation in hospitalized patients is feasible and can provide an immediate and appropriate therapy avoiding further problems and improving their quality of life. PMID:22666830

  13. One patient with Sjogren’s syndrome presenting schizophrenia-like symptoms

    PubMed Central

    Lin, Ching-En

    2016-01-01

    Comorbid depression in patients with Sjogren’s syndrome has been reported frequently, while comorbid psychosis in subjects with Sjogren’s syndrome has rarely been reported. Here we report a patient with Sjogren’s syndrome who presented with schizophrenia-like symptoms such as persecutory delusions and auditory hallucinations in contrast to her previous psychiatric presentations, which only included depression and anxiety. PMID:27042076

  14. Diminished serum repetin levels in patients with schizophrenia and bipolar disorder.

    PubMed

    Wang, Shuai; Ren, Huixun; Xu, Jie; Yu, Yanjun; Han, Shuiping; Qiao, Hui; Cheng, Shaoli; Xu, Chang; An, Shucheng; Ju, Bomiao; Yu, Chengyuan; Wang, Chanyuan; Wang, Tao; Yang, Zhenjun; Taylor, Ethan Will; Zhao, Lijun

    2015-01-01

    Repetin (RPTN) protein is a member of S100 family and is known to be expressed in the normal epidermis. Here we show that RPTN is ubiquitously expressed in both mouse and human brain, with relatively high levels in choroid plexus, hippocampus and prefrontal cortex. To investigate the expression of RPTN in neuropsychiatric disorders, we determined serum levels of RPTN in patients with schizophrenia (n = 88) or bipolar disorder (n = 34) and in chronic psychostimulant users (n = 91). We also studied its expression in a mouse model of chronic unpredictable mild stress (CUMS). The results showed that serum RPTN levels were significantly diminished in patients with schizophrenia and bipolar disorder or in psychostimulant users, compared with healthy subjects (n = 115) or age-matched controls (n = 92) (p < 0.0001). In CUMS mice, RPTN expression in hippocampus and prefrontal cortex was reduced with progression of the CUMS procedure; the serum RPTN level remained unchanged. Since CUMS is a model for depression and methamphetamine (METH) abuse induced psychosis recapitulates many of the psychotic symptoms of schizophrenia, the results from this study may imply that RPTN plays a potential role in emotional and cognitive processing; its decrease in serum may indicate its involvement in the pathogenesis of schizophrenia and bipolar disorder. PMID:25613293

  15. Clozapine and risperidone influence on cortisol and estradiol levels in male patients with schizophrenia.

    PubMed

    Piriu, G; Torac, E; Gaman, L E; Iosif, L; Tivig, I C; Delia, C; Gilca, M; Stoian, I; Atanasiu, V

    2015-01-01

    Estrogens role in schizophrenia patients is a subject, which has gained an increased attention from the medical community. Estrogens have been shown to inhibit dopamine actions, improve neuronal regeneration, and overall, have a protective role in the pathology of schizophrenia. The adjunctive estrogen therapy for men is currently under debate. Antipsychotic medication is known to influence the hypothalamo-hypophyseal - gonadal axis by inducing variable degrees of hyperprolactinemia. Several studies have found that some of the atypical antipsychotics lower cortisol levels in patients and also in healthy controls. We have investigated the effects of clozapine and risperidone on estradiol levels in men with schizophrenia. We have also evaluated the levels of prolactin and cortisol, taking into account the possible influence of antipsychotic drugs on both these hormones. Both prolactin and cortisol also have the potential to regulate sexual hormones biosynthesis. Our study found decreased estradiol levels in men with schizophrenia treated with clozapine and risperidone, while prolactin levels were increased only in the risperidone treated group. Cortisol levels are not statistically significant different between groups. PMID:26664488

  16. Schizophrenia Patients Demonstrate Both Inter-Voxel Level and Intra-Voxel Level White Matter Alterations.

    PubMed

    Zhuo, Chuanjun; Ma, Xiaolei; Qu, Hongru; Wang, Lina; Jia, Feng; Wang, Chunli

    2016-01-01

    Fractional anisotropy (FA) and mean diffusivity (MD) are the most frequently used metrics to investigate white matter impairments in mental disorders. However, these two metrics are derived from intra-voxel analyses and only reflect the diffusion properties solely within the voxel unit. Local diffusion homogeneity (LDH) is a newly developed inter-voxel metric which quantifies the local coherence of water molecule diffusion in a model-free manner. In this study, 94 schizophrenia patients and 91 sex- and age-matched healthy controls underwent diffusion tensor imaging (DTI) examinations. White matter integrity was assessed by FA, MD and LDH. Group differences in these metrics were compared using tract-based spatial statistics (TBSS). Compared with healthy controls, schizophrenia patients exhibited reduced FA and increased MD in the corpus callosum, cingulum, internal capsule, fornix and widespread superficial white matter in the frontal, parietal, occipital and temporal lobes. We also found decreased LDH in the corpus callosum, cingulum, internal capsule and fornix in schizophrenia. Our findings suggest that both intra-voxel and inter-voxel diffusion metrics are able to detect impairments in the anisotropic white matter regions, and intra-voxel diffusion metrics could detect additional impairments in the widespread isotropic white matter regions in schizophrenia. PMID:27618693

  17. Diminished serum repetin levels in patients with schizophrenia and bipolar disorder

    PubMed Central

    Wang, Shuai; Ren, Huixun; Xu, Jie; Yu, Yanjun; Han, Shuiping; Qiao, Hui; Cheng, Shaoli; Xu, Chang; An, Shucheng; Ju, Bomiao; Yu, Chengyuan; Wang, Chanyuan; Wang, Tao; Yang, Zhenjun; Taylor, Ethan Will; Zhao, Lijun

    2015-01-01

    Repetin (RPTN) protein is a member of S100 family and is known to be expressed in the normal epidermis. Here we show that RPTN is ubiquitously expressed in both mouse and human brain, with relatively high levels in choroid plexus, hippocampus and prefrontal cortex. To investigate the expression of RPTN in neuropsychiatric disorders, we determined serum levels of RPTN in patients with schizophrenia (n = 88) or bipolar disorder (n = 34) and in chronic psychostimulant users (n = 91). We also studied its expression in a mouse model of chronic unpredictable mild stress (CUMS). The results showed that serum RPTN levels were significantly diminished in patients with schizophrenia and bipolar disorder or in psychostimulant users, compared with healthy subjects (n = 115) or age-matched controls (n = 92) (p < 0.0001). In CUMS mice, RPTN expression in hippocampus and prefrontal cortex was reduced with progression of the CUMS procedure; the serum RPTN level remained unchanged. Since CUMS is a model for depression and methamphetamine (METH) abuse induced psychosis recapitulates many of the psychotic symptoms of schizophrenia, the results from this study may imply that RPTN plays a potential role in emotional and cognitive processing; its decrease in serum may indicate its involvement in the pathogenesis of schizophrenia and bipolar disorder. PMID:25613293

  18. REM sleep EEG spectral analysis in patients with first-episode schizophrenia.

    PubMed

    Poulin, Julie; Stip, Emmanuel; Godbout, Roger

    2008-10-01

    The pathophysiology of schizophrenia includes abnormalities in subcortical-cortical transfer of information that can be studied using REM sleep EEG spectral analysis, a measure that reflects spontaneous and endogenous thalamocortical activity. We recorded 10 patients with first-episode schizophrenia and 30 healthy controls for two consecutive nights in a sleep laboratory, using a 10-electrode EEG montage. Sixty seconds of REM sleep EEG without artifact were analyzed using FFT spectral analysis. Absolute and relative spectral amplitudes of five frequency bands (delta, theta, alpha, beta1 and beta2) were extracted and compared between the two groups. Frequency bands with significant differences were correlated with BPRS positive and negative symptoms scores. Patients with schizophrenia showed lower relative alpha and higher relative beta2 spectral amplitudes compared to healthy controls over the averaged total scalp. Analysis using cortical regions showed lower relative alpha over frontal, central and temporal regions and higher relative beta2 over the occipital region. Absolute spectral amplitude was not different between groups for any given EEG band. However, absolute alpha activity correlated negatively with BPRS positive symptoms scores and correlated positively with negative symptoms scores. Since similar results have been reported following EEG spectral analysis during the waking state, we conclude that abnormalities of subcortical-cortical transfer of information in schizophrenia could be generated by mechanisms common to REM sleep and waking. PMID:18280502

  19. Neurocognitive Mechanisms of Conceptual Processing in Healthy Adults and Patients with Schizophrenia

    PubMed Central

    Sitnikova, Tatiana; Perrone, Christopher; Goff, Donald; Kuperberg, Gina R.

    2010-01-01

    This overview outlines findings of cognitive and neurocognitive studies on comprehension of verbal, pictorial, and video stimuli in healthy participants and patients with schizophrenia. We present evidence for a distinction between two complementary neurocognitive streams of conceptual analysis during comprehension. In familiar situations, adequate understanding of events may be achieved by mapping the perceived information on the associative and similarity-based connections between concepts in semantic memory – a process reflected by an N400 waveform of event-related electrophysiological potentials (ERPs). However, in less conventional contexts, a more flexible mechanism may be needed. We suggest that this alternative processing stream, reflected by a P600 ERP waveform, may use discrete, rule-like goal-related requirements of real-world actions to comprehend relationships between the perceived people, objects, and actions. This neurocognitive model of comprehension is used as a basis in discussing relevant studies in schizophrenia. These studies suggest an imbalanced engagement of the two neurocognitive streams in schizophrenia, whereby patients may rely on the associative and similarity-based networks in semantic memory even when it would be more adaptive to recruit mechanisms that draw upon goal-related requirements. Finally, we consider the roles that these conceptual mechanisms may play in real-life behavior, and the consequences that their dysfunction may have for disorganized behavior and inability to plan actions to achieve behavioral goals in schizophrenia. Imbalanced PMID:20004221

  20. The relationship between hope and patient activation in consumers with schizophrenia: Results from longitudinal analyses.

    PubMed

    Oles, Sylwia K; Fukui, Sadaaki; Rand, Kevin L; Salyers, Michelle P

    2015-08-30

    Hope (goal-directed thinking) and patient activation (knowledge and skills to manage one's illness) are both important in managing chronic conditions like schizophrenia. The relationship between hope and patient activation has not been clearly defined. However, hope may be viewed as a foundational, motivating factor that can lead to greater involvement in care and feelings of efficacy. The purpose of the present study was to understand the prospective relationship between hope and patient activation in a sample of adults with schizophrenia (N=118). This study was a secondary data analysis from a study on Illness Management and Recovery (IMR) - a curriculum-based approach to schizophrenia self-management. Data were collected at baseline (prior to any intervention), and at 9 and 18-month follow-up. As predicted, hope and patient activation were significantly related with each other, showing large positive concurrent correlations. Demographics and background characteristics were not significantly related to patient activation or hope. Longitudinal analyses found no specific directional effect, yet suggested that hope and patient activation mutually influence each other over time. Our findings add flexibility in designing recovery-based interventions - fostering hope may not be a pre-requisite for activating consumers to be more involved in their own care. PMID:26165962

  1. Olfactory performance segregates effects of anhedonia and anxiety on social function in patients with schizophrenia

    PubMed Central

    Cieslak, Kristina; Walsh-Messinger, Julie; Stanford, Arielle; Vaez-Azizi, Leila; Antonius, Daniel; Harkavy-Friedman, Jill; Goetz, Deborah; Goetz, Raymond R.; Malaspina, Dolores

    2015-01-01

    Background Social dysfunction is common among individuals with schizophrenia. While often attributed to anhedonia, social dysfunction could also result from unrecognized anxiety. We examined the contributions of anhedonia and anxiety to social function using olfactory function to examine whether the domains had separate underpinnings. Methods We assessed anhedonia, anxiety and social function as well as olfactory function in well-characterized patients with schizophrenia or schizoaffective disorder and healthy controls. Results We included 56 patients and 37 controls in our study. Patients exhibited significantly higher levels of anhedonia and anxiety than controls, and the domains were highly correlated in patients. The combination of anhedonia and anxiety more strongly predicted social dysfunction than either measure alone. Smell identification was differentially related to the symptoms, with better performance predicting less anhedonia but more social fear in male patients. Limitations The use of self-report measures precludes differentiation between recollected or recounted experience. Aside from smell identification and odour threshold, additional measures of olfaction may be considered for future studies. Conclusion Anhedonia and anxiety were strongly correlated and both negatively impacted social function. The olfactory biomarker results support the conclusion that these domains are separate. Social function in patients with schizophrenia may improve with interventions for anxiety, even in the presence of marked negative symptoms. PMID:26107162

