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Sample records for hospitalized schizophrenia patients

  1. 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

  2. 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

  3. 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

  4. Examining patient race and area predictors of inpatient admission for schizophrenia among hospital users in California.

    PubMed

    Durbin, Anna; Rudoler, David; Durbin, Janet; Laporte, Audrey; Callaghan, Russell C

    2014-12-01

    According to international research African-Caribbean and Black African populations have increased risk of hospitalization for schizophrenia, compared to Whites. Less is known about admission risk for other racial-ethnic groups. This study investigated racial-ethnic differences in hospital admission for schizophrenia in California. It also investigated the influence of area social factors (racial-ethnic neighborhood composition, and per capita income) and health service factors (presence of primary care clinics). The study sample included individuals admitted to a California hospital during 1990-2005 with a primary appendicitis related diagnosis, and without a prior or concurrent indication of schizophrenia. The adjusted logistic model examined how patient racial-ethnicity (White, Black, Hispanic, Other), other personal, area social characteristics and presence of primary care clinics influenced hospital admissions for schizophrenia. Black individuals were almost twice as likely as Whites to be admitted while Hispanics and Other race individuals were less to be admitted. In addition, male sex, having more comorbidities and living in areas with greater proportions of non-Whites increased risk. The increased risk for Blacks compared to Whites was consistent with the existing literature. However, this is among the first studies to report that Hispanics had a reduced risk of admission for schizophrenia, compared to Whites. Future studies may want to include a broader range of health services to better understand patterns of care use among individuals with schizophrenia.

  5. Influence of patient characteristics on care time in patients hospitalized with schizophrenia

    PubMed Central

    Sugibayashi, Yukiko; Yoshimura, Kimio; Yamauchi, Keita; Inagaki, Ataru; Ikegami, Naoki

    2014-01-01

    Background In the current Japanese payment system for the treatment of psychiatric inpatients, the length of hospital stay and nurse staffing levels are key determinants of the amount of payment. These factors do not fully reflect the costs of care for each patient. The objective of this study was to clarify the relationship between patient characteristics and their care costs as measured by “care time” for patients with schizophrenia. Methods Patient characteristics and care time were investigated in 14,557 inpatients in 102 psychiatric hospitals in Japan. Of these 14,557 inpatients, data for 8,379 with schizophrenia were analyzed using a tree-based model. Results The factor exerting the greatest influence on care time was ”length of stay”, so subjects were divided into 2 groups, a “short stay group” with length of stay ≦104 days, and “long stay group” ≧105 days. Each group was further subdivided according to dependence with regard to “activities of daily living”, “psychomotor agitation”, “verbal abuse”, and “frequent demands/repetitive complaints”, which were critical variables affecting care time. The mean care time was shorter in the long-stay group; however, in some long-stay patients, the mean care time was considerably longer than that in patients in the short-stay group. Conclusion The results of this study suggest that it is necessary to construct a new payment system reflecting not only length of stay and nurse staffing levels, but also individual patient characteristics. PMID:25187720

  6. A comparison of olanzapine and risperidone on the risk of psychiatric hospitalization in the naturalistic treatment of patients with schizophrenia

    PubMed Central

    Ascher-Svanum, Haya; Zhu, Baojin; Faries, Douglas; Ernst, Frank R

    2004-01-01

    Background Decreasing hospital admissions is important for improving outcomes for people with schizophrenia and for reducing cost of hospitalization, the largest expenditure in treating this persistent and severe mental illness. This prospective observational study compared olanzapine and risperidone on one-year psychiatric hospitalization rate, duration, and time to hospitalization in the treatment of patients with schizophrenia in usual care. Methods We examined data of patients newly initiated on olanzapine (N = 159) or risperidone (N = 112) who continued on the index antipsychotic for at least one year following initiation. Patients were participants in a 3-year prospective, observational study of schizophrenia patients in the US. Outcome measures were percent of hospitalized patients, total days hospitalized per patient, and time to first hospitalization during the one-year post initiation. Analyses employed a generalized linear model with adjustments for demographic and clinical variables. A two-part model was used to confirm the findings. Time to hospitalization was measured by the Kaplan-Meier survival formula. Results Compared to risperidone, olanzapine-treated patients had significantly lower hospitalization rates, (24.1% vs. 14.4%, respectively, p = 0.040) and significantly fewer hospitalization days (14.5 days vs. 9.9 days, respectively, p = 0.035). The mean difference of 4.6 days translated to $2,502 in annual psychiatric hospitalization cost savings per olanzapine-treated patient, on average. Conclusions Consistent with prior clinical trial research, treatment-adherent schizophrenia patients who were treated in usual care with olanzapine had a lower risk of psychiatric hospitalization than risperidone-treated patients. Lower hospitalization costs appear to more than offset the higher medication acquisition cost of olanzapine. PMID:15175112

  7. [Patients with schizophrenia in forensic-psychiatric hospitals (section 63 German Penal Code) in North Rhine-Westphalia].

    PubMed

    Kutscher, S; Schiffer, B; Seifert, D

    2009-02-01

    The aim of our study was to determine the development of the number of patients with schizophrenia in detention (section 63 German Penal Code) in North Rhine-Westphalia and the characterization of these patients. Patients with schizophrenia are examined, by using a standardized questionnaire answered by the attending psychiatrist or psychologist (n = 531). During the last 12 years the number of patients with schizophrenia in forensic-psychiatric hospitals has increased three times, whereas the number of patients with other diagnoses heightened only twofold. The patients with schizophrenia showed high rates of psychiatric comorbidities (substance disorders 73.9 %, personality disorders 17.2 %), previous inpatient treatments (78.3 % with a mean of 7.5 stays) and previous convictions (63.4 %). Almost half of these convictions (46.6 %) were violent offences (e. g. assault, homicide). Possible explanations for this development are discussed.

  8. Insight, social functioning and readmission to hospital in patients with schizophrenia-spectrum disorders: prospective associations.

    PubMed

    Startup, Mike; Jackson, Mike C; Startup, Sue

    2010-06-30

    It has been claimed that insight is capable of predicting important clinical outcomes among people with schizophrenia. However, the supporting evidence is sparse. Although many cross-sectional studies have been undertaken, only prospective studies can provide convincing evidence. The aims of the present research were to assess the ability of insight to predict subsequent readmissions to hospital and social functioning. Patients with schizophrenia-spectrum disorders (N=90) were recruited at the time of an acute psychotic episode and then re-assessed after 6, 12, and 24 months. Assessments included insight, three measures of social functioning, and symptoms of psychosis. There was no evidence that having been readmitted to hospital since a previous assessment was associated with insight at the previous assessment. None of the associations between insight at one assessment and social functioning at subsequent assessments was significant. Changes in insight were associated with changes in contemporary functioning, but it was found that changes in insight made no significant contributions to changes in functioning which were independent of changes in symptoms. The general aim of improving clinical outcomes would probably be better met with interventions designed to improve functioning rather than interventions to improve insight. PMID:20421137

  9. Long-term course of cognitive function in chronically hospitalized patients with schizophrenia transitioning to community-based living.

    PubMed

    Nemoto, Takahiro; Niimura, Hidehito; Ryu, Yonosuke; Sakuma, Kei; Mizuno, Masafumi

    2014-05-01

    Schizophrenia is associated with impairments in social interactions, and the conditions under which patients live and undergo treatment appear to have an important role in the course of the disease. However, the influences of care settings on the course of cognition remain controversial. The closure of psychiatric hospitals and the transition to community-based living is a golden opportunity to address this issue. The aims of the present study were to examine (1) the longitudinal course of cognition as well as the psychopathology and social functioning of schizophrenia patients who had been chronically hospitalized and then discharged, and (2) the key cognitive predictors of the functional outcome of such patients. Seventy-eight patients were transferred to the community after the closure of a psychiatric hospital. These patients were followed-up for 5 years and underwent annual examinations that included measures of cognition, psychiatric symptoms, and social functioning. Fifty-six patients completed all the assessments. Although consistent improvements were shown in the cognitive domains for attention and memory, the initial improvements in global cognition and processing speed ultimately began to decline. Symptoms and global functioning improved almost consistently over the course of the follow-up period. Stepwise multiple regressions revealed category fluency at baseline predicted social functioning at 5 years. However, this correlation was no longer significant when psychopathological variables were included as predictors. These results suggest that care settings affect the course of cognition, and addressing these conditions may lead to a certain degree of cognitive improvement even among schizophrenia patients who have been chronically institutionalized. PMID:24725850

  10. 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.

  11. 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

  12. 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

  13. Hospitalization resource utilization and costs among Medicaid insured patients with schizophrenia with different treatment durations of long-acting injectable antipsychotic therapy.

    PubMed

    Bera, Rimal; Offord, Steve; Zubek, Donna; Lau, Gina; Lin, Jay; Karson, Craig

    2014-02-01

    This study evaluated the impact of using long-acting injectable (LAI) antipsychotics for a longer treatment duration versus a short duration on health care resource utilization among Medicaid-insured schizophrenia patients. Schizophrenia patients 13 years or older initiating LAI antipsychotics were identified from the Truven Health Analytics MarketScan Research Medicaid database between July 1, 2005, and June 30, 2010. The study population was grouped into 2 study cohorts (longer-usage-duration cohort: ≥ 180 days of supply and short-usage-duration cohort: <180 days of supply). Hospitalization-related resource utilization and costs were determined during a variable follow-up period and compared at the unadjusted and adjusted levels. Of the 5694 patients identified, 2838 patients were treated with LAI antipsychotics for a mean duration of 604 (SD, 432) days (mean age, 38.91 years), and 2856 were treated for 86 (SD, 43) days (mean age, 39.96 days). Total hospital lengths of stay, all cause (6.56 [SD, 18.63] vs 4.93 [SD, 13.40] days, P < 0.001) and schizophrenia related (5.18 [SD, 14.96] vs 4.16 [SD, 11.94] days, P = 0.005), and the mean number of hospitalizations, all cause (0.79 [SD, 1.78] vs 0.61 [SD, 1.41], P < 0.001) and schizophrenia related (0.63 [SD, 1.55] vs 0.51 [SD, 1.26], P = 0.001), were lower for the longer-usage-duration cohort. Cox regression results showed that using LAI antipsychotics for a longer duration was correlated with longer time to the first hospitalization for any cause and for schizophrenia. After multivariate regression, longer usage duration of LAI antipsychotics was associated with a decreased number of hospitalizations (-0.15 per year, P < 0.001), a decreased hospital length of stay (-1.50 days, P < 0.001), and reduced hospital payment (-26%, P < 0.001). Patients who are treated with LAI antipsychotics for a longer versus shorter duration use hospital resources less. PMID:24135840

  14. Cardiac risk factors and metabolic syndrome in patients with schizophrenia admitted to a general hospital psychiatric unit

    PubMed Central

    Grover, Sandeep; Nebhinani, Naresh; Chakrabarti, Subho; Avasthi, Ajit; Basu, Debasish; Kulhara, Parmanand; Mattoo, Surendra Kumar; Malhotra, Savita

    2014-01-01

    Objective: The study aimed to evaluate the prevalence of cardiovascular risk (CVR) factors and metabolic syndrome (MS) in patients with schizophrenia. Materials and Methods: By consecutive sampling, 143 patients (of age ≥ 20 years), out of total 159 patients with schizophrenia admitted to the inpatient unit were evaluated for the coronary heart disease (CHD) risk as per Framingham (10-year all CHD events) function/risk equation and systematic coronary risk evaluation (SCORE) - 10-year cardiovascular mortality risk (CMR). Prevalence of MS was estimated by using the consensus definition. Results: Fifty-two (36.4%) patients fulfilled the criteria for MS. 10-year CHD risk was 1.65%, and 10-year CMR was 1.39%. Compared to females, males had higher Framingham score (1.96 ± 2.74 vs. 1.09 ± 0.41, U value 1987.5*, P < 0.05). Conclusion: Patients of schizophrenia have a high prevalence of MS and CVR factors. Hence, there is a need to screen the patient of schizophrenia for the same and manage the same as early as possible during the course of illness. PMID:25568478

  15. 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.

  16. 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

  17. Time to rehospitalization in patients with major depression vs. those with schizophrenia or bipolar I disorder in a public psychiatric hospital.

    PubMed

    Lin, Ching-Hua; Chen, Ming-Chao; Chou, Li-Shiu; Lin, Chieh-Hsin; Chen, Cheng-Chung; Lane, Hsien-Yuan

    2010-12-30

    Compared rehospitalization rates in patients with schizophrenia or bipolar I disorder to patients with major depressive disorder remains unclear. This study aimed to compare the time to rehospitalization of the three groups. Other clinical variables were also examined. Rehospitalization status was monitored for all admitted inpatients with schizophrenia (n=637), bipolar I disorder (n=197), or major depressive disorder (n=191), from January 1, 2006 to December 31, 2006. Time to rehospitalization within 1 year after discharge was measured using the Kaplan-Meier method. Risk factors associated with rehospitalization were examined using the Cox proportional hazards regression model. The three groups were comparable for comorbid alcohol abuse/dependence, family history of severe psychiatric illness, years of education, and number of previous hospitalizations. No significant differences were noted among the three groups for the time to rehospitalization or the time to discontinuation. Age onset and number of previous admission were associated with risks of rehospitalization. This study suggests that the major depressive disorder, schizophrenia, and bipolar I disorder have comparable influences on time to rehospitalization and discontinuation from treatment and that earlier onset of illness and more previous hospitalizations are associated with higher risks of rehospitalization. Further prospective research is warranted. PMID:20494450

  18. Patients with Schizophrenia and Social Contacts

    PubMed Central

    Arsova, Slavica; Barsova, Gabriela Kopacheva

    2016-01-01

    BACKGROUND: Patients with schizophrenia have severe problems with personal and social relations which affect their quality of life. AIM: The aim of the paper was to monitor personal and social relations in patients with schizophrenia and to find out the differences regarding socio-demographic characteristics and ambulatory and day hospital treatment. MATERIAL AND METHODS: The investigation included 120 subjects each with diagnosis F20 according to ICD 10 criteria; divided into two groups of 60 patients regarding their actual treatment (the first group received ambulatory care whereas those from the second group had a day hospital treatment). Patients were of different age and gender, receiving regular antipsychotic therapy. They were included in individual and group psychosocial therapeutic procedures during the day hospital treatment. The investigation utilised the following diagnostic instruments: standardised clinical interview and Personal and social performance scale (PSP scale), a non-standardized questionnaire of socio-demographic data, family support and existence of mental disorder in other family members. RESULTS: The results have shown better personal and social functioning in patients who had family support, in those who are employed, in those with no mental disorder in other family members and in patients on day hospital treatment against patients receiving ambulatory care. CONCLUSION: Day hospital treatment, family support and social support improve the ability for personal and social contacts of patients with schizophrenia. PMID:27703560