  2. An eye-tracking investigation of intentional motion perception in patients with schizophrenia

    PubMed Central

    Roux, Paul; Passerieux, Christine; Ramus, Franck

    2015-01-01

    Background Schizophrenia has been characterized by an impaired attribution of intentions in social interactions. However, it remains unclear to what extent poor performance may be due to low-level processes or to later, higher-level stages or to what extent the deficit reflects an over-(hypermentalization) or underattribution of intentions (hypomentalization). Methods We evaluated intentional motion perception using a chasing detection paradigm in individuals with schizophrenia or schizoaffective disorder and in healthy controls while eye movements were recorded. Smooth pursuit was measured as a control task. Eye-tracking was used to dissociate ocular from cognitive stages of processing. Results We included 27 patients with schizophrenia, 2 with schizoaffective disorder and 29 controls in our analysis. As a group, patients had lower sensitivity to the detection of chasing than controls, but showed no bias toward the chasing present response. Patients showed a slightly different visual exploration strategy, which affected their ocular sensitivity to chasing. They also showed a decreased cognitive sensitivity to chasing that was not explained by differences in smooth pursuit ability, in visual exploration strategy or in general cognitive abilities. Limitations It is not clear whether the deficit in intentional motion detection demonstrated in this study might be explained by a general deficit in motion perception in individuals with schizophrenia or whether it is specific to the social domain. Conclusion Participants with schizophrenia showed a hypomentalization deficit: they adopted suboptimal visual exploration strategies and had difficulties deciding whether a chase was present or not, even when their eye movement revealed that chasing information had been seen correctly. PMID:25247443

  3. Association between neurological soft signs, temperament and character in patients with schizophrenia and non-psychotic relatives

    PubMed Central

    Pastoriza, Francisco; Bergé, Daniel; Mané, Anna; Picado, Marisol; Bulbena, Antonio; Robledo, Patricia; Pérez, Victor; Vilarroya, Oscar; Cloninger, Claude Robert

    2016-01-01

    The heritability of schizophrenia and most personality traits has been well established, but the role of personality in susceptibility to schizophrenia remains uncertain. The aim of this study was to test for an association between personality traits and Neurological Soft Signs (NSS), a well-known biological marker of schizophrenia, in non-psychotic relatives of patients with schizophrenia. For this purpose, we evaluated the NSS scale and personality measured by the Temperament and Character inventory (TCI-R) in three groups of subjects: 29 patients with schizophrenia, 24 unaffected relatives and 37 controls. The results showed that patients with schizophrenia were more asocial (higher harm avoidance and lower reward dependence), more perseverative (higher persistence), and more schizotypal (lower self-directedness and cooperativeness, higher self-transcendence). The unaffected relatives showed higher harm avoidance, lower self-directedness and cooperativeness than the healthy controls. Higher NSS scores and sub-scores were found in patients and non-psychotic relatives compared with the controls. Among all the patients, total NSS scores were positively correlated with harm avoidance but negatively correlated with novelty seeking and persistence. Total NSS were also correlated with low scores on self-directedness and cooperativeness, which are indicators of personality disorder. Our results show that susceptibility to NSS and to schizophrenia are both related to individual differences in the temperament and character features in non-psychotic relatives of patients with schizophrenia. High harm avoidance, low persistence, low self-directedness and low cooperativeness contribute to both the risk of NSS and schizophrenia. These findings highlight the value of using both assessments to study high risk populations. PMID:27168955

  4. Association between neurological soft signs, temperament and character in patients with schizophrenia and non-psychotic relatives.

    PubMed

    Galindo, Liliana; Pastoriza, Francisco; Bergé, Daniel; Mané, Anna; Picado, Marisol; Bulbena, Antonio; Robledo, Patricia; Pérez, Victor; Vilarroya, Oscar; Cloninger, Claude Robert

    2016-01-01

    The heritability of schizophrenia and most personality traits has been well established, but the role of personality in susceptibility to schizophrenia remains uncertain. The aim of this study was to test for an association between personality traits and Neurological Soft Signs (NSS), a well-known biological marker of schizophrenia, in non-psychotic relatives of patients with schizophrenia. For this purpose, we evaluated the NSS scale and personality measured by the Temperament and Character inventory (TCI-R) in three groups of subjects: 29 patients with schizophrenia, 24 unaffected relatives and 37 controls. The results showed that patients with schizophrenia were more asocial (higher harm avoidance and lower reward dependence), more perseverative (higher persistence), and more schizotypal (lower self-directedness and cooperativeness, higher self-transcendence). The unaffected relatives showed higher harm avoidance, lower self-directedness and cooperativeness than the healthy controls. Higher NSS scores and sub-scores were found in patients and non-psychotic relatives compared with the controls. Among all the patients, total NSS scores were positively correlated with harm avoidance but negatively correlated with novelty seeking and persistence. Total NSS were also correlated with low scores on self-directedness and cooperativeness, which are indicators of personality disorder. Our results show that susceptibility to NSS and to schizophrenia are both related to individual differences in the temperament and character features in non-psychotic relatives of patients with schizophrenia. High harm avoidance, low persistence, low self-directedness and low cooperativeness contribute to both the risk of NSS and schizophrenia. These findings highlight the value of using both assessments to study high risk populations. PMID:27168955

  5. Trends in the access to and the use of antipsychotic medications and psychotropic co-treatments in Asian patients with schizophrenia.

    PubMed

    Xiang, Y-T; Ungvari, G S; Correll, C U; Chiu, H F K; Shinfuku, N

    2016-02-01

    To date, antipsychotics remain the mainstay of treatment for schizophrenia and related disorders although other psychotropic medications and non-pharmaceutical interventions have been used adjunctively in some patients and settings. Regular surveys on access to and prescription patterns of psychotropic medications in clinical practice are an important and efficient way of examining the use and time trends of treatments in a given population and region. Unlike developed Western countries, Asian countries have not fully undergone deinstitutionalisation of the severely and chronically mentally ill, and community-based mental health services are still under-developed. As a result, a large number of psychiatric patients still receive treatments in psychiatric hospitals. Moreover, there have been very limited studies examining access to and prescription patterns of psychotropic medications for schizophrenia patients in Asian countries. In this paper, we focus on the only international project on the use of psychotropic medications in schizophrenia patients in selected East and Southeast Asian countries/territories summarising its major findings. Most of the first- and second-generation antipsychotics (FGAs and SGAs) are available in Asian countries, but the access to psychotropic medications is largely affected by socio-cultural and historical contexts, health insurance schemes, health care policy, medication cost and consumers' preference across different countries/territories. Overall, the proportional use of FGAs, high dose antipsychotic treatment and antipsychotic polypharmacy have decreased, while the use of SGAs and antidepressants have increased and the utilisation of benzodiazepines and mood stabilisers has remained relatively stable over time. However, within these general trends, there is great inter-country variation regarding the psychotropic prescribing patterns and trends in Asian schizophrenia patients that also seems to differ from data in many Western

  6. Community Service Models for Schizophrenia

    PubMed Central

    2005-01-01

    Schizophrenia is a chronic relapsing and remitting mental illness with lifetime prevalence between 0.40 to 1.4 percent. Most people with schizophrenia are treated in psychiatric units of local general hospitals for short periods of time when acutely ill. With the worldwide trend toward closure of asylums and institutions in the 1950s, there has been an increasing focus on treatment in the community. Community mental health teams (CMHT) are the kernel of community treatment. Although their composition and modus operandi differ according to patient need, all models claim superiority over outcomes of long inpatient stay. Case management, assertive outreach, and crisis resolution sometimes compete for resources. What is the evidence for their efficacy? What is the right mix of their use? As we discuss these, we propose that there may be room for the application of established industry models of service delivery, such as Just-in-Time (JIT), in the treatment of patients with schizophrenia. PMID:21179632

  7. Lifestyle related factors & impact of metabolic syndrome on quality of life, level of functioning & self-esteem in patients with bipolar disorder & schizophrenia

    PubMed Central

    Malhotra, Nidhi; Kulhara, Parmanand; Chakrabarti, Subho; Grover, Sandeep

    2016-01-01

    Background & objectives: Though studies have reported high prevalence rates of metabolic syndrome among patients with bipolar disorder (BPAD) and schizophrenia, there is lack of data on the impact of the same on the patients’ life. This study was aimed to assess the lifestyle related factors associated with metabolic syndrome (MetS) and to study the impact of MetS on functioning and quality of life (QOL) in patients with BPAD and schizophrenia. Methods: A total of 102 patients with BPAD and 72 patients with schizophrenia attending the output unit of a tertiary care hospital in north India were evaluated for MetS. These patients were assessed on Health Promoting Lifestyle Profile scale II (HPLP II), World Health Organization QOL -Bref Version (WHOQOL-Bref), Impact of Weight on Quality of Life- Lite version (IWOQOL -Lite), Body weight, Image and Self-esteem Evaluation questionnaire (BWISE), Obesity-related Problem scale (OP scale) and Global Assessment of Functioning (GAF) scale. Results: MetS was associated with lower scores on domains of health responsibility and nutrition habit domain on HPLP-II scale in both groups, and additionally on physical activity and stress management domain in BPAD group. On WHOQOL-Bref, MetS was associated with lower scores on the domains of physical and psychological health in both groups. On IWQOL–Lite, scores on personal distress and self esteem domains were higher in those with obesity in both groups and also on physical activity domain in schizophrenia group. Those with MetS had lower level of functioning as measured by GAF in schizophrenia group. Fulfillment of higher number of criteria of MetS correlated with poorer quality of life and higher problems in both groups. Interpretation & conclusions: Many modifiable lifestyle factors increase the risk of MetS. MetS was found to be associated with poorer QOL in patients with BPAD and schizophrenia; in addition, obesity led to poor self-esteem and excessive personal distress. PMID

  8. [Interferon status in the treatment of neuroleptic-resistant patients with paranoid schizophrenia].

    PubMed

    Maruta, N A; Rachkauskas, G S; Frolov, V M; Vysochin, E V

    2012-01-01

    We studied 73 patients with paranoid schizophrenia with resistance to neuroleptics. All patients were divided into two groups - basic (37 patients) and comparison (36 patients). Both groups received traditional treatment. Patients of the basic group were treated with the combination of reamberin and cycloferon. Before treatment, significant alterations in the interferon status (IFS), which were characterized by the decrease of serum interferon (SIFN) activity and blood α- and γ-interferons (IFN) levels, were identified in both group. The positive effect of the drug combination on clinical symptoms and interferon status (the normalization of SIFN activity, increase in blood α- and γ-IFN levels) was found. PMID:22677752

  9. Lifetime positive symptoms in patients with schizophrenia and cannabis abuse are partially explained by co-morbid addiction.

    PubMed

    Dubertret, Caroline; Bidard, Isabelle; Adès, Jean; Gorwood, Philip

    2006-09-01

    Recent prospective findings have shown that cannabis use by young people could be a risk factor for psychotic symptoms in adulthood, but the long-term impact of cannabis abuse on the clinical features of declared schizophrenia remains to be explored. We assessed the independent influence of cannabis abuse on the clinical symptoms of schizophrenia, after controlling for frequently co-occurring addictive disorders. Patients with schizophrenia, and with (N=66), or without (N=139) cannabis abuse, were compared for lifetime positive and negative symptoms, taking into account presence of any other addictive disorders. The incidence of the abuse of drugs other than cannabis was nearly five times greater amongst patients with both schizophrenia and cannabis abuse. When the analyses were limited to subjects with no other abuse, less avolution and fewer apathy symptoms were still detected in patients with schizophrenia and cannabis abuse than in those with no abuse (p=0.0001). In contrast, between-group differences for positive symptoms were abolished when multiple substance abuses were taken into account. The strong association between cannabis abuse and fewer negative symptoms in schizophrenia was thus replicated in this sample, but once co-morbid addictive disorders had been controlled no influence of cannabis abuse on hallucinations was detected. Distinguishing the effects of co-occurring addictive disorder(s) in patients with schizophrenia and cannabis dependence may thus be important when attempting to analyse the impact of cannabis abuse. PMID:16806837

  10. Hospital Choice of Rural Medicare Beneficiaries: Patient, Hospital Attributes, and the Patient–Physician Relationship