  19. 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

  20. Dermatoglyphics in patients with schizophrenia*

    PubMed Central

    Shakibaei, Fereshteh; Asadollahi, Ghorban Ali; Tabibi, Amirpooyan

    2011-01-01

    BACKGROUND: There are controversial evidences on the association between fingerprint traits and schizophrenia. We compared fingerprint traits of patients with schizophrenia and normal individuals in Iranian population. METHODS: Finger tip dermal ridge of 290 patients with schizophrenia and 290 normal subjects were studied for four dermal traits. Data was analyzed with Pearson correlation and student's tests. RESULTS: Finger print patterns and secondary creases were not significantly different between the two groups (p > 0.05). Although mean ridge counts of left and right index fingers of the case group were greater than the control group (p < 0.05), these differences were not significant in females. CONCLUSIONS: Probably the left index ridge counts and fluctuating asymmetry in schizophrenic patients are different from those of the normal population. This difference may serve as a diagnostic biological marker for screening people susceptible to schizophrenia. Further studies are needed to determine predictive value of fingerprint trait as a biomarker for the schizophrenia. PMID:22279482

  1. Schizophrenia and tobacco smoking in a Spanish psychiatric hospital.

    PubMed

    LLerena, Adrián; de la Rubia, Alfredo; Peñas-Lledó, Eva M; Diaz, Francisco J; de Leon, Jose

    2003-04-01

    This study in a Spanish hospital replicated two US studies suggesting that schizophrenia is associated with smoking when compared with other severe mental illnesses. Neither antipsychotics nor institutionalism could explain this relationship. Seventy of the 100 schizophrenic and 53 of the 100 non-schizophrenic inpatients were current smokers. After correcting for confounding factors, schizophrenia increased the risk of smoking by 2- to 3-fold. Heavy smoking was not associated with schizophrenia.

  2. Cardiovascular diseases among patients with schizophrenia.

    PubMed

    Azad, Muhammad Chanchal; Shoesmith, Wendy Diana; Al Mamun, Mohammad; Abdullah, Ahmad Faris; Naing, Daw Khin Saw; Phanindranath, Mahadasa; Turin, Tanvir Chowdhury

    2016-02-01

    The presence of comorbid physical illnesses especially, cardiovascular diseases (CVD) in schizophrenia is a growing area of concern in recent years. In order to reduce disease burden, to improve quality of life and to provide holistic care, it is important to know about the relationship between schizophrenia and CVD. The objective of this review is to explore the extent of CVD problems, relevant risk factors and potential measures for early diagnosis and prevention of CVD among patients with schizophrenia. Worldwide studies show that patients with schizophrenia have a higher mortality and lower life expectancy than the general population. CVD is the leading cause of increased mortality in schizophrenia. Common CVD risk factors in schizophrenia include metabolic syndrome, sedentary behaviour, tobacco smoking, effects of antipsychotics, long chain omega-3 fatty acid deficiency and shared genetics between CVD and schizophrenia. The potential methods for early detection and prevention of CVD in schizophrenia are also discussed. Though the patients with schizophrenia form a high risk group for CVD, consensus guidelines for early detection and prevention of CVD in schizophrenia are lacking. Comorbidity of CVD in schizophrenia needs more serious attention by clinicians and researchers. PMID:26957335

  3. Cardiovascular diseases among patients with schizophrenia.

    PubMed

    Azad, Muhammad Chanchal; Shoesmith, Wendy Diana; Al Mamun, Mohammad; Abdullah, Ahmad Faris; Naing, Daw Khin Saw; Phanindranath, Mahadasa; Turin, Tanvir Chowdhury

    2016-02-01

    The presence of comorbid physical illnesses especially, cardiovascular diseases (CVD) in schizophrenia is a growing area of concern in recent years. In order to reduce disease burden, to improve quality of life and to provide holistic care, it is important to know about the relationship between schizophrenia and CVD. The objective of this review is to explore the extent of CVD problems, relevant risk factors and potential measures for early diagnosis and prevention of CVD among patients with schizophrenia. Worldwide studies show that patients with schizophrenia have a higher mortality and lower life expectancy than the general population. CVD is the leading cause of increased mortality in schizophrenia. Common CVD risk factors in schizophrenia include metabolic syndrome, sedentary behaviour, tobacco smoking, effects of antipsychotics, long chain omega-3 fatty acid deficiency and shared genetics between CVD and schizophrenia. The potential methods for early detection and prevention of CVD in schizophrenia are also discussed. Though the patients with schizophrenia form a high risk group for CVD, consensus guidelines for early detection and prevention of CVD in schizophrenia are lacking. Comorbidity of CVD in schizophrenia needs more serious attention by clinicians and researchers.

  4. Vergence Eye Movements in Patients with Schizophrenia

    PubMed Central

    Bolding, MS; Lahti, AC; White, D; Moore, C; Gurler, D; Gawne, TJ; Gamlin, PD

    2014-01-01

    Previous studies have shown that smooth pursuit eye movements are impaired in patients with schizophrenia. However, under normal viewing conditions, targets move not only in the frontoparallel plane but also in depth, and tracking them requires both smooth pursuit and vergence eye movements. Although previous studies in humans and non-human primates suggest that these two eye movement subsystems are relatively independent of one another, to our knowledge, there have been no prior studies of vergence tracking behavior in patients with schizophrenia. Therefore, we have investigated these eye movements in patients with schizophrenia and in healthy controls. We found that patients with schizophrenia exhibited substantially lower gains compared to healthy controls during vergence tracking at all tested speeds (e.g. 0.25 Hz vergence tracking mean gain of 0.59 vs. 0.86). Further, consistent with previous reports, patients with schizophrenia exhibited significantly lower gains than healthy controls during smooth pursuit at higher target speeds (e.g. 0.5 Hz smooth pursuit mean gain of 0.64 vs. 0.73). In addition, there was a modest (r≈0.5), but significant, correlation between smooth pursuit and vergence tracking performance in patients with schizophrenia. Our observations clearly demonstrate substantial vergence tracking deficits in patients with schizophrenia. In these patients, deficits for smooth pursuit and vergence tracking are partially correlated suggesting overlap in the central control of smooth pursuit and vergence eye movements. PMID:25088242

  5. Are psychiatrist characteristics associated with postdischarge suicide of schizophrenia patients?

    PubMed

    Lee, Hsin-Chien; Lin, Herng-Ching

    2009-07-01

    Information on the relationship between characteristics of mental healthcare providers, including hospitals and psychiatrists, and postdischarge suicide is scanty. This study aims to identify the risk factors for suicide among schizophrenia patients in the 3-month postdischarge period. The study cohort comprised all patients with a principal diagnosis of schizophrenia discharged from psychiatric inpatient care from 2002 to 2004 who committed suicide within 90 days of discharge. The control cohort consisted of all surviving schizophrenia patients discharged from psychiatric inpatient care in the same period and were matched to cases for age, gender, and date of discharge. There were 87 and 348 cases in the study and control cohorts, respectively. For suicide cases, death most frequently occurred on the first day after leaving the hospital (16.1%). The adjusted hazard ratios for committing suicide during the 90-day postdischarge period were 2.639 times greater for patients without previous psychiatric admission than for those hospitalized more than 3 times in the year preceding the index hospitalization. The adjusted suicide hazard for schizophrenia patients treated by male psychiatrists was significantly higher than for patients treated by female psychiatrists, by a multiple of 5.117 (P = .032). The adjusted suicide hazard among patients treated by psychiatrists over age 44 years was 2.378 times (P = .043) that for patients treated by psychiatrists aged younger than 35 years. Risk factors related to psychiatric hospitalization, including number of psychiatric admissions in the previous year and length of stay, together with gender and age of the psychiatrist providing inpatient care, are identified. PMID:18281712

  6. Schizophrenia and tobacco smoking: a replication study in another US psychiatric hospital.

    PubMed

    de Leon, Jose; Tracy, Joseph; McCann, Eileen; McGrory, Amy; Diaz, Francisco J

    2002-07-01

    A prior study in a US state hospital suggested that schizophrenia is more closely associated with tobacco smoking when compared with other severe mental illnesses. This second study, in a neighborhood hospital, tries to (1) replicate that schizophrenia is associated with smoking and heavy smoking, and (2) rule out that this relationship is explained by substance use. The methodology was very similar to the first study. The sample included 588 inpatients. Logistic regression was used to develop models of variables associated with smoking or heavy smoking. The frequency of current smoking for the total, schizophrenic and non-schizophrenic samples were respectively 71, 75, and 55%. The sequence of frequencies from the highest to lowest was the same as in the first study: male schizophrenic patients, male non-schizophrenic patients, female schizophrenic patients and female non-schizophrenic patients. This second study consistently replicated the relationship between schizophrenia and smoking (after correcting for other variables) including history of alcohol and drug abuse or dependence. Only one of two definitions of heavy smoking showed a significant association with schizophrenia. In summary, these two studies suggest that schizophrenia is strongly associated with smoking. Neither substance use, antipsychotics, nor institutionalism can explain this relationship.

  7. 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.

  8. 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

  9. 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

  10. Total antioxidant response in patients with schizophrenia.

    PubMed

    Ustundag, Bilal; Atmaca, Murad; Kirtas, Ozlem; Selek, Sahabettin; Metin, Kerem; Tezcan, Ertan

    2006-08-01

    There is a large amount of convincing data demonstrating that reactive oxygen species (ROS) are involved in initiation and development of many different forms of neuropsychiatric disorders. The levels of oxidants and antioxidants in schizophrenia have been evaluated. However, measurements of total antioxidant response (TAR) were not evaluated up to now. Therefore, the objectives of this study are to investigate plasma TAR levels in schizophrenia subtypes. A total of 76 patients with schizophrenia and 25 healthy volunteers were included in the study. Positive and Negative Syndrome Scale (SANS and SAPS, respectively) were applied to patients. TAR values were determined in the plasma of normal healthy controls and patients with schizophrenia. Plasma TAR levels of each schizophrenia subtype were significantly lower than healthy controls (P < 0.01 for disorganized, residual and undifferentiated subtypes and P < 0.01 for paranoid subtype). When intragroup comparisons were performed, paranoid subtype had higher plasma TAR levels compared to other subtypes (P < 0.01). Accordingly, as a whole group, patients with schizophrenia had lower plasma TAR levels compared to controls. Plasma TAR levels were significantly and negatively correlated with SANS scores, and duration of illness was evaluated but not related to other parameters. Consequently, the present study further emphasizes the growing consideration that free radical damage may have an important etiopathogenetic role on the development of schizophrenia and suggests that decreased plasma total antioxidant levels may be related to the progression of illness.

  11. Negative symptom assessment of chronic schizophrenia patients.

    PubMed

    Raskin, A; Pelchat, R; Sood, R; Alphs, L D; Levine, J

    1993-01-01

    A new scale for assessing negative symptoms in schizophrenia, the Negative Symptom Assessment (NSA), was administered to 101 male chronic, inpatient schizophrenia patients. Factor analysis of the NSA yielded seven factors, but most of the explained variance resided in Factor 1, Restricted Affect/Emotion. The factors that emerged from this study closely resembled NSA factors derived from an earlier study of outpatient schizophrenia patients, which indicates the factor structure of the NSA is robust. A constellation of variables reflecting long-term or chronic illness were significantly related to six of the seven factors. These results suggest that "institutionalism" may play a role in the evolution of some negative symptoms.

  12. 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

  13. Smoking rates among schizophrenia patients in Japan.

    PubMed

    Shinozaki, Yasuko; Nakao, Mutsuhiro; Takeuchi, Takeaki; Yano, Eiji

    2011-04-30

    According to the meta-analysis performed by de Leon and Diaz, the smoking rate was higher among schizophrenia patients than in the general population with the exception of the populations of Japan and Colombia. The purpose of this study was to reexamine the association between schizophrenia and smoking among Japanese schizophrenia patients using objective measures. The sample comprised 172 schizophrenia inpatients (mean age: 54years; 55% male). Participants were asked by a psychiatrist whether they currently smoked, and their answers were confirmed by the Fagerström Test for Nicotine Dependence and a measurement of the carbon monoxide level in expired air. Data on 7496 Japanese people obtained from the national survey of health were used as the control group. Seventy schizophrenia patients (40.7%) were identified as smokers; the smoking rate was higher among men in their 50s (66.7%) and among women in their 40s (54.6%). The smoking rate was 24.2% in the control group, and multiple logistic regression analysis showed that this percentage was significantly higher in the schizophrenia than in the control group (odds ratio: 2.17), adjusting for sex and age. The association between smoking rate and schizophrenia is consistent across countries, including Japan.

  14. Numerical distance effect in patients with schizophrenia.

    PubMed

    Pourrahimi, Ali Mohammad; Mazhari, Shahrzad; Shabani, Mohammad; Tabrizi, Yousef Moghadas; Sheibani, Vahid

    2016-03-23

    There is growing evidence showing that mental representation of numbers is impaired in patients with schizophrenia. Yet, no study has examined the distance effect in the patients. We assessed the distance effect using two number size comparison tasks, with different number references (5 and 7) in 23 patients and 28 healthy individuals. Response times and error rates significantly increased when the distances between the centered references and the targets decreased in both groups. However, patients responded significantly slower and had more error rates compared to controls. Our finding indicates distance effect in patients is similar to the controls, indicating an automatic numerical processing is preserved in patients with schizophrenia.

  15. 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.

  16. History of religious delusions and psychosocial functioning among Mexican patients with paranoid schizophrenia.

    PubMed

    Robles-García, Rebeca; López-Luna, Sonia; Páez, Francisco; Escamilla, Raúl; Camarena, Beatriz; Fresán, Ana

    2014-12-01

    The association between global functionality and religiosity among patients from developing and predominantly Catholic countries warrants attention. To compare religiosity and psychosocial functioning in Mexican schizophrenia patients with and without a history of religious delusions, seventy-four patients with paranoid schizophrenia were recruited. Patients with a history of religious delusions had more psychiatric hospitalizations and poorer psychosocial functioning compared with those without a history of religious delusions. No differences emerged between groups in the total scores of religiosity scales. A history of religious delusions rather than religiosity itself may have an influence on psychosocial functioning among Mexican patients with schizophrenia.