    PubMed Central

    Tai, Wan-Tzu Connie; Porell, Frank W; Adams, E Kathleen

    2004-01-01

    Objective To examine how patient and hospital attributes and the patient–physician relationship influence hospital choice of rural Medicare beneficiaries. Data Sources Medicare Current Beneficiary Survey (MCBS), Health Care Financing Administration (HCFA) Provider of Services (POS) file, American Hospital Association (AHA) Annual Survey, and Medicare Hospital Service Area (HSA) files for 1994 and 1995. Study Design The study sample consisted of 1,702 hospitalizations of rural Medicare beneficiaries. McFadden's conditional logit model was used to analyze hospital choices of rural Medicare beneficiaries. The model included independent variables to control for patients' and hospitals' attributes and the distance to hospital alternatives. Principal Findings The empirical results show strong preferences of aged patients for closer hospitals and those of greater scale and service capacity. Patients with complex acute medical conditions and those with more resources were more likely to bypass their closest rural hospitals. Beneficiaries were more likely to bypass their closest rural hospital if they had no regular physician, had a shorter patient–physician tie, were dissatisfied with the availability of health care, and had a longer travel time to their physician's office. Conclusions The significant influences of patients' socioeconomic, health, and functional status, their satisfaction with and access to primary care, and their strong preferences for certain hospital attributes should inform federal program initiatives about the likely impacts of policy changes on hospital bypassing behavior. PMID:15533193

  11. Rural Hospital Patient Safety Systems Implementation in Two States

    ERIC Educational Resources Information Center

    Longo, Daniel R.; Hewett, John E.; Ge, Bin; Schubert, Shari

    2007-01-01

    Context and Purpose: With heightened attention to medical errors and patient safety, we surveyed Utah and Missouri hospitals to assess the "state of the art" in patient safety systems and identify changes over time. This study examines differences between urban and rural hospitals. Methods: Survey of all acute care hospitals in Utah and Missouri…

  12. Neurological soft signs might be endophenotype candidates for patients with deficit syndrome schizophrenia

    PubMed Central

    Albayrak, Yakup; Akyol, Esra Soydaş; Beyazyüz, Murat; Baykal, Saliha; Kuloglu, Murat

    2015-01-01

    Background Schizophrenia is a chronic, disabling, disorder that affects approximately 1% of the population. The nature of schizophrenia is heterogeneous, and unsuccessful efforts to subtype this disorder have been made. Deficit syndrome schizophrenia (DS) is a clinical diagnosis that has not been placed in main diagnostic manuals. In this study, we aimed to investigate and compare neurological soft signs (NSS) in DS patients, non-deficit schizophrenia (NDS) patients, and healthy controls (HCs). We suggest that NSS might be an endophenotype candidate for DS patients. Methods Sixty-six patients with schizophrenia and 30 HCs were enrolled in accordance with our inclusion and exclusion criteria. The patients were sub-typed as DS (n=24) and NDS (n=42) according to the Schedule for the Deficit Syndrome. The three groups were compared in terms of sociodemographic and clinical variables and total scores and subscores on the Physical and Neurological Examination for Soft Signs (PANESS). Following the comparison, a regression analysis was performed for predictability of total PANESS score and its subscales in the diagnosis of DS and NDS. Results The groups were similar in terms of age, sex, and smoking status. The results of our study indicated that the total PANESS score was significantly higher in the DS group compared to the NDS and HC groups, and all PANESS subscales were significantly higher in the DS group than in the HC group. The diagnosis of DS was predicted significantly by total PANESS score (P<0.001, odds ratio =9.48, 95% confidence interval: 0.00–4.56); the synergy, graphesthesia, stereognosis, motor tasks, and ability to maintain posture subscales were found to be significant predictors. Conclusion This study confirms that NSS were higher in patients with DS. In addition, we suggest that our results might support the notion of DS as a different and distinct type of schizophrenia. NSS might also be a promising candidate as an endophenotype for DS. However

  13. Integrated Patient Education on U.S. Hospital Web Sites.

    PubMed

    Huang, Edgar; Wu, Kerong; Edwards, Kelsey

    2016-01-01

    Based on a census of the 2015 Most Wired Hospitals, this content analysis aimed to find out how patient education has been integrated on these best IT hospitals' Web sites to serve the purposes of marketing and meeting online visitors' needs. This study will help hospitals to understand where the weaknesses are in their interactive patient education implementation and come up with a smart integration strategy. The study found that 70% of these hospitals had adopted interactive patient education contents, 76.6% of such contents were from a third-party developer, and only 20% of the hospitals linked their patient education contents to one or more of the hospital's resources while 26% cross-references such contents. The authors concluded that more hospitals should take advantage of modern information communication technology to cross-reference their patient education contents and to integrate such contents into their overall online marketing strategy to benefit patients and themselves. PMID:27139406

  14. Volumetric analysis of the diagonal band of Broca in patients with schizophrenia and affective disorders: A post-mortem study.

    PubMed

    Brisch, Ralf; Bernstein, Hans-Gert; Dobrowolny, Henrik; Krzyżanowska, Marta; Jankowski, Zbigniew; Bogerts, Bernhard; Gos, Tomasz

    2016-05-01

    The human diagonal band of Broca is connected to other parts of the limbic system, such as the hippocampus, that are involved in the pathology of schizophrenia. This study aimed to characterize the volume and anterior-to-posterior distance of the human diagonal band of Broca (vertical limb) from post-mortem brains obtained from three groups: healthy control subjects (N = 17), patients with schizophrenia (N = 26), and patients with affective disorders (N = 12). There were no significant differences in the volume or anterior-to-posterior distance in the patients with schizophrenia or affective disorders compared with the healthy control subjects. To date, this is the first post-mortem investigation measuring the volume and the anterior-to-posterior distance of the diagonal band of Broca (vertical limb) in patients with schizophrenia or affective disorders compared with healthy control subjects. Clin. Anat. 29:466-472, 2016. © 2015 Wiley Periodicals, Inc. PMID:26457806

  15. Time perception and its neuropsychological correlates in patients with schizophrenia and in healthy volunteers.

    PubMed

    Lee, Kwang-Hyuk; Bhaker, Rajinder S; Mysore, Ashok; Parks, Randolph W; Birkett, Paul B L; Woodruff, Peter W R

    2009-04-30

    Disordered time perception has been reported in schizophrenia. We investigated time perception dysfunction and its neuropsychological correlates in patients with schizophrenia. Participants comprised 38 patients and 38 age- and sex-matched healthy volunteers who were compared in an auditory temporal bisection paradigm using two interval ranges (a 400/800 ms condition and a 1000/2000 ms condition). In the temporal bisection, subjects were required to categorise a probe duration as short or long, based upon the similarity with two reference durations. All subjects also completed a battery of neuropsychological tests measuring sustained attention, short- and long-term memory and executive function. In the 400/800 ms condition, patients judged durations significantly shorter than did control subjects. Patients also exhibited decreased temporal sensitivity in both conditions. We found in both groups a negative association between temporal sensitivity and sustained attention for the 400/800 ms condition, and between temporal sensitivity and long-term memory for the 1000/200 ms condition. In patients, short-term memory performance was negatively associated with duration judgement in both conditions, while executive dysfunction was correlated to a general performance deficit in the 400/800 ms condition. These findings suggest the possibility that time perception abnormalities in schizophrenia are part of neuropsychological dysfunction and are likely to adversely impact upon activity of daily living. PMID:19278734

  16. Metabolic issues in patients affected by schizophrenia: clinical characteristics and medical management

    PubMed Central

    Ventriglio, Antonio; Gentile, Alessandro; Stella, Eleonora; Bellomo, Antonello

    2015-01-01

    Patients affected by psychotic disorders are more likely to develop high rates of co-morbidities, such as obesity, type 2 diabetes, dyslipidemias, hypertension, metabolic syndrome, myocardial infarction, stroke etc., in the long-term. These morbidities have a significant impact on the life-expectancy of these patients. Patients with chronic psychoses show a 2–3-fold increased risk of death mostly from cardiovascular and metabolic diseases. Although there may be an independent link, between schizophrenia and metabolic conditions the cardio-metabolic risk is mostly related to an unhealthy lifestyle and the usage of antipsychotic agents (especially Second Generation Antipsychotics or atypical) even when these remain effective treatments in the management of major psychoses. Recently, many international organizations have developed screening and monitoring guidelines for the control of modifiable risk factors in order to reduce the rate of co-morbidity and mortality among patients affected by schizophrenia. This paper is a review of current knowledge about the metabolic issues of patients affected by schizophrenia and describes clinical characteristics and medical management strategies for such conditions. PMID:26388714

  17. [The Influence of Threatening Stimuli on the Component P200 in Patients with Paranoid Schizophrenia].

    PubMed

    Strelets, V B; Arkhipov, A Yu

    2015-01-01

    We studied schizophrenic patients with the dominance of pseudohallucinations. As is well known, pseudohallucinations are the main syndrome of schizophrenia, the so-called first rank syndrome. Pseudohallucinations are defined as a disorder of sense (affective) perception. This disorder is mainly diagnosed from the clinical picture or by pathopsychologichal observations. We investigated the evoked potentials (EP) of brain after neutral and emotionally meaningful (threatening) visual stimuli in order to specify the neurophysiological disorders of affective perception in schizophrenic patients with severe paranoid-hallucinatory syndrome who did not receive neuroleptic therapy. The analysis of P200 component in healthy subjects showed an increase in the amplitude and shortening of the latency of this wave in response to thretaning stimuli, as compared to neutral stimuli. In the group of patients with schizophrenia, the analysis showed the same increase in the level of excitation in response to emotionally threatening stimuli. However, in schizophrenic patients there were also found certain areas where the amplitude and latency decreased or increased at the same time. The results show that patients with schizophrenia have the pathological effect of having parameters typical of the processes of both excitation and inhibition. PMID:26601410

  18. Second-generation long-acting injectable antipsychotics in schizophrenia: patient functioning and quality of life

    PubMed Central

    Montemagni, Cristiana; Frieri, Tiziana; Rocca, Paola

    2016-01-01

    Long-acting injectable antipsychotics (LAIs) were developed to make treatment easier, improve adherence, and/or signal the clinician when nonadherence occurs. Second-generation antipsychotic LAIs (SGA-LAIs) combine the advantages of SGA with a long-acting formulation. The purpose of this review is to evaluate the available literature concerning the impact of SGA-LAIs on patient functioning and quality of life (QOL). Although several studies regarding schizophrenia patients’ functioning and QOL have been performed, the quantity of available data still varies greatly depending on the SGA-LAI under investigation. After reviewing the literature, it seems that SGA-LAIs are effective in ameliorating patient functioning and/or QOL of patients with schizophrenia, as compared with placebo. However, while methodological design controversy exists regarding the superiority of risperidone LAI versus oral antipsychotics, the significant amount of evidence in recently published research demonstrates the beneficial influence of risperidone LAI on patient functioning and QOL in stable patients and no benefit over oral treatment in unstable patients. However, the status of the research on SGA-LAIs is lacking in several aspects that may help physicians in choosing the correct drug therapy. Meaningful differences have been observed between SGA-LAIs in the onset of their clinical efficacy and in the relationships between symptoms and functioning scores. Moreover, head-to-head studies comparing the effects of SGA-LAIs on classical measures of psychopathology and functioning are available mainly on risperidone LAI, while those comparing olanzapine LAI with other SGA-LAIs are still lacking. Lastly, some data on their use, especially in first-episode or recent-onset schizophrenia and in refractory or treatment-resistant schizophrenia, is available. PMID:27143893

  19. A cross-sectional study on perception of stigma by Chinese schizophrenia patients

    PubMed Central

    Ren, Zhibin; Wang, Heqiu; Feng, Bin; Gu, Chenyu; Ma, Yongchun; Chen, Hong; Li, Bingling; Liu, Lanying

    2014-01-01

    Objective In this cross-sectional study, we sought to assess the extent of internalized stigma among inpatients and outpatients with schizophrenia in the People’s Republic of China and to investigate whether education level correlated with the experience of stigma. Methods Schizophrenia patients were evaluated using the Brief Psychiatric Rating Scale (BPRS), the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impressions-Severity of Illness (CGI-S) scale and the Stigma Scale for Mental Illness (SSMI-C). Patients were categorized into high education and low education groups, according to their educational levels. Results One hundred thirty-three subjects were included in the study. Their mean course of illness was 4.32±6.14 years (range: 1 month to 15 years). Their mean BPRS score was 19.87±5.46, their mean PANSS score was 44.11±13.1, and their mean CGI-S score was 2.22±0.81. In addition, their mean SSMI-C score was 6.49±0.9. The mean SSMI-C score of patients who have received high school education or above was 7.15±0.98, which was markedly higher than that of patients who have received middle school education or below, which was 5.75±0.79 (P<0.05). Before the study most patients (92.5%, 123/133) took atypical drugs. Conclusion Education level impacts on the perception of stigma by schizophrenia patients, and more psychoeducation should be undertaken to improve patients’ knowledge about schizophrenia. PMID:24707179

  20. Antibodies to Toxoplasma gondii in Patients With Schizophrenia: A Meta-Analysis

    PubMed Central

    Torrey, E. Fuller; Bartko, John J.; Lun, Zhao-Rong; Yolken, Robert H.