  17. 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

  18. 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

  19. 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

  20. 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

  1. Resource utilization in patients with schizophrenia who initiated risperidone long-acting therapy: results from the Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation (SOURCE)

    PubMed Central

    2011-01-01

    Background Schizophrenia is a chronic mental health disorder associated with increased hospital admissions and excessive utilization of outpatient services and long-term care. This analysis examined health care resource utilization from a 24-month observational study of patients with schizophrenia initiated on risperidone long-acting therapy (RLAT). Methods Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation (SOURCE) was a 24-month observational study designed to examine real-world treatment outcomes by prospectively following patients with schizophrenia initiated on RLAT. At baseline visit, prior hospitalization and ER visit dates were obtained for the previous 12 months and subsequent hospitalization visit dates were obtained at 3-month visits, if available. The health care resource utilization outcomes measures observed in this analysis were hospitalizations for any reason, psychiatric-related hospitalizations, and emergency room (ER) visits. Incidence density analysis was used to assess pre-event and postevent rates per person-year (PY). Results The primary medical resource utilization analysis included 435 patients who had a baseline visit, ≥1 postbaseline visits after RLAT initiation, and valid hospitalization dates. The number of hospitalizations and ER visits per PY declined significantly (p < .0001) after initiation with RLAT. A 41% decrease (difference of -0.29 hospitalizations per PY [95% CI: -0.39 to -0.18] from baseline) in hospitalizations for any reason, a 56% decrease (a difference of -0.35 hospitalizations per PY [95% CI: -0.44 to -0.26] from baseline) in psychiatric-related hospitalizations, and a 40% decrease (-0.26 hospitalizations per PY [95% CI: -0.44 to -0.10] from baseline) in ER visits were observed after the baseline period. The percentage of psychiatric-related hospitalizations decreased significantly after RLAT initiation, and patients had fewer inpatient hospitalizations and ER visits (all p < .0001). Conclusion The

  2. Substance abuse and the risk of readmission of people with schizophrenia at Amanuel Psychiatric Hospital, Ethiopia.

    PubMed

    Bimerew, M S; Sonn, F C T; Kortenbout, W P

    2007-06-01

    Frequent readmissions of people with schizophrenia pose considerable pressure on the psychiatric service provision of Amanuel Psychiatric Hospital. The purpose of the study was to ascertain factors mainly contributing to the rate of readmissions of people with schizophrenia. Descriptive survey methods and qualitative focus group interviews were employed to conduct the study. Random sampling techniques were used to select 43 respondents of people with schizophrenia from 231 people with schizophrenia who were readmitted for two or more times in the last two years and who gained access during the time of the study. Structured interviews were used for respondents of people with schizophrenia. Fourteen (N=14) family members/caregivers were selected using purposive sampling methods for focus group discussions. Quantitative data was analyzed using the SPSS Version 11.00 program and the qualitative data was analyzed by generating themes and categories. The results suggest that alcohol and khat abuse were contributing factors for the rate of readmissions of people with schizophrenia into the Amanuel Psychiatric Hospital. It was found that communities contribute to the problems of substance abuse by providing and/or selling it to those mentally ill people. The study also revealed that patients use alcohol and khat in order to tolerate the severe side effects of the anti-psychotic drugs, to suppress hunger due to shortage of food and to avoid drowsiness. Raising community awareness, psycho-education, strengthening the capacities of caretakers and laws to prevent substance abuse, as well as campaigning to prevent people from abusing mentally ill sufferers, should be established. PMID:17703825

  3. 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

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

    PubMed

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

    2015-01-01

    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

  5. 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

  6. Cerumen impaction in patients with schizophrenia.

    PubMed

    Saana, Eskelinen; Eila, Sailas; Kaisla, Joutsenniemi; Matti, Holi; Jaana, Suvisaari

    2014-07-01

    Cerumen impaction may cause hearing loss and pain. We investigated the prevalence of cerumen impaction in a population of outpatients with schizophrenia spectrum psychoses and studied factors contributing to it. As a part of our study--"The Living Conditions and Physical Health of Outpatients with Schizophrenia"--we performed a thorough medical examination including otoscopy of the ear canal for patients treated in the community mental health center of one Finnish municipality. Out of a total of 61 patients, cerumen impaction was found in 12 (19.7%). In a logistic regression model, living in a group home (OR 13.7, 95% confidence interval 3.0-64.0, p=0.0008) significantly predicted cerumen impaction. Cerumen impaction was also associated with male gender and lower GAF scores. Cerumen impaction is common in patients with schizophrenia, and is associated with low level of functioning. Diagnosis and treatment of cerumen impaction among schizophrenia patients is essential in avoiding this easily treatable cause of hearing loss and its consequences such as difficulties in cognition and social interaction. PMID:23446199

  7. 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

  8. Caffeine consumption in a long-term psychiatric hospital: Tobacco smoking may explain in large part the apparent association between schizophrenia and caffeine use.

    PubMed

    Arrojo-Romero, Manuel; Armas Barbazán, Carmen; López-Moriñigo, Javier D; Ramos-Ríos, Ramón; Gurpegui, Manuel; Martínez-Ortega, José M; Jurado, Dolores; Diaz, Francisco J; de Leon, Jose

    2015-05-01

    This study further explores the association between schizophrenia and caffeine use by combining two prior published Spanish samples (250 schizophrenia outpatients and 290 controls from the general population) with two Spanish long-term inpatient samples from the same hospital (145 with schizophrenia and 64 with other severe mental illnesses). The specific aims were to establish whether or not, after controlling for confounders including tobacco smoking, the association between schizophrenia and caffeine is consistent across schizophrenia samples and across different definitions of caffeine use. The frequency of caffeine use in schizophrenia inpatients was not significantly higher than that in non-schizophrenia inpatients (77%, 111/145 vs. 75%, 48/64) or controls but was significantly higher than in schizophrenia outpatients. The frequency of high caffeine users among caffeine users in schizophrenia inpatients was not significantly higher than in non-schizophrenia inpatients (45%, 50/111 vs. 52%, 25/48) or controls, but was significantly lower than in schizophrenia outpatients. Smoking was significantly associated with caffeine use across all samples and definitions. Between 2 and 3% of schizophrenia inpatients, schizophrenia outpatients and non-schizophrenia inpatients showed caffeinism (>700 mg/day in smokers). Several of these smoking patients with caffeinism were also taking other inducers, particularly omeprazole. The lack of consistent association between schizophrenia and caffeine use is surprising when compared with the very consistent association between tobacco smoking and caffeine use across all of our analyses (use and high use in users) and all our samples. The confounding effects of tobacco smoking may explain in large part the apparent association between schizophrenia and caffeine use.

  9. Impact of short-term temperature variability on emergency hospital admissions for schizophrenia stratified by season of birth

    NASA Astrophysics Data System (ADS)

    Zhao, Desheng; Zhang, Xulai; Xu, Zhiwei; Cheng, Jian; Xie, Mingyu; Zhang, Heng; Wang, Shusi; Li, Kesheng; Yang, Huihui; Wen, Liying; Wang, Xu; Su, Hong

    2016-08-01

    Diurnal temperature range (DTR) and temperature change between neighboring days (TCN) are important meteorological indicators closely associated with global climate change. However, up to date, there have been no studies addressing the impacts of both DTR and TCN on emergency hospital admissions for schizophrenia. We conducted a time-series analysis to assess the relationship between temperature variability and daily schizophrenia onset in Hefei, an inland city in southeast China. Daily meteorological data and emergency hospital admissions for schizophrenia from 2005 to 2014 in Hefei were collected. After stratifying by season of birth, Poisson generalized linear regression combined with distributed lag nonlinear model (DLNM) was used to examine the relationship between temperature variability and schizophrenia, adjusting for long-term trend and seasonality, mean temperature, and relative humidity. Our analysis revealed that extreme temperature variability may increase the risk for schizophrenia onset among patients born in spring, while no such association was found in patients born in summer and autumn. In patients born in spring, the relative risks of extremely high DTR comparing the 95th and 99th percentiles with the reference (50th, 10 °C) at 3-day lag were 1.078 (95 % confidence interval (CI) 1.025-1.135) and 1.159 (95 % CI 1.050-1.279), respectively. For TCN effects, only comparing 99th percentile with reference (50th, 0.7 °C) was significantly associated with emergency hospital admissions for schizophrenia (relative risk (RR) 1.111, 95 % CI 1.002-1.231). This study suggested that exposure to extreme temperature variability in short-term may trigger later days of schizophrenia onset for patients born in spring, which may have important implications for developing intervention strategies to prevent large temperature variability exposure.