    2007-01-01

    Recent studies have linked infectious agents to schizophrenia. The largest number of studies has involved the analysis of Toxoplasma gondii; these studies were subjected to a meta-analysis. Published articles and abstracts were identified by searches of MEDLINE, Ovid, and Google Scholar; by a search of Chinese publications; through letters to researchers; and by visiting China. Published and unpublished controlled studies that used serological methods for measuring T. gondii antibodies to assess inpatients and/or outpatients diagnosed with schizophrenia were selected for analysis, and source documents were translated as needed. Forty-two studies carried out in 17 countries over 5 decades were identified; 23 of these (6 unpublished) met selection criteria. The combined odds ratio (OR) was 2.73 (95% confidence interval, 2.10 to 3.60; chi-square with 1 df 263; P < .000001). Seven studies that included only patients with first-episode schizophrenia (OR 2.54) did not differ significantly from 16 studies that included patients in all clinical phases (OR 2.79). The results suggest that individuals with schizophrenia have an increased prevalence of antibodies to T. gondii. This association is consistent with other epidemiological studies as well as with animal studies. Although the OR of 2.73 is modest, it exceeds that for genetic or other environmental factors identified to date and suggests that Toxoplasma is in some way associated with a large number of cases of schizophrenia. If an etiological association can be proven, it would have implications for the design of measures for the prevention and treatment of this disease. PMID:17085743

  1. Highlighting Hospital and Patient Concerns this Election Year.

    PubMed

    Nickels, Tom

    2016-03-01

    Campaign 2016 is in full swing, and the American Hospital Association is seizing the opportunity to make sure the concerns of patients and hospitals are heard. On the front burner: escalating drug prices. PMID:27180391

  2. Flu Shot Safe for Surgery Patients in Hospital: Study

    MedlinePlus

    ... nlm.nih.gov/medlineplus/news/fullstory_157754.html Flu Shot Safe for Surgery Patients in Hospital: Study ... increased risk for complications if they receive a flu shot in the hospital, a new study suggests. ...

  3. Hospital utilization outcome of an assertive outreach model for schizophrenic patients - results of a quasi-experimental study.

    PubMed

    Büchtemann, Dorothea; Kästner, Denise; Warnke, Ingeborg; Radisch, Jeanett; Baumgardt, Johanna; Giersberg, Steffi; Kleine-Budde, Katja; Moock, Jörn; Kawohl, Wolfram; Rössler, Wulf

    2016-07-30

    We assessed whether an Assertive Outreach (AO) program for patients with schizophrenia implemented in German routine care in rural areas reduces psychiatric hospital admissions and/or psychiatric hospital days. We conducted a quasi-experimental controlled study with 5 assessments in 12 months. Data collection included health care utilization (Client Sociodemographic and Service Receipt Inventory), and clinical parameters. The assessments took place in the practices of the psychiatrists. Admission incidence rates were calculated. For bivariate group comparison, we used U-tests, T-tests and Chi(2)-Tests, multivariate analysis was conducted using zero-inflated regression models. For hospital outcomes, data of 295 patients was analysed. No statistically significant differences between AO and TAU patients in terms of hospital admissions or hospital days were found. Overall hospital utilization was low (8%). Advantages of AO over TAU referring to hospital utilization were not found. However, a spill-over effect might have reduced hospital utilization in both groups. Further research should differentiate patient subgroups. These two appear to be key factors to explain effects or absence of effects and to draw conclusions for the mental health care delivery. PMID:27208511

  4. White matter alterations associated with suicide in patients with schizophrenia or schizophreniform disorder.

    PubMed

    Lee, Sung-Jae; Kim, Borah; Oh, Daeyoung; Kim, Min-Kyoung; Kim, Keun-Hyang; Bang, Seong Yun; Choi, Tai Kiu; Lee, Sang-Hyuk

    2016-02-28

    The risk of suicide is disproportionately high among people diagnosed with schizophrenia or schizophreniform disorder. Brain imaging studies have shown a few relationships between neuroanatomy and suicide. This study examines the relationship between alterations in brain white matter (WM) and suicidal behavior in people with schizophrenia or schizophreniform disorder. The study participants were 56 patients with schizophrenia or schizophreniform disorder, with (n=15) and without (n=41) a history of suicide attempts. Fractional anisotropy (FA) values were compared between suicide attempters and non-attempters using Tract-Based Spatial Statistics (TBSS). Attempters showed significantly higher FA values than non-attempters in the left corona radiata, the superior longitudinal fasciculus, the posterior limb and retrolenticular part of the internal capsule, the external capsule, the insula, the posterior thalamic radiation, the cerebral peduncle, the sagittal stratum, and temporal lobe WM. Scores of the picture arrangement test showed a significant positive correlation with FA values of the right corona radiata, the right superior longitudinal fasciculus, the body of the corpus callosum, and the left corona radiata in attempters but not in non-attempters. These findings suggest that fronto-temporo-limbic circuits can be associated mainly with suicidal behavior in people with schizophrenia or schizophreniform disorder. PMID:26774424

  5. Speech and language therapies to improve pragmatics and discourse skills in patients with schizophrenia.

    PubMed

    Joyal, Marilyne; Bonneau, Audrey; Fecteau, Shirley

    2016-06-30

    Individuals with schizophrenia display speech and language impairments that greatly impact their integration to the society. The aim of this systematic review was to identify the importance of speech and language therapy (SLT) as part of rehabilitation curriculums for patients with schizophrenia emphasizing on the speech and language abilities assessed, the therapy setting and the therapeutic approach. This article reviewed 18 studies testing the effects of language therapy or training in 433 adults diagnosed with schizophrenia. Results showed that 14 studies out of 18 lead to improvements in language and/or speech abilities. Most of these studies comprised pragmatic or expressive discursive skills being the only aim of the therapy or part of it. The therapy settings vary widely ranging from twice daily individual therapy to once weekly group therapy. The therapeutic approach was mainly operant conditioning. Although the evidence tends to show that certain areas of language are treatable through therapy, it remains difficult to state the type of approach that should be favoured and implemented to treat language impairments in schizophrenia. PMID:27092861

  6. Changing the Name of Schizophrenia: Patient Perspectives and Implications for DSM-V

    PubMed Central

    Tranulis, Constantin; Lecomte, Tania; El-Khoury, Bassam; Lavarenne, Anaïs; Brodeur-Côté, Daniel

    2013-01-01

    Introduction The diagnosis of schizophrenia is increasingly contested by researchers, clinicians, patients and family members. Preeminent researchers proposed its replacement with the salience syndrome concept, arguing for increased validity and less stigmatizing potential. This is the first study exploring the effects on stigma of this nosological proposal. Methods Two studies were conducted: one with 161 undergraduate students regarding their stigmatizing attitudes linked to the label of schizophrenia or salience syndrome, the other involved in-depth qualitative interviews with 19 participants treated in a first episode psychosis program. The interviews explored the subjective validity, acceptability and effects on stigma of a diagnosis of schizophrenia or salience syndrome. Results Overall, no significant differences were found between labels in study 1. For study 2, the majority of participants preferred a diagnosis of salience syndrome, considering it less stigmatizing mostly because of its novelty and the concealing potential of the new diagnostic entity, though many found it hard to relate to and somewhat difficult to understand. Discussion Our results suggest that the label change does not impact the stigmatizing potential for individuals who are not familiar with mental illness - they appear to base their attitudes on descriptions rather than the label alone. For those suffering from mental illness, a name change for schizophrenia to “salience syndrome” might offer only a temporary relief from stigma. Claims of de-stigmatizing effects should be grounded in sound scientific models of stigma and ideally in empirical data. PMID:23457490

  7. Spatial Variance in Resting fMRI Networks of Schizophrenia Patients: An Independent Vector Analysis.

    PubMed

    Gopal, Shruti; Miller, Robyn L; Michael, Andrew; Adali, Tulay; Cetin, Mustafa; Rachakonda, Srinivas; Bustillo, Juan R; Cahill, Nathan; Baum, Stefi A; Calhoun, Vince D

    2016-01-01

    Spatial variability in resting functional MRI (fMRI) brain networks has not been well studied in schizophrenia, a disease known for both neurodevelopmental and widespread anatomic changes. Motivated by abundant evidence of neuroanatomical variability from previous studies of schizophrenia, we draw upon a relatively new approach called independent vector analysis (IVA) to assess this variability in resting fMRI networks. IVA is a blind-source separation algorithm, which segregates fMRI data into temporally coherent but spatially independent networks and has been shown to be especially good at capturing spatial variability among subjects in the extracted networks. We introduce several new ways to quantify differences in variability of IVA-derived networks between schizophrenia patients (SZs = 82) and healthy controls (HCs = 89). Voxelwise amplitude analyses showed significant group differences in the spatial maps of auditory cortex, the basal ganglia, the sensorimotor network, and visual cortex. Tests for differences (HC-SZ) in the spatial variability maps suggest, that at rest, SZs exhibit more activity within externally focused sensory and integrative network and less activity in the default mode network thought to be related to internal reflection. Additionally, tests for difference of variance between groups further emphasize that SZs exhibit greater network variability. These results, consistent with our prediction of increased spatial variability within SZs, enhance our understanding of the disease and suggest that it is not just the amplitude of connectivity that is different in schizophrenia, but also the consistency in spatial connectivity patterns across subjects. PMID:26106217

  8. [Schizophrenia is still a stigmatized disease].

    PubMed

    Flyckt, Lena; Torell, Per

    2015-01-01

    In Sweden like in other countries the mentally ill, especially individuals with schizophrenia, are marginalized and stigmatized by society but also by themselves. Their close families and friends have served as informal care-givers after the closing down of mental hospitals, and open-care units have not sufficiently met the needs of the patients. Non-profit organizations and private initiatives such as the Association of families to persons with schizophrenia (Schizofreniförbundet) have played a crucial role for the well-being of patients and their families. Anti-stigmatizing campaigns and processes have proven successful and are possible to perform on all levels, private, in society, and on the political arena. Both self-stigmatization and marginalization would diminish if individuals with schizophrenia were let in on the open labor market. An equal health care, both psychiatric and somatic, is today a utopia for individuals with schizophrenia and other forms of psychoses. PMID:26461501

  9. Comparing the influences of age and disease on the Brief Assessment of Cognition in Schizophrenia in Japanese patients with schizophrenia

    PubMed Central

    Kaneda, Ayako; Katagai, Takeshi; Yasui-Furukori, Norio

    2013-01-01

    Background The Brief Assessment of Cognition in Schizophrenia (BACS) is an evaluation of cognitive function that can be completed with more cases. However, there are few studies that compare which factor, disease or aging, is a better determinant of performance on the BACS. The present study aimed to investigate the influences of disease and aging on BACS performance in schizophrenic patients using subjects with a wide range of ages. Methods Schizophrenic patients (n = 165) and a comparison group (n = 171) were recruited as subjects. All participants completed the Japanese language version of the BACS (BACS-J), and the influences of disease and aging on performance in the BACS were examined with the use of multiple regression analysis. Results There was a significant influence of diagnosis and level of education on all six tasks of the BACS and the performance and composite scores. In addition, age was found to influence five tasks and the composite score, the duration of illness influenced four tasks and the composite score, and gender influenced one task and the composite score. Conclusion The present study suggests that performance on the BACS was impaired not only by disease but also by level of education and aging. PMID:23983469

  10. 13C-phenylalanine breath test detects altered phenylalanine kinetics in schizophrenia patients.

    PubMed

    Teraishi, T; Ozeki, Y; Hori, H; Sasayama, D; Chiba, S; Yamamoto, N; Tanaka, H; Iijima, Y; Matsuo, J; Kawamoto, Y; Kinoshita, Y; Hattori, K; Ota, M; Kajiwara, M; Terada, S; Higuchi, T; Kunugi, H

    2012-01-01

    Phenylalanine is an essential amino acid required for the synthesis of catecholamines including dopamine. Altered levels of phenylalanine and its metabolites in blood and cerebrospinal fluid have been reported in schizophrenia patients. This study attempted to examine for the first time whether phenylalanine kinetics is altered in schizophrenia using L-[1-(13)C]phenylalanine breath test ((13)C-PBT). The subjects were 20 chronically medicated schizophrenia patients (DSM-IV) and the same number of age- and sex-matched controls. (13)C-phenylalanine (99 atom% (13)C; 100 mg) was administered orally and the breath (13)CO(2) /(12)CO(2) ratio was monitored for 120 min. The possible effect of antipsychotic medication (risperidone (RPD) or haloperidol (HPD) treatment for 21 days) on (13)C-PBT was examined in rats. Body weight (BW), age and diagnostic status were significant predictors of the area under the curve of the time course of Δ(13)CO(2) (‰) and the cumulative recovery rate (CRR) at 120 min. A repeated measures analysis of covariance controlled for age and BW revealed that the patterns of CRR change over time differed between the patients and controls and that Δ(13)CO(2) was lower in the patients than in the controls at all sampling time points during the 120 min test, with an overall significant difference between the two groups. Chronic administration of RPD or HPD had no significant effect on (13)C-PBT indices in rats. Our results suggest that (13)C-PBT is a novel laboratory test that can detect altered phenylalanine kinetics in chronic schizophrenia patients. Animal experiments suggest that the observed changes are unlikely to be attributable to antipsychotic medication. PMID:22832963

  11. Internal consistency & validity of Indian Disability Evaluation and Assessment Scale (IDEAS) in patients with schizophrenia

    PubMed Central

    Grover, Sandeep; Shah, Ruchita; Kulhara, Parmanand; Malhotra, Rama

    2014-01-01

    Background & objectives: The Indian Disability Evaluation and Assessment Scale (IDEAS) has been recommended for assessment and certification of disability by the Government of India (GOI). However, the psychometric properties of IDEAS as adopted by GOI remain understudied. Our aim, thus, was to study the internal consistency and validity of IDEAS in patients with schizophrenia. Methods: A total of 103 consenting patients with residual schizophrenia were assessed for disability, quality of life (QOL) and psychopathology using the IDEAS, WHO QOL-100 and Positive and Negative symptom scale (PANSS) respectively. Internal consistency was calculated using Cronbach's alpha. For construct validity, relations between IDEAS, and psychopathology and QOL were studied. Results: The inter-item correlations for IDEAS were significant with a Cronbach's alpha of 0.721. All item scores other than score on communication and understanding; total and global IDEAS scores correlated significantly with the positive, negative and general sub-scales, and total PANSS scores. Communication and understanding was significantly related to negative sub-scale score only. Total and global disability scores correlated negatively with all the domains of WHOQOL-100 (P<0.01). The individual IDEAS item scores correlated negatively with various WHOQOL-100 domains (P< 0.01). Interpretation & conclusions: This study findings showed that the GOI-modified IDEAS had good internal consistency and construct validity as tested in patients with residual schizophrenia. Similar studies need to be done with other groups of patients. PMID:25579145

  12. Mastery and stigma in predicting the subjective quality of life of patients with schizophrenia in Taiwan.

    PubMed

    Hsiung, Ping-Chuan; Pan, Ay-Woan; Liu, Shi-Kai; Chen, Shing-Chia; Peng, Szu-Yi; Chung, Lyinn

    2010-07-01

    A total of 199 outpatients with schizophrenia are assessed in this study for their sense of mastery, stigma, social support, symptom severity, and quality of life (QOL), with path models being used to test the direct and indirect effects of these factors on the physical, psychological, social, and environmental QOL domains. Symptoms, stigma, mastery, and social support are found to be key direct predictors for all 4 QOL domains, with mastery having the greatest direct effect on QOL, whereas stigma has the greatest indirect effect, although mediated by mastery and social support. Such results imply that in nonwestern cultures, mastery and stigma are still crucial factors affecting the QOL of patients with schizophrenia. Our results highlight the importance of enhancing the mastery of such patients and reducing the associated stigma when designing treatment programs. To enhance the QOL of patients with schizophrenia, interventions which can optimize the meaningful use of time may well enhance the mastery of these patients, whereas strategies aimed at improving their ability to cope with perceived stigma, at both individual and community levels, may help to reduce the detrimental effects. PMID:20611052

  13. Holistic Consideration of Patients with Schizophrenia to Improve Medication Adherence and Outcomes

    PubMed Central

    Lee, Lan-Ting; Chen, Kao Chin; Chang, Wei Hung; Chen, Po See; Lee, I Hui; Yang, Yen Kuang

    2015-01-01

    Although several algorithms have been applied to treat patients with schizophrenia, their clinical use remains still limited, because most emphasize the prescription of antipsychotics. A new algorithm with a more holistic approach to treating patients with schizophrenia, to be used before applying traditional prescribing guidelines, was thus proposed by an expert team of Taiwanese psychiatrists. In this algorithm, several important treatment tasks/modalities are proposed, including long-acting injection anti-psychotics, shared decision-making, a case management system, compulsory treatment by law, community rehabilitation programs, the patients’ feeling about their health care professionals (patients’ behaviors) and their attitude/knowledge of their conditions/illness. This study proposes that evaluating the medication adherence of patients can be determined by two key domains, namely patients’ behaviors and attitudes. Based on different levels of their behaviors (X-axis) and attitude/knowledge (Y-axis), it is possible to categorize patients with schizophrenia into six subgroups, for which various different interventions, including the use of antipsychotics, could be applied and integrated. Further research is needed to assess the applicability of this treatment algorithm in clinical settings. PMID:26243839

  14. [Clinical characteristics of patients treated with electroconvulsive therapy in a public hospital in Peru].

    PubMed

    Cortez-Vergara, Carla; Cruzado, Lizardo; Rojas-Rojas, Ira Galia; Sánchez-Fernández, Miguel; Ladd-Huarachi, Guillermo

    2016-03-01

    With the purpose of describe the profile of use of electroconvulsive therapy (ECT) on hospitalized patients at "Honorio Delgado - Hideyo Noguchi" National Institute of Mental Health in Lima, Peru, the medical records of patients receiving ECT between 2001 and 2011 were reviewed. The main findings were: four hundred and nineteen ECT courses were applied to 372 patients, with a total of 5439 applications the most common diagnosis was paranoid schizophrenia (70.7%), the most common indication was resistance to treatment (80.7%), also the clinical response to ECT was good in 70.1% of cases while side effects were generally transient and mild. The use of ECT decreased over the period of the study but it was tolerable and safe, especially in the modified version, and it had a high response rate so remains as a first-line psychiatric treatment. PMID:27384628

  15. Community care of patients with schizophrenia: the role of the primary health care team.

    PubMed Central

    King, M; Nazareth, I

    1996-01-01

    Schizophrenia is a severe, chronic mental disorder that usually begins in early adulthood. Recurrent relapse leading to long-term psychological and social disability means that patients may require intensive community support. Despite a recent fall in the overall numbers of patients consulting their general practitioner with mental disorders, presentations by those suffering from severe mental disorders have risen. This review encompasses the role of general practitioner in the management of schizophrenia, considering in turn drug and psychological therapies, family interventions, innovations in care, the effects of community care developments, and the liasion between primary health care and mental health professionals. There is a need for further research in the area of family-practice-based interventions involving general practitioners and the practice team. PMID:8703526

  16. Fluvoxamine for blonanserin-associated akathisia in patients with schizophrenia: report of five cases

    PubMed Central

    2010-01-01

    Background Atypical antipsychotic drugs have been reported to cause fewer incidences of extrapyramidal side effects (EPS) than typical antipsychotic drugs, but adverse events such as akathisia have been observed even with atypical antipsychotic drugs. Although understanding of the pathophysiology of akathisia remains limited, it seems that a complex interaction of several neurotransmitter systems plays a role in its pathophysiology. The endoplasmic reticulum protein sigma-1 receptors have been shown to regulate a number of neurotransmitter systems in the brain. Methods We report on five cases in which monotherapy of the selective serotonin reuptake inhibitor and sigma-1 receptor agonist fluvoxamine was effective in ameliorating the akathisia of patients with schizophrenia treated with the new atypical antipsychotic drug blonanserin. Results The global score on the Barnes Akathisia Scale in five patients with schizophrenia treated with blonanserin rapidly decreased after fluvoxamine treatment. Conclusion Doctors should consider that fluvoxamine may be an alternative approach in treating akathisia associated with atypical antipsychotic drugs. PMID:20416096

  17. Brain volume in male patients with recent onset schizophrenia with and without cannabis use disorders

    PubMed Central

    Koenders, Laura; Machielsen, Marise W.J.; van der Meer, Floor J.; van Gasselt, Angelique C.M.; Meijer, Carin J.; van den Brink, Wim; Koeter, Maarten W.J.; Caan, Matthan W.A.; Cousijn, Janna; den Braber, Anouk; van ‘t Ent, Dennis; Rive, Maaike M.; Schene, Aart H.; van de Giessen, Elsmarieke; Huyser, Chaim; de Kwaasteniet, Bart P.; Veltman, Dick J.; de Haan, Lieuwe

    2015-01-01

    Background Schizophrenia is highly comorbid with cannabis use disorders (CUDs), and this comorbidity is associated with an unfavourable course. Early onset or frequent cannabis use may influence brain structure. A key question is whether comorbid CUDs modulate brain morphology alterations associated with schizophrenia. Methods We used surface-based analysis to measure the brain volume, cortical thickness and cortical surface area of a priori–defined brain regions (hippocampus, amygdala, thalamus, caudate, putamen, orbitofrontal cortex, anterior cingulate cortex, insula, parahippocampus and fusiform gyrus) in male patients with schizophrenia or related disorders with and without comorbid CUDs and matched healthy controls. Associations between age at onset and frequency of cannabis use with regional grey matter volume were explored. Results We included 113 patients with (CUD, n = 80) and without (NCUD, n = 33) CUDs and 84 controls in our study. As expected, patients with schizophrenia (with or without a CUD) had smaller volumes of most brain regions (amygdala, putamen, insula, parahippocampus and fusiform gyrus) than healthy controls, and differences in cortical volume were mainly driven by cortical thinning. Compared with the NCUD group, the CUD group had a larger volume of the putamen, possibly driven by polysubstance use. No associations between age at onset and frequency of use with regional grey matter volumes were found. Limitations We were unable to correct for possible confounding effects of smoking or antipsychotic medication. Conclusion Patients with psychotic disorders and comorbid CUDs have larger putamen volumes than those without CUDs. Future studies should elaborate whether a large putamen represents a risk factor for the development of CUDs or whether (poly)substance use causes changes in putamen volume. PMID:25510948

  18. The time course and characteristics of procedural learning in schizophrenia patients and healthy individuals

    PubMed Central

    Adini, Yael; Bonneh, Yoram S.; Komm, Seva; Deutsch, Lisa; Israeli, David

    2015-01-01

    Patients with schizophrenia have deficits in some types of procedural learning. Several mechanisms contribute to this learning in healthy individuals, including statistical and sequence-learning. To find preserved and impaired learning mechanisms in schizophrenia, we studied the time course and characteristics of implicitly introduced sequence-learning (SRT task) in 15 schizophrenia patients (seven mild and eight severe) and nine healthy controls, in short sessions over multiple days (5–22). The data show speed gains of similar magnitude for all groups, but the groups differed in overall speed and in the characteristics of the learning. By analyzing the data according to its spatial-position and temporal-order components, we provide evidence for two types of learning that could differentiate the groups: while the learning of the slower, severe group was dominated by statistical learning, the control group moved from a fast learning phase of statistical-related performance to subsequence learning (chunking). Our findings oppose the naïve assumption that a similar gain of speed reflects a similar learning process; they indicate that the slower performance reflects the activation of a different motor plan than does the faster performance; and demonstrate that statistical learning and subsequence learning are two successive stages in implicit sequence learning, with chunks inferred from prior statistical computations. Our results indicate that statistical learning is intact in patients with schizophrenia, but is slower to develop in the severe patients. We suggest that this slow learning rate and the associated slow performance contribute to their deficit in developing sequence-specific learning by setting a temporal constraint on developing higher order associations. PMID:26379536

  19. Isochromosome 13 in a patient with childhood-onset schizophrenia, ADHD, and motor tic disorder

    PubMed Central

    2012-01-01

    Background A small percentage of all cases of schizophrenia have a childhood onset. The impact on the individual and family can be devastating. We report the results of genetic analyses from a patient with onset of visual hallucinations at 5 years, and a subsequent diagnosis at 9 years of schizophrenia, attention deficit hyperactivity disorder (ADHD) with hyperactivity and impulsivity, and chronic motor tic disorder. Results Karyotypic analysis found 45,XX,i(13)(q10) in all cells examined. Alpha satellite FISH of isochromosome 13 revealed a large unsplit centromeric region, interpreted as two centromeres separated by minimal or undetectable short-arm material or as a single monocentric centromere, indicating that the isochromosome likely formed post-zygotically by a short arm U-type or centromeric exchange. Characterization of chromosome 13 simple tandem repeats and Affymetrix whole-genome 6.0 SNP array hybridization found homozygosity for all markers, and the presence of only a single paternal allele in informative markers, consistent with an isodisomic isochromosome of paternal origin. Analysis of two chromosome 13 schizophrenia candidate genes, D-amino acid oxidase activator (DAOA) and 5-hydroxytryptamine (serotonin) receptor 2A (5-HTR2A), failed to identify non-synonymous coding mutations but did identify homozygous risk polymorphisms. Conclusions We report a female patient with childhood-onset schizophrenia, ADHD, and motor tic disorder associated with an isodisomic isochromosome 13 of paternal origin and a 45,XX,i(13)(q10q10) karyotype. We examined two potential mechanisms to explain chromosome 13 involvement in the patient's pathology, including reduction to homozygosity of a paternal mutation and reduction to homozygosity of a paternal copy number variation, but were unable to identify any overtly pathogenic abnormality. Future studies may consider whether epigenetic mechanisms resulting from uniparental disomy (UPD) and the lack of chromosome 13 maternal

  20. [A female patient with late-onset schizophrenia and fear of Katwijk disease].