  10. 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

  11. 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

  12. 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.

  13. 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

  14. [Face recognition in patients with schizophrenia].

    PubMed

    Doi, Hirokazu; Shinohara, Kazuyuki

    2012-07-01

    It is well known that patients with schizophrenia show severe deficiencies in social communication skills. These deficiencies are believed to be partly derived from abnormalities in face recognition. However, the exact nature of these abnormalities exhibited by schizophrenic patients with respect to face recognition has yet to be clarified. In the present paper, we review the main findings on face recognition deficiencies in patients with schizophrenia, particularly focusing on abnormalities in the recognition of facial expression and gaze direction, which are the primary sources of information of others' mental states. The existing studies reveal that the abnormal recognition of facial expression and gaze direction in schizophrenic patients is attributable to impairments in both perceptual processing of visual stimuli, and cognitive-emotional responses to social information. Furthermore, schizophrenic patients show malfunctions in distributed neural regions, ranging from the fusiform gyrus recruited in the structural encoding of facial stimuli, to the amygdala which plays a primary role in the detection of the emotional significance of stimuli. These findings were obtained from research in patient groups with heterogeneous characteristics. Because previous studies have indicated that impairments in face recognition in schizophrenic patients might vary according to the types of symptoms, it is of primary importance to compare the nature of face recognition deficiencies and the impairments of underlying neural functions across sub-groups of patients.

  15. 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

  16. Application in Mexico of psychosocial rehabilitation with schizophrenia patients.

    PubMed

    Valencia, Marcelo; Rascon, Maria Luisa; Juarez, Francisco; Escamilla, Raul; Saracco, Ricardo; Liberman, Robert Paul

    2010-01-01

    To determine whether evidence-based, psychosocial treatments developed in the United States and England are applicable to Mexican outpatients with schizophrenia, the present study was carried out to evaluate the relative effectiveness of family psycho-education and psychosocial skills training added to customary treatment vs. customary treatment alone. Clinically stable outpatients with schizophrenia participated in a 12-month randomized, controlled trial at the National Institute of Psychiatry in Mexico City. An experimental group (N = 47) received the combination of psychosocial skills training, family psycho-education and customary pharmacotherapy while the comparison group (N = 36) received customary treatment alone. Patients were assessed at baseline and one year after commencement of treatment. Significant differences favoring the group that received psychosocial rehabilitation were found in ratings of adherence to medication, attendance at appointments, symptoms, social functioning, relapse, and re-hospitalization. While some adaptations were made in the psychosocial treatments to resolve cultural differences, the results provide cross-national validation of evidence-based treatments for persons with schizophrenia.

  17. Characteristics of trees drawn by patients with paranoid schizophrenia.

    PubMed

    Inadomi, Hiroyuki; Tanaka, Goro; Ohta, Yasuyuki

    2003-08-01

    The objective of the present study was to investigate the relationship between schizophrenia subtype and morphological characteristics of trees drawn in the Baum test. Subjects comprised the following three groups: 20 patients diagnosed with paranoid schizophrenia according to International Classification of Diseases (10th revision; ICD-10) criteria; 26 patients with non-paranoid schizophrenia according to ICD-10 criteria; and 53 healthy individuals. Differences in psychiatric symptoms as assessed using the Brief Psychiatric Rating Scale (BPRS) score were compared between patients with paranoid and non-paranoid schizophrenia. In addition, differences in two morphological characteristics of trees, namely trunk-to-crown ratio and trunk end opening, were compared between the three groups. No differences in psychiatric symptoms were identified between patients with paranoid and non-paranoid schizophrenia. Conversely, mean +/- SD trunk-to-crown ratio was 13.1 +/- 8.0 for patients with non-paranoid schizophrenia, 8.8 +/- 4.6 for patients with paranoid schizophrenia, and 5.4 +/- 3.4 for healthy individuals. Significant differences were identified between all three groups. Furthermore, mean trunk end opening was 0.80 +/- 0.7 for patients with paranoid schizophrenia, 0.38 +/- 0.6 for patients with non-paranoid schizophrenia, and 0.06 +/- 0.3 for healthy individuals. Again, significant differences were apparent between all three groups. These findings suggest that morphological differences in trees drawn in the Baum test can be observed between the two schizophrenia subtypes in terms of not only psychopathological interpretation, but also gestalt formation, as assessed on the basis of trees with collapsed gestalt or with some degree of gestalt. This suggests the possibility of multiple disorders at a physiological level. The present study confirmed that the Baum test can quantitatively assess facets of schizophrenia that existing scales such as BPRS are unable to analyze

  18. Hospital Admission for Schizophrenia and Discharge Against Medical Advice in the United States

    PubMed Central

    Robison, Linda M.

    2010-01-01

    Objective: Hospital discharge against medical advice may leave a patient at risk for adverse health outcomes and/or readmission, yet little is known regarding its occurrence, especially among patients with mental illness. The objective of this study was to discern the prevalence of, and predictive factors for, being discharged against medical advice among hospitalized patients with a primary diagnosis of schizophrenia. Method: The 2004 US Healthcare Cost and Utilization Project Nationwide Inpatient Sample was used to discern demographic predictors, length of stay, and costs for discharge against medical advice relative to discharge with medical approval. Inpatient discharges from US community hospitals for patients of all ages with The International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes 295.0–295.9 were included. Conditional logistic regression was used to discern factors predictive of discharge against medical advice, and least squares mean analysis was used to examine differences in length of stay and mean cost per day relative to discharge with medical approval. Least squares means were adjusted for age (continuous), sex, race, region, payer, hospital setting, and bed size. Results: Within the study population, 1.6% of patients admitted for schizophrenia were discharged against medical advice (n = 3,382/210,722). Patients discharged against medical advice were significantly more likely to be younger (OR = 0.985, 95% CI, 0.982–0.987) and male (OR = 1.421, 95% CI, 1.321–1.529). Race was not a significant factor. Mean ± SE length of stay for discharge against medical advice was 5.0 ± 0.24 days, as compared to 8.7 ± 0.06 days for patients discharged with medical approval (P < .0001). Mean cost per day was significantly higher for discharge against medical advice ($1,886.02 ± 49.67 vs $1,565.79 ± 13.42, P < .0001). Conclusions: Although the percentage of patients discharged against medical advice was small, the

  19. 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 ...

  20. 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

  1. 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

  2. Poor physical health and mortality in patients with schizophrenia.

    PubMed

    Pack, Steven

    Schizophrenia, its treatment and the lifestyle of patients contribute to high rates of mortality. Patients often have poorer diets, lower rates of physical activity and smoke more than the general population. Such lifestyle choices predispose them to physical health problems and disease. This article explores the impact of poor physical health on mortality in patients with schizophrenia. Suggestions are made for patient education and promotion of a healthy lifestyle to improve the quality of life for patients with the illness.