    PubMed

    Veerman, S R T; Sno, H N; Ravelli, D P; Roos, R A C

    2009-01-01

    A 66-year-old patient had suffered from late-onset schizophrenia from the age of 44. Her family history included reports of brain haemorrhages, possibly resulting from hereditary amyloidal angiopathy of the Dutch type (Katwijk disease). She was very afraid for having this disease. The progression of the psychiatric symptoms and the age at which they began, led us to suspect an organic process. Differential diagnoses that were discussed included cerebral amyloidal angiopathy, frontal lobe dementia and Huntington's disease. PMID:19434580

  1. The Association of Child Abuse and Neglect with Adult Disability in Schizophrenia and the Prominent Role of Physical Neglect

    ERIC Educational Resources Information Center

    Gil, Alexei; Gama, Clarissa S.; de Jesus, Danilo Rocha; Lobato, Maria Ines; Zimmer, Marilene; Belmonte-de-Abreu, Paulo

    2009-01-01

    Objective: To assess long-lasting effects of childhood trauma on the functional outcome of adult patients diagnosed with schizophrenia. Method: Ninety-nine stable patients with schizophrenia followed in an outpatient program at a public university hospital in Porto Alegre, southern Brazil, were investigated for childhood traumatic experiences by…

  2. Duration of Untreated Psychosis Is Associated with More Negative Schizophrenia Symptoms after Acute Treatment for First-Episode Psychosis

    ERIC Educational Resources Information Center

    Grano, Niklas; Lindsberg, Jenni; Karjalainen, Marjaana; Gronroos, Peter; Blomberg, Ari-Pekka

    2010-01-01

    Evidence of association between duration of untreated psychosis (DUP) and negative symptoms of schizophrenia in first-episode psychosis (FEP) patients is inconsistent in the recent literature. In the present study, DUP, schizophrenia symptoms, duration of medication, and diagnosis were obtained from hospital archives in a sample of FEP patients.…

  3. Homocysteine and disability in hospitalized geriatric patients.

    PubMed

    Marengoni, Alessandra; Cossi, Stefania; De Martinis, Monica; Calabrese, Paolo A; Orini, Stefania; Grassi, Vittorio

    2004-08-01

    Elevated total homocysteine (tHcy) concentrations have been found to be associated with cardiovascular disease and dementia in old age. The present study was performed to identify the prevalence of hyperhomocysteinemia (HHcy) and to analyze the association between tHcy concentration and sociodemographic characteristics, nutritional parameters, and cognitive and functional status in this sample of hospitalized geriatric patients. A total of 214 patients (77% females) 65+ years old admitted into an acute care geriatric ward of an internal medical department in the Northern Italy were studied. tHcy concentration was measured using a high-performance liquid chromatography with fluorescence detection (HPLC-F). Information about nutrition (body mass index [BMI], serum albumin, cholesterol, and transferrin) was collected on admission. Functional status was investigated with the Basic Activities of Daily Living scale (ADL) and the Instrumental Activities of Daily Living scale (IADL); cognitive and affective status were assessed by the Mini-Mental State Evaluation (MMSE) and the Geriatric Depression Scale (GDS). The mean tHcy concentration was 18.4 +/- 13.1 micromol/L; 74.2% of males and 68.9% of females had HHcy (> 12 micromol/L). Sixty-four percent of patients with normal serum vitamin B12 and folate concentrations had HHcy. Elevated tHcy concentrations were associated with older age, male gender, increasing serum creatinine, lower MMSE score, and disability. The mean tHcy concentration depended on the occurrence of different diseases. Patients affected by atherosclerotic diseases, such as ischemic heart diseases, cerebrovascular diseases, and dementia had higher mean tHcy concentration than those without diagnosed vascular diseases. In multivariate analysis, vitamin B12, folate, serum albumin, creatinine, and disability emerged as factors associated with tHcy, adjusted for age, gender, education, MMSE score, and atherosclerotic diseases. Our results suggest that the

  4. Critical evaluation of paliperidone in the treatment of schizophrenia in Chinese patients: a systematic literature review

    PubMed Central

    Zhang, LiLi; Li, JiTao; Zhao, YanJie; Su, Yun’Ai; Si, Tianmei

    2016-01-01

    Background Paliperidone (9-hydroxyrisperidone), the major active metabolite of risperidone, has been introduced as a novel atypical antipsychotic agent in many countries. It is available both as an oral extended-release (ER) formulation and as a long-acting injection (paliperidone palmitate, PP), which have been approved for treating schizophrenia in the People’s Republic of China since 2009 and 2012, respectively. This systematic review summarizes the efficacy, effectiveness, and safety of paliperidone in the treatment of schizophrenia in the Chinese population. Methods A systematic literature search was conducted on the databases covering international and Chinese core journals, published from January 1, 2008, to May 22, 2015. Results A total of 122 publications were retrieved, of which 63 studies were identified for inclusion; most studies were related to paliperidone ER (n=53), nine were related to PP, and one study was related to both agents. Paliperidone ER demonstrated at least comparable efficacy with active comparators, including risperidone, olanzapine, ziprasidone, or aripiprazole, and was found to be superior with respect to the onset of action and improvement in the Personal and Social Performance Scale score. Paliperidone ER appeared to be associated with a lower risk of metabolic syndromes; the most common treatment-emergent adverse events were extrapyramidal symptoms, akathisia, insomnia, and somnolence. Results from interventional and observational studies showed that PP was also an effective and well-tolerated treatment for Chinese patients with schizophrenia. The findings were generally consistent with those observed in non-Chinese populations. Conclusion Both paliperidone ER and PP were effective and well-tolerated agents for the treatment of schizophrenia in the Chinese population according to the data we reviewed. No new safety signals specific for the Chinese population were raised for paliperidone. Further studies may be needed to collect

  5. Event-related brain potentials to emotional images and gonadal steroid hormone levels in patients with schizophrenia and paired controls

    PubMed Central

    Champagne, Julie; Mendrek, Adrianna; Germain, Martine; Hot, Pascal; Lavoie, Marc E.

    2014-01-01

    Prominent disturbances in the experience, expression, and emotion recognition in patients with schizophrenia have been relatively well documented over the last few years. Furthermore, sex differences in behavior and brain activity, associated with the processing of various emotions, have been reported in the general population and in schizophrenia patients. Others proposed that sex differences should be rather attributed to testosterone, which may play a role in the etiology of schizophrenia. Also, it had been suggested that estradiol may play a protective role in schizophrenia. Surprisingly, few studies investigating this pathology have focused on both brain substrates and gonadal steroid hormone levels, in emotional processing. In the present study, we investigated electrocortical responses related to emotional valence and arousal as well as gonadal steroid hormone levels in patients with schizophrenia. Event-Related Potentials (ERP) were recorded during exposition to emotional pictures in 18 patients with schizophrenia and in 24 control participants paired on intelligence, manual dominance and socioeconomic status. Given their previous sensitivity to emotional and attention processes, the P200, N200 and the P300 were selected for analysis. More precisely, emotional valence generally affects early components (N200), which reflect early process of selective attention, whereas emotional arousal and valence both influences the P300 component, which is related to memory context updating, and stimulus categorization. Results showed that, in the control group, the amplitude of the N200 was significantly more lateralized over the right hemisphere, while there was no such lateralization in patients with schizophrenia. In patients with schizophrenia, significantly smaller anterior P300 amplitude was observed to the unpleasant, compared to the pleasant. That anterior P300 reduction was also correlated with negative symptoms. The N200 and P300 amplitudes were positively

  6. Cerebral spectroscopic and oxidative stress studies in patients with schizophrenia who have dangerously violently offended

    PubMed Central

    Treasaden, Ian H; Puri, Basant K

    2008-01-01

    Background The aim of this study was to bring together all the results of in vivo studies of ethane excretion and cerebral spectroscopy in patients with schizophrenia who have dangerously seriously violently offended in order to determine the extent to which they shed light on the degree to which the membrane phospholipid hypothesis and the actions of free radicals and other reactive species are associated with cerebral pathophysiological mechanisms in this group of patients. Methods The patients investigated were inpatients from a medium secure unit with a DSM-IV-TR diagnosis of schizophrenia. There was no history of alcohol dependency or any other comorbid psychoactive substance misuse disorder. Expert psychiatric opinion, accepted in court, was that all these patients had violently offended directly as a result of schizophrenia prior to admission. These offences consisted of homicide, attempted murder or wounding with intent to cause grievous bodily harm. Excreted ethane was analyzed and quantified by gas chromatography and mass spectrometry (m/z = 30). 31-phosphorus magnetic resonance spectroscopy data were obtained at a magnetic field strength of 1.5 T using an image-selected in vivo spectroscopy sequence (TR = 10 s; 64 signal averages localized on a 70 × 70 × 70 mm3 voxel). Results Compared with age- and sex-matched controls, in the patient group the mean alveolar ethane level was higher (p < 0.0005), the mean cerebral beta-nucleotide triphosphate was lower (p < 0.04) and the mean gamma-nucleotide triphosphate was higher (p < 0.04). There was no significant difference between the two groups in respect of phosphomonoesters, phosphodiesters or broad resonances. Conclusion Our results are not necessarily inconsistent with the membrane phospholipid hypothesis, given that the patients studied suffered predominantly from positive symptoms of schizophrenia. The results suggest that there is increased cerebral mitochondrial oxidative phosphorylation in patients

  7. Perspectives on the Use of eHealth in the Management of Patients With Schizophrenia

    PubMed Central

    Treisman, Glenn J.; Jayaram, Geetha; Margolis, Russell L.; Pearlson, Godfrey D.; Schmidt, Chester W.; Mihelish, Gary L.; Kennedy, Adrienne; Howson, Alexandra; Rasulnia, Maziar; Misiuta, Iwona E.

    2016-01-01

    Abstract Mobile devices, digital technologies, and web-based applications—known collectively as eHealth (electronic health)—could improve health care delivery for costly, chronic diseases such as schizophrenia. Pharmacologic and psychosocial therapies represent the primary treatment for individuals with schizophrenia; however, extensive resources are required to support adherence, facilitate continuity of care, and prevent relapse and its sequelae. This paper addresses the use of eHealth in the management of schizophrenia based on a roundtable discussion with a panel of experts, which included psychiatrists, a medical technology innovator, a mental health advocate, a family caregiver, a health policy maker, and a third-party payor. The expert panel discussed the uses, benefits, and limitations of emerging eHealth with the capability to integrate care and extend service accessibility, monitor patient status in real time, enhance medication adherence, and empower patients to take a more active role in managing their disease. In summary, to support this technological future, eHealth requires significant research regarding implementation, patient barriers, policy, and funding. PMID:26828911

  8. The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2003.

    PubMed

    Lehman, Anthony F; Kreyenbuhl, Julie; Buchanan, Robert W; Dickerson, Faith B; Dixon, Lisa B; Goldberg, Richard; Green-Paden, Lisa D; Tenhula, Wendy N; Boerescu, Daniela; Tek, Cenk; Sandson, Neil; Steinwachs, Donald M

    2004-01-01

    Since publication of the original Schizophrenia Patient Outcomes Research Team (PORT) treatment recommendations in 1998, considerable scientific advances have occurred in our knowledge about how to help persons with schizophrenia. Today an even stronger body of research supports the scientific basis of treatment. This evidence, taken in its entirety, points to the value of treatment approaches combining medications with psychosocial treatments, including psychological interventions, family interventions, supported employment, assertive community treatment, and skills training. The most significant advances lie in the increased options for pharmacotherapy, with the introduction of second generation antipsychotic medications, and greater confidence and specificity in the application of psychosocial interventions. Currently available treatment technologies, when appropriately applied and accessible, should provide most patients with significant relief from psychotic symptoms and improved opportunities to lead more fulfilling lives in the community. Nonetheless, major challenges remain, including the need for (1) better knowledge about the underlying etiologies of the neurocognitive impairments and deficit symptoms that account for much of the disability still associated with schizophrenia; (2) treatments that more directly address functional impairments and that promote recovery; and (3) approaches that facilitate access to scientifically based treatments for patients, the vast majority of whom currently do not have such access. PMID:15279040

  9. A Comparative Study of Terminally Ill Hospice and Hospital Patients.

    ERIC Educational Resources Information Center

    Labus, Janet G.; Dambrot, Faye H.