  3. Hospitalization patterns in schizophrenia. A 13-year follow-up.

    PubMed

    Munk-Jørgensen, P; Mortensen, P B; Machón, R A

    1991-01-01

    All first admitted patients in 1972 from a catchment area of 582,000 inhabitants aged 15 years or more who were diagnosed as schizophrenic at least once from 1972 until September 1983 (n = 53) were followed-up on average 13 years after first admission. About 20% of the cohort was hospitalized on any given day throughout the length of the follow-up period. The duration of hospitalization decreased from a mean of 8.2 months for the first admission to 1.7 months for the tenth or later admission. The readmission risk increased as a function of the number of previous admissions. Patients with income from occupation or from grants for education had shorter duration of first in-patient period. If the patients were diagnosed as schizophrenics already during the first hospitalization the risk for prolonged duration of the first in-patient period was increased but the readmission risk diminished. Furthermore, readmission risk after the first discharge was diminished by own income and by out-patient treatment and increased by low social status. High proportion of follow-up time in hospital (greater than or equal to 30%) was correlated to affective flattening present at first admission. Of the cohorts' total number of admissions (n = 493) 12% were involuntary. Involuntary admissions were more frequent in the first half of the follow-up period and were correlated to a previous involuntary admission. PMID:2009251

  4. 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…

  5. Quality of life of patients with schizophrenia treated in foster home care and in outpatient treatment

    PubMed Central

    Mihanović, Mate; Restek-Petrović, Branka; Bogović, Anamarija; Ivezić, Ena; Bodor, Davor; Požgain, Ivan

    2015-01-01

    Background The Sveti Ivan Psychiatric Hospital in Zagreb, Croatia, offers foster home care treatment that includes pharmacotherapy, group psychodynamic psychotherapy, family therapy, and work and occupational therapy. The aim of this study is to compare the health-related quality of life of patients with schizophrenia treated in foster home care with that of patients in standard outpatient treatment. Methods The sample consisted of 44 patients with schizophrenia who, upon discharge from the hospital, were included in foster home care treatment and a comparative group of 50 patients who returned to their families and continued receiving outpatient treatment. All patients completed the Short Form 36 Health Survey Questionnaire on the day they completed hospital treatment, 6 months later, and 1 year after they participated in the study. The research also included data on the number of hospitalizations for both groups of patients. Results Though directly upon discharge from the hospital, patients who entered foster home care treatment assessed their health-related quality of life as poorer than patients who returned to their families, their assessments significantly improved over time. After 6 months of treatment, these patients even achieved better results in several dimensions than did patients in the outpatient program, and they also had fewer hospitalizations. These effects remained the same at the follow-up 1 year after the inclusion in the study. Conclusion Notwithstanding the limitations of this study, it can be concluded that treatment in foster home care is associated with an improvement in the quality of life of patients with schizophrenia, but the same was not observed for the patients in standard outpatient treatment. We hope that these findings will contribute to an improved understanding of the influence of psychosocial factors on the functioning of patients and the development of more effective therapeutic methods aimed at improving the patients

  6. 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.

  7. 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

  8. Age disorientation in schizophrenia: a constant prevalence of 25 per cent in a chronic mental hospital population?

    PubMed

    Stevens, M; Crow, T J; Bowman, M J; Coles, E C

    1978-08-01

    The prevalence of age disorientation was estimated in the population of patients with a diagnosis of schizophrenia in a large mental hospital. Of these 357 patients 25 per cent demonstrated age disorientation, defined as a five-year discrepancy between true and subjective age, and 11 per cent of the population believed themselves to be within five years of the age they were at admission, although they were a mean 28.9 years older. Age-disorientated patients differed from the age-orientated in being significantly older. However, when age-matched, they were younger at first admission and had a longer duration of stay than patients with a diagnosis of schizophrenia without age-disorientation. Age-disorientation may thus be a feature of a type of schizophrenic illness of early onset and poor prognosis.

  9. 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…

  10. Novelty-elicited mismatch negativity in patients with schizophrenia on admission and discharge.

    PubMed Central

    Grzella, I; Müller, B W; Oades, R D; Bender, S; Schall, U; Zerbin, D; Wolstein, J; Sartory, G

    2001-01-01

    OBJECTIVE: Given recent reports of differences between mismatch negativity (MMN) elicited by always novel sounds (novelty-elicited MMN) and that elicited by repeated rare deviants (conventional MMN), we investigated novelty-elicited MMN and P3a in patients with schizophrenia before and after a nonstandardized inpatient treatment. DESIGN: Electrophysiological and clinical assessment of patients on admission and discharge from hospital. Assessment of control subjects on 2 sessions. SETTING: Inpatient treatment in a psychiatric university hospital. SUBJECTS: 20 patients with schizophrenia and 21 healthy control subjects of similar age and sex. Selection of patients with first- to third-episode schizophrenia. OUTCOME MEASURES: Early and late component MMN amplitudes and latencies, P3a amplitudes and latencies, Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), Extrapyramidal Symptom Scale (EPS), Abnormal Involuntary Movement Scale (AIMS) and chlorpromazine equivalents. RESULTS: In patients with schizophrenia, novelty-elicited MMN was unimpaired on admission, and there was a statistically significant reduction of the late MMN component with treatment. Improvements in symptom expression were associated with increased latencies of the early MMN component. CONCLUSION: Results indicate differences in information processing between conventional and novelty-elicited MMN. Some components of the novelty-elicited MMN might be more state dependent than those of the conventional MMN. PMID:11394193

  11. Selective, sustained, and shift in attention in patients with diagnoses of schizophrenia.

    PubMed

    Hagh-Shenas, H; Toobai, S; Makaremi, A

    2002-12-01

    Attentional deficits are a prominent aspect of cognitive dysfunction in schizophrenia. The present study was designed to investigate attention deficit in a group of patients with diagnosis of schizophrenia. According to the segmental set theory suggested by Hogarty and Flesher, three aspects of attention problems, selective, sustained, and shift in attention, were studied. The 30 patients hospitalized on three psychiatric wards at Shiraz and Isfahan and 30 normal healthy subjects matched for age, sex, and years of education were administered a computerized Continuous Performance Test, Stroop Color-word Test, and Wisconsin Card Sorting test. Analysis showed patients performed more poorly than control subjects on measured aspects of attention. The acute/chronic classification did not predict differences in attention scores between subtypes of schizophrenia, while the positive/negative classification did. Paranoid, undifferentiated, and residual groups by subtypes of schizophrenia showed similar performance on the Continuous Performance Test, but were significantly different on errors on the Wisconsin Card Sorting test and on reaction time to Stroop stimuli in the incongruent color-word condition. Patients with paranoid diagnosis performed better than other subtypes on these tasks. Present results suggest that the Continuous Performance Test is valuable for differentiating of schizophrenia spectrum disorder, while scores on Stroop and Wisconsin card sorting may have better diagnostic value for differentiating subtypes of the disorder.

  12. Therapeutic horseback riding for ACT patients with schizophrenia.

    PubMed

    Corring, Deborah; Lundberg, Erica; Rudnick, Abraham

    2013-02-01

    One form of psychiatric leisure rehabilitation which has only recently been explored for individuals with schizophrenia is Therapeutic Horseback Riding (THBR). This study is the first to examine THBR for Assertive Community Treatment (ACT) patients with schizophrenia. A sample of 6 ACT patients with schizophrenia or schizoaffective disorder who reside in the community and 6 mental health care staff participated in 10 weeks of weekly horseback riding sessions with an experienced THBR instructor. Participating patients, staff and the THBR instructor were qualitatively interviewed at the start, during and at the end of the THBR program and these semi-structured interviews were analyzed for recurrent themes. We found that THBR benefitted this group of patients. In spite of our study's limitations, such as its exploratory nature and the small sample size, it demonstrates that THBR has promise and should be further developed and studied for individuals with schizophrenia.