    1986-01-01

    Investigated differences between 28 hospice and 28 hospital patients who died. Comparison found that hospice patients were younger, had more people living in the home, and had shorter disease history. Age, number of people living in the home, and primary cancer site significantly discriminated between hospice and hospital patients and predicted…

  10. Self-Mutilation of Tongue and Lip in a Patient with Simple Schizophrenia

    PubMed Central

    Munerato, Maria Cristina; Moure, Sabrina Pozatti; Machado, Vivian; Gomes, Fernando Grilo

    2011-01-01

    Self-inflicted lesions that cause mutilation are observed in schizophrenic patients. This case report describes the diagnosis and treatment of simple schizophrenia in a 31-year-old male patient who bit his own tongue and lower lip. The dental treatment proposed included the construction of a splint to prevent new lesions and to allow healing of existing ones. The treatment afforded to avoid tooth extraction before the patient responded to psychiatric drug treatment. The importance of a transdisciplinary approach to self-mutilation due to psychiatric disorders is stressed. The interaction between the two teams, stomatology and psychiatry, was crucial for the improvement of the patient’s condition. PMID:20852088

  11. Investigation of Dysregulation of Several MicroRNAs in Peripheral Blood of Schizophrenia Patients

    PubMed Central

    Camkurt, Mehmet Akif; Karababa, Fatih; Erdal, Mehmet Emin; Bayazıt, Hüseyin; Kandemir, Sultan Basmacı; Ay, Mustafa Ertan; Kandemir, Hasan; Ay, Özlem İzci; Çiçek, Erdinç; Selek, Salih; Taşdelen, Bahar

    2016-01-01

    Objective The prevalence of schizophrenia is 1%, and it is a debilitating disorder that often results in a shortened lifespan. Peripheral blood samples are good candidates to investigate because they can be easily drawn, and they are widely studied in psychiatric disorders. MicroRNAs are small non-coding RNA transcripts. They regulate the expression of genes by binding to the 3′-untranslated region (UTR) of mRNAs and pointing them to degrade. In this study, we aimed to investigate the expression of miR-9-5p, miR-29a-3p, miR-106-5p, miR-106b-5p, miR-107, miR-125a-3p, and miR-125b-3p in schizophrenia patients and healthy controls. Methods We collected blood samples from 16 patients with schizophrenia and 16 healthy controls. MicroRNAs were measured with reverse transcriptase polymerase chain reaction. Results Schizophrenia patients showed statistically significant upregulation of five microRNAs: miR9-5p (p=0.002), miR29a-3p (p<0.001), miR106b-5p (p=0.002), miR125a-3p (p<0.001), and miR125b-3p (p=0.018). Conclusion Our results increased the value of the miR106 and miR29 families as potentially and consistently dysregulated in psychiatric disorders. Our results should be considered preliminary, and they need confirmation in future studies with larger sample sizes. PMID:27489379

  12. Whole genome methylation analyses of schizophrenia patients before and after treatment

    PubMed Central

    Rukova, Blaga; Staneva, Rada; Hadjidekova, Savina; Stamenov, Georgi; Milanova, Vihra; Toncheva, Draga

    2014-01-01

    The aetiology of schizophrenia is still unknown but it involves both heritable and non-heritable factors. DNA methylation is an inheritable epigenetic modification that stably alters gene expression. It takes part in the regulation of neurodevelopment and may be a contributing factor to the pathogenesis of brain diseases. It was found that many of the antipsychotic drugs may lead to epigenetic modifications. We have performed 42 high-resolution genome-wide methylation array analyses to determine the methylation status of 27,627 CpG islands. Differentially methylated regions were studied with samples from 20 Bulgarian individuals divided in four groups according to their gender (12 males/8 females) and their treatment response (6 in complete/14 in incomplete remission). They were compared to two age and sex matched control pools (110 females in female pool/110 males in male pool) before and after treatment. We found significant differences in the methylation profiles between male schizophrenia patients with complete remission and control male pool before treatment (C16orf70, CST3, DDRGK1, FA2H, FLJ30058, MFSD2B, RFX4, UBE2J1, ZNF311) and male schizophrenia patients with complete remission and control male pool after treatment (AP1S3, C16orf59, KCNK15, LOC146336, MGC16384, XRN2) that potentially could be used as target genes for new therapeutic strategies as well as markers for good treatment response. Our data revealed major differences in methylation profiles between male schizophrenia patients in complete remission before and after treatment and healthy controls which supports the hypothesis that antipsychotic drugs may play a role in epigenetic modifications. PMID:26019538

  13. Shallow medication extraction from hospital patient records.

    PubMed

    Boytcheva, Svetla

    2011-01-01

    This paper presents methods for shallow Information Extraction (IE) from the free text zones of hospital Patient Records (PRs) in Bulgarian language in the Patient Safety through Intelligent Procedures in medication (PSIP) project. We extract automatically information about drug names, dosage, modes and frequency and assign the corresponding ATC code to each medication event. Using various modules for rule-based text analysis, our IE components in PSIP perform a significant amount of symbolic computations. We try to address negative statements, elliptical constructions, typical conjunctive phrases, and simple inferences concerning temporal constraints and finally aim at the assignment of the drug ACT code to the extracted medication events, which additionally complicates the extraction algorithm. The prototype of the system was used for experiments with a training corpus containing 1,300 PRs and the evaluation results are obtained using a test corpus containing 6,200 PRs. The extraction accuracy (f-score) for drug names is 98.42% and for dose 93.85%. PMID:21685617

  14. Reduction of Pavlovian Bias in Schizophrenia: Enhanced Effects in Clozapine-Administered Patients

    PubMed Central

    Albrecht, Matthew A.; Waltz, James A.; Cavanagh, James F.; Frank, Michael J.; Gold, James M.

    2016-01-01

    The negative symptoms of schizophrenia (SZ) are associated with a pattern of reinforcement learning (RL) deficits likely related to degraded representations of reward values. However, the RL tasks used to date have required active responses to both reward and punishing stimuli. Pavlovian biases have been shown to affect performance on these tasks through invigoration of action to reward and inhibition of action to punishment, and may be partially responsible for the effects found in patients. Forty-five patients with schizophrenia and 30 demographically-matched controls completed a four-stimulus reinforcement learning task that crossed action (“Go” or “NoGo”) and the valence of the optimal outcome (reward or punishment-avoidance), such that all combinations of action and outcome valence were tested. Behaviour was modelled using a six-parameter RL model and EEG was simultaneously recorded. Patients demonstrated a reduction in Pavlovian performance bias that was evident in a reduced Go bias across the full group. In a subset of patients administered clozapine, the reduction in Pavlovian bias was enhanced. The reduction in Pavlovian bias in SZ patients was accompanied by feedback processing differences at the time of the P3a component. The reduced Pavlovian bias in patients is suggested to be due to reduced fidelity in the communication between striatal regions and frontal cortex. It may also partially account for previous findings of poorer “Go-learning” in schizophrenia where “Go” responses or Pavlovian consistent responses are required for optimal performance. An attenuated P3a component dynamic in patients is consistent with a view that deficits in operant learning are due to impairments in adaptively using feedback to update representations of stimulus value. PMID:27044008

  15. Reduction of Pavlovian Bias in Schizophrenia: Enhanced Effects in Clozapine-Administered Patients.

    PubMed

    Albrecht, Matthew A; Waltz, James A; Cavanagh, James F; Frank, Michael J; Gold, James M

    2016-01-01

    The negative symptoms of schizophrenia (SZ) are associated with a pattern of reinforcement learning (RL) deficits likely related to degraded representations of reward values. However, the RL tasks used to date have required active responses to both reward and punishing stimuli. Pavlovian biases have been shown to affect performance on these tasks through invigoration of action to reward and inhibition of action to punishment, and may be partially responsible for the effects found in patients. Forty-five patients with schizophrenia and 30 demographically-matched controls completed a four-stimulus reinforcement learning task that crossed action ("Go" or "NoGo") and the valence of the optimal outcome (reward or punishment-avoidance), such that all combinations of action and outcome valence were tested. Behaviour was modelled using a six-parameter RL model and EEG was simultaneously recorded. Patients demonstrated a reduction in Pavlovian performance bias that was evident in a reduced Go bias across the full group. In a subset of patients administered clozapine, the reduction in Pavlovian bias was enhanced. The reduction in Pavlovian bias in SZ patients was accompanied by feedback processing differences at the time of the P3a component. The reduced Pavlovian bias in patients is suggested to be due to reduced fidelity in the communication between striatal regions and frontal cortex. It may also partially account for previous findings of poorer "Go-learning" in schizophrenia where "Go" responses or Pavlovian consistent responses are required for optimal performance. An attenuated P3a component dynamic in patients is consistent with a view that deficits in operant learning are due to impairments in adaptively using feedback to update representations of stimulus value. PMID:27044008

  16. Effects of Antipsychotics on Bone Mineral Density in Patients with Schizophrenia: Gender Differences.

    PubMed

    Chen, Chien-Yu; Lane, Hsien-Yuan; Lin, Chieh-Hsin

    2016-08-31

    Low bone mineral density (BMD) and osteoporosis are common in patients with schizophrenia and detrimental to illness prognosis and life quality. Although the pathogenesis is not fully clear, series of studies have revealed factors related to low BMD such as life style, psychotic symptoms, medication use and the activity of bone absorption markers. It has been known that antipsychotic-induced hyperprolactinemia plays a critical role on decreased BMD. However, it remains uncertain whether the risk factors differ between men and women. According to the effect on prolactin, antipsychotics can be classified into two groups: prolactin-sparing (PS) and prolactin-raising (PR). Our previous study has demonstrated that clozapine which is among the PS antipsychotics is beneficial for BMD when compared with PR antipsychotics in women with chronic schizophrenia. We have also found that risks factors associated with low BMD are different between men and women, suggesting that gender-specific risk factors should be considered for intervention of bone loss in patients with schizophrenia. This article reviews the effects of antipsychotics use on BMD with particular discussion for the differences on gender and age, which implicate the alterations of sex and other related hormones. In addition, currently reported protective and risk factors, as well as the effects of medication use on BMD including the combination of antipsychotics and other psychotropic agents and other potential medications are also reviewed. PMID:27489377

  17. Effects of Antipsychotics on Bone Mineral Density in Patients with Schizophrenia: Gender Differences

    PubMed Central

    Chen, Chien-Yu; Lane, Hsien-Yuan; Lin, Chieh-Hsin

    2016-01-01

    Low bone mineral density (BMD) and osteoporosis are common in patients with schizophrenia and detrimental to illness prognosis and life quality. Although the pathogenesis is not fully clear, series of studies have revealed factors related to low BMD such as life style, psychotic symptoms, medication use and the activity of bone absorption markers. It has been known that antipsychotic-induced hyperprolactinemia plays a critical role on decreased BMD. However, it remains uncertain whether the risk factors differ between men and women. According to the effect on prolactin, antipsychotics can be classified into two groups: prolactin-sparing (PS) and prolactin-raising (PR). Our previous study has demonstrated that clozapine which is among the PS antipsychotics is beneficial for BMD when compared with PR antipsychotics in women with chronic schizophrenia. We have also found that risks factors associated with low BMD are different between men and women, suggesting that gender-specific risk factors should be considered for intervention of bone loss in patients with schizophrenia. This article reviews the effects of antipsychotics use on BMD with particular discussion for the differences on gender and age, which implicate the alterations of sex and other related hormones. In addition, currently reported protective and risk factors, as well as the effects of medication use on BMD including the combination of antipsychotics and other psychotropic agents and other potential medications are also reviewed. PMID:27489377

  18. Hypomania after augmenting venlafaxine and olanzapine with sarcosine in a patient with schizophrenia: a case study.

    PubMed

    Strzelecki, Dominik; Szyburska, Justyna; Kotlicka-Antczak, Magdalena; Kałużyńska, Olga

    2015-01-01

    Glutamate is the main excitatory neurotransmitter in the central nervous system. Dysfunction of the glutamatergic system plays an important and well-established role in the pathogenesis of schizophrenia. Agents with glutamatergic properties such as N-methyl-D-aspartate receptor coagonists (ie, glycine, D-cycloserine) and glycine transporter type 1 inhibitors (eg, sarcosine, bitopertin) are investigated in schizophrenia with special focus on negative and cognitive symptomatology. In this article, we describe a case of a 34-year-old woman with diagnosis of schizophrenia with persistent moderate negative and cognitive symptoms, a participant of the Polish Sarcosine Study (PULSAR) treated with olanzapine (25 mg per day) and venlafaxine (75 mg per day). During ten weeks of sarcosine administration (2 g per day) the patient's activity and mood improved, but in the following 2 weeks, the patient reported decreased need for sleep, elevated mood, libido and general activity. We diagnosed drug-induced hypomania and recommended decreasing the daily dose of venlafaxine to 37.5 mg per day, which resulted in normalization of mood and activity in about 1 week. After this change, activity and mood remained stable and better than before adding sarcosine, and subsequent depressive symptoms were not noted. We describe here the second case report where sarcosine induced important affect changes when added to antidepressive and antipsychotic treatment, which supports the hypothesis of clinically important glutamate-serotonin interaction. PMID:25784808