  13. [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.

  14. 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

  15. Crowding deficits in the visual periphery of schizophrenia patients.

    PubMed

    Kraehenmann, Rainer; Vollenweider, Franz X; Seifritz, Erich; Kometer, Michael

    2012-01-01

    Accumulating evidence suggests that basic visual information processing is impaired in schizophrenia. However, deficits in peripheral vision remain largely unexplored. Here we hypothesized that sensory processing of information in the visual periphery would be impaired in schizophrenia patients and, as a result, crowding - the breakdown in target recognition that occurs in cluttered visual environments - would be stronger. Therefore, we assessed visual crowding in the peripheral vision of schizophrenia patients and healthy controls. Subjects were asked to identify a target letter that was surrounded by distracter letters of similar appearance. Targets and distracters were displayed at 8° and 10° of visual angle from the fixation point (eccentricity), and target-distracter spacing was 2°, 3°, 4°, 5°, 6°, 7° or 8° of visual angle. Eccentricity and target-distracter spacing were randomly varied. Accuracy was defined as the proportion of correctly identified targets. Critical spacing was defined as the spacing at which target identification accuracy began to deteriorate, and was assessed at viewing eccentricities of 8° and 10°. Schizophrenia patients were less accurate and showed a larger critical spacing than healthy individuals. These results indicate that crowding is stronger and sensory processing of information in the visual periphery is impaired in schizophrenia. This is in line with previous reports of preferential magnocellular dysfunction in schizophrenia. Thus, deficits in peripheral vision may account for perceptual alterations and contribute to cognitive dysfunction in schizophrenia.

  16. Amisulpride for older patients with long-standing schizophrenia.

    PubMed

    Pridan, Shani; Baruch, Yehuda; Swartz, Marnina; Barak, Yoram

    2014-12-01

    A large and growing number of older people across the world experience schizophrenia. Recommendations for their treatment are largely based on data extrapolated from studies of the use of antipsychotic medications in younger populations. The present study was designed to evaluate the efficacy and safety of amisulpride monotherapy in a diagnostically homogeneous group of elderly patients without cognitive impairment experiencing schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for schizophrenia). Mortality and rehospitalization for a 5-year period were the predefined outcome measures. We conducted a retrospective chart review of all elderly (60 years and older) schizophrenia patients treated in a large tertiary care center. Of the 527 elderly schizophrenia patients for a 5-year period (2007-2013), 30 patients, mean (SD) age of 67.5 (5.8) years, were treated with amisulpride monotherapy. There were 19 women and 11 men in the analyzed group. Mean duration of disease was 34.4 years. All had been exposed to at least 3 first- and second-generation antipsychotics before amisulpride treatment. Amisulpride was very well tolerated by the patients, and mortality rate (10% vs 19%) was significantly lower than that of other first- and second-generation antipsychotics (P < 0.02). Rehospitalization rates with amisulpride were significantly lower than those with other second-generation antipsychotics (P < 0.001). We tentatively conclude that our preliminary results demonstrate that amisulpride is an efficacious and safe atypical antipsychotic for the treatment for elderly schizophrenia patients.

  17. 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

  18. Internalization of stigma and self-esteem as it affects the capacity for intimacy among patients with schizophrenia.

    PubMed

    Segalovich, Jenny; Doron, Adiel; Behrbalk, Pnina; Kurs, Rena; Romem, Pnina

    2013-10-01

    The study examines the relationship between internalization of stigma, self-esteem, and the ability of people diagnosed with schizophrenia to form intimate attachments with loved ones. The study included sixty patients with schizophrenia, ages 18-60, men and women. After providing informed consent, all participants completed four questionnaires: Demographics Questionnaire, Self-Esteem Scale, Internalized Stigma of Mental Illness Scale and the Intimacy Attitude Scale-Revised. Internalization of social stigma was found to be a statistically significant core factor that affects self-esteem and the ability to create intimacy among patients with schizophrenia. There was statistically significantly less internalization of stigma of mental illness among hospitalized patients than among individuals with schizophrenia who live in the community.

  19. 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 ...

  20. 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

  1. 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

  2. [Factor analysis on the intelligence of patients with schizophrenia].

    PubMed

    Hu, Z; Liu, X; Huo, K; Li, Y

    2000-03-01

    The authors made a factor analysis on the intelligence of patients with schizophrenia. 119 patients with schizophrenia were measured by Wechsler Adult Intelligence Scale-Revised China (WAIS-RC). The results revealed the average full intelligence quotient (IQ) of schizophrenia was 79.70, the verbal intelligence quotient(VIQ) 84.43, and the performance intelligence quotient(PIQ) 74.10. Multiple regression showed the regression coefficient of educational level for IQ was 8.6721. The regression coefficient of the course of disease for IQ was negative 0.1519. Factor analysis showed that the cumulative percent of three-factor solution of schizophrenia was 73.5. In conclusion, the IQ of most patients with schizophrenia was lower than norm, VIQ > PIQ(P = 0.0000). Educational level had greater influence on IQ. The longer the course of disease was, the worse the intelligence came to be. Factor analysis indicated that three-factor solution of schizophrenia was similar to that of norm, but each subtest value was lower than norm.

  3. Impact of oral antipsychotic medication adherence on healthcare resource utilization among schizophrenia patients with Medicare coverage.

    PubMed

    Offord, Steve; Lin, Jay; Wong, Bruce; Mirski, Dario; Baker, Ross A

    2013-12-01

    Nonadherence to antipsychotic medications is widespread and compromises the outcome of patients with schizophrenia. Using the MarketScan Medicare claims database, this study examined the impact of medication adherence on healthcare utilization among Medicare insured schizophrenia patients. The study population was separated into two cohorts defined by medication adherence, one with a medication possession ratio (MPR) ≥0.7 (high adherence) and the other with a MPR <0.7(low adherence). Of the 354 patients identified, 126 (36 %) had high adherence (mean ± SD MPR 0.94 ± 0.09) and 228 (64 %) had low adherence (MPR 0.24 ± 0.19). All cause hospitalizations (0.68 vs. 0.44; p = 0.015) and length of stay (LOS) (7.0 vs. 2.6 days; p = 0.005), and relapse hospitalizations (0.22 vs. 0.11; p = 0.028) and LOS (3.2 vs. 0.7 days; p = 0.027) were greater among patients with low adherence. Low adherent Medicare insured patients with schizophrenia require significantly more inpatient care and represent a patient population in which effective interventions are needed to improve disease management.

  4. 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

  5. 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

  6. Understanding the direct and indirect costs of patients with schizophrenia.

    PubMed

    Tajima-Pozo, Kazuhiro; de Castro Oller, María Jesús; Lewczuk, Adrian; Montañes-Rada, Francisco

    2015-01-01

    Background : Schizophrenia is a disabling mental disorder with high prevalence and that usually  requires long-term follow-up and expensive lifelong treatment. The cost of schizophrenia treatment consumes a significant amount of the health services' budget in western countries. Objective : The aim of the study was to find out about the costs related to schizophrenia across different european countries and compare them. Results : Schizophrenia treatment costs an estimated 18 billion euros annually worldwide. The direct costs associated with medical help are only part of the total expenditure. The indirect costs are an equally (or even more)important part of the total cost. These expenses are related to the lack of productivity of schizophrenic patients and the cost that relatives have to bear as a result of taking care of their affected relatives. Conclusions