  19. Treatment effectiveness and adherence in patients with schizophrenia treated with risperidone long-acting injection.

    PubMed

    Chang, Chen-Lin; Tzeng, Dong-Sheng; Lung, For-Wey

    2010-11-30

    This study investigated the variables related to the effectiveness and adherence to treatment with risperidone long-acting injection (RLAI) in patients with schizophrenia. We performed a retrospective medical chart review of 137 patients with schizophrenia who were prescribed RLAI between July 2004 and December 2006. Cox regression analysis showed that the effectiveness of treatment in patients treated with RLAI was affected significantly by the provision of home care and the use of illicit drugs. The adherence of patients to treatment with RLAI was affected most by the provision of home care. Bayesian analysis showed that patients who received the provision of home care or who had no history of illicit drug use continued treatment for, on average, 15.27 and 17.14days longer, respectively, than those who did not receive such care or take illicit drugs. Patients who received the provision of home care adhered to treatment for 343.98 more days than those who did not. Even though patients taking RLAI show better adherence than those taking oral risperidone, home care services can have a significant additional effect on adherence. Randomized clinical follow-up trial studies are necessary to explore the risk factors for nonadherence in more detail. PMID:20488552

  20. Effects of discontinuing anticholinergic treatment on movement disorders, cognition and psychopathology in patients with schizophrenia

    PubMed Central

    Beauclair, Linda; Annable, Lawrence; Bélanger, Marie-Claire; Kolivakis, Theodore T.; Margolese, Howard C.

    2014-01-01

    Background: Physicians have prescribed anticholinergic agents such as benztropine, procyclidine, biperiden and trihexyphenidyl for treatment and prophylaxis of antipsychotic-induced extrapyramidal symptoms (EPS) for decades. Anticholinergic agents can however worsen tardive dyskinesia and cause many adverse effects, including cognitive impairment. Previous studies of anticholinergic discontinuation in patients with schizophrenia receiving antipsychotics have yielded a wide range of EPS relapse rates. Improvement in cognition after anticholinergic withdrawal was observed in some studies. Objective: This study evaluated the effect of anticholinergic discontinuation on movement disorders, cognition and general psychopathology after a 4-week taper in 20 outpatients with schizophrenia or schizoaffective disorder treated with antipsychotics. Results: Eighteen of twenty patients successfully discontinued their anticholinergic medication; two did not because of akathisia. Repeated measures analysis of variance did not show a significant effect of anticholinergic discontinuation on total Extrapyramidal Symptoms Rating Scale score or on the Parkinsonism, Akathisia, Dystonia or Tardive Dyskinesia subscales. However, significant improvement was found on the Brief Assessment of Cognition in Schizophrenia composite z score at weeks 6, 8 and 12 compared with baseline. Significant improvements were seen on the motor and the symbol-coding tasks. No significant effects were observed on the Positive and Negative Syndrome Scale, Clinical Global Impression – Severity and Clinical Global Impression – Improvement scales. Conclusion: In this 12-week study of anticholinergic discontinuation in 20 outpatients with schizophrenia or schizoaffective disorder, gradual decrease and discontinuation of anticholinergics led to a positive effect on cognition. There were no adverse consequences on general psychopathology and no significant differences for 18 of 20 subjects on movement disorders

  1. Life skills profile of patients with schizophrenia and its correlation to a feeling of rejection among key family carers

    PubMed Central

    Manickam, L.S.S; Chandran, R. Satheesh

    2005-01-01

    Background: The behaviour of patients with schizophrenia is of great concern to key family carers. Life skills profile (LSP) is the measure that has considerable importance in assessing the functioning of people with schizophrenia in the community. Aim: To assess the sociodemographic correlates of LSP, and to find the correlation between LSP and the rejection response of key family carers. Methods: The LSP of 48 patients with chronic schizophrenia (29 men and 19 women) was assessed. The rejection responses of key family carers (28 men and 20 women) were evaluated using the Patient Rejection Scale. Results: The LSP did not significantly differ on the variables of gender, income level or attendance of day-care centre. However, there were differences between patients from urban and rural areas. A new dimension of family harmony, added as a subscale to LSP, also did not show any significant difference on the above variables. The rejection responses of key family carers were found to be significantly related to the LSP of the patients and, among the subscales, family harmony and communication were positively related to rejection. Conclusion: Though family interventions have been found to have positive implications on relapse and social functioning of patients with schizophrenia, a model of a family intervention programme for families of patients with schizophrenia needs to be developed. PMID:20711289

  2. Evidence of IQ-modulated association between ZNF804A gene polymorphism and cognitive function in schizophrenia patients.

    PubMed

    Chen, Min; Xu, Zhansheng; Zhai, Jinguo; Bao, Xin; Zhang, Qiumei; Gu, Huang; Shen, Qiuge; Cheng, Lina; Chen, Xiongying; Wang, Keqin; Deng, Xiaoxiang; Ji, Feng; Liu, Chuanxin; Li, Jun; Dong, Qi; Chen, Chuansheng

    2012-06-01

    ZNF804A gene polymorphism rs1344706 has been suggested as the most compelling case of a candidate gene for schizophrenia by a genome-wide association study and several replication studies. The current study of 570 schizophrenia patients and 448 controls again found significantly different genotype frequencies of rs1344706 between patients and controls. More important, we found that this association was modulated by IQ, with a stronger association among individuals with relatively high IQ, which replicated results of Walters et al, 2010. We further examined whether this IQ-modulated association also existed between the SNP and the intermediate phenotypes (working memory and executive functions) of schizophrenia. Data were available from an N-back task (366 patients and 414 controls) and the attention network task (361 patients and 416 controls). We found that the SNP and IQ had significant interaction effects on the intermediate phenotypes for patients, but not for controls. The disease risk allele was associated with poorer cognitive function in patients with high IQ, but better cognitive function in patients with low IQ. Together, these results indicated that IQ may modulate the role of rs1344706 in the etiology of both schizophrenia and its cognitive impairments, and pointed to the necessity of considering general cognitive function as indexed by IQ in the future studies of genetic bases of schizophrenia. PMID:22373944

  3. Hot bitumen burns: 92 hospitalized patients.

    PubMed

    Baruchin, A M; Schraf, S; Rosenberg, L; Sagi, A A

    1997-08-01

    Bitumen burns while comprising a small percentage of all types of burns are troublesome. They affect persons engaged in gainful employment which the burns then curtail, as well as requiring special attention because the substance adheres to the skin and is therefore difficult to remove. Ninety-two consecutive patients with such burns who were admitted as in-patients over a 10-year period (1985-1995) have been reviewed. Most of the burns occurred on a worksite and involved active young persons (mean age 29.6 years) the mean size of the burn was 3.87 per cent TBSA, mainly affecting the upper extremities and hands. Mean hospitalization time was 10.6 days. Bitumen burns are fully predictable and can easily be prevented by avoiding unsafe practice and/or equipment. Bitumen is a general term for petroleum-derived substances ranging from true petroleum through so-called mineral tars, to asphalt. Asphalt (Asphaltum) is a semi-solid mixture of several hydrocarbons probably formed by the evaporation of the lighter or more volatile constituents. It is amorphous of low specific gravity, 1-2, with a black or brownish black colour and pitchy lustre. At room temperature it is solid becoming molten and spreadable when heated to 93 degrees C and over. Roofing tars and asphalts are usually heated to temperatures of 232 degrees C to achieve desirable viscosities (e.g. for spraying), whereas lower temperatures are required for the manageable form to pave roads. Notable localities for asphaltum are the island of Trinidad and the Dead Sea region where lake asphaltums were long known to the ancient. Ironically, none of the 92 patients who were treated for bitumen injuries in the 'Soroka' (Beer-Sheba, Israel) and 'Barzilai' (Ashkelon, Israel) Medical Centres (80 and 150 km from the lake respectively) had anything to do with the Dead Sea area. PMID:9426915

  4. Comparison of Subjective Experiences and Effectiveness of First-Generation Long-Acting Injectable Antipsychotics and Risperidone Long-Acting Injectables in Patients With Schizophrenia.

    PubMed

    Chen, Wen-Yin; Lin, Shih-Ku

    2016-10-01

    We conducted a cross-sectional study to compare the subjective experiences and clinical effects of first-generation long-acting injectable (FGA-LAI) antipsychotics with those of risperidone long-acting injectables (RIS-LAIs) in 434 schizophrenia patients. Compared with the RIS-LAI group, the patients treated with FGA-LAIs had a significantly longer duration of illness and LAI treatment and were older. Our results suggest that patients treated with FGA-LAI have more satisfactory subjective experiences compared with patients treated with RIS-LAI and that both FGA-LAI and RIS-LAI treatments can prevent relapses and hospitalization. Additional longitudinal studies determining the long-term benefits of RIS-LAI are warranted. PMID:27580495

  5. [Frequency of drug adverse reactions among hospitalized patients].

    PubMed

    González Martínez, L

    1995-01-01

    This article describes the frequency of adverse reactions to drugs in a sample of hospitalized patients in the internal medicine ward seen during a year's term. Of 61 medical charts, we found 8 patients with adverse reactions to drugs during their hospital stay and another 4 patients hospitalized due to adverse reactions to drugs. The majority of the adverse reactions were of moderate degree (75%) and were related to drugs of cardiovascular action (58%). The frequency of reactions in hospitalized patients (13%) is comparable with the results obtained from other hospitals. Yet, the real magnitude of the problem is probably greater since the source of information (hospital charts) the totality of the clinical manifestations are not registered. PMID:8581452

  6. The Inequality of Patient Profile Information in Japanese Hospitals.

    PubMed

    Kurihara, Yukio; Ishida, Haku; Kimura, Ezen; Gochi, Akira; Kondoh, Hiroshi; Shimai, Ken-Ichiro; Nakajima, Noriaki; Tanaka, Takeshi; Ishikawa, Kiyomu; Oohara, Michihiro; Sonoda, Takeharu; Takai, Kohei

    2016-01-01

    A model dataset of patient profile information was created based on the items used at five Japanese university hospitals, the patient information data elements in Health Level 7 (HL7) v2.5, and the standard datasets for medical information exchange used in Japan. In order to check the validity of the model dataset, a cross-sectional survey was performed. A preliminary analysis of 20 Japanese hospitals found that most items were implemented at some hospitals, but the number of items implemented at many hospitals was rather small. This result strongly shows the necessity for a standardized dataset of patient profile information. PMID:27577415

  7. Intraindividual neurophysiological variability in ultra-high-risk for psychosis and schizophrenia patients: single-trial analysis

    PubMed Central

    Shin, Kyung Soon; Kim, June Sic; Kim, Sung Nyun; Hong, Kyung Sue; O’Donnell, Brian F; Chung, Chun Kee; Kwon, Jun Soo

    2015-01-01

    Background: Intraindividual variability in neurophysiological responses is an important factor in the study of schizophrenia. Interestingly, this variability strongly predicts individual differences in cognitive processing. Neurobiological abnormalities that present during the prodromal phase of schizophrenia are not well characterized. However, these symptoms may provide insight into the key circuits involved in the disorder. Aims: To investigate the variability in magnetoencephalographic responses at ultrahigh risk and schizophrenia patients. Methods: Twenty-four ultrahigh risk, 21 patients with schizophrenia and 28 healthy controls were evaluated. The intraindividual variability was estimated by calculating the s.d. of the across-trial amplitude in responses to deviant and standard stimuli. The degree of phase locking across trials was calculated by intertrial coherence. Results: Greater variability in the responses to deviant and standard tones was noted in the schizophrenia and ultrahigh risk groups compared with controls. Variability in response to standard stimuli was positively correlated with the amplitude for the standard stimuli in all of the groups. Moreover, schizophrenia patients displayed lower alpha and theta intertrial coherence compared with ultrahigh risk and controls. Mismatch negativity amplitude was correlated with the alpha intertrial coherence in all groups. Taken together, the augmented variability and reduced inter-trial coherence provide empirical evidence for increased amplitude and phase inconsistencies in schizophrenia and ultrahigh risk. Conclusions: The results implicate widespread dysfunction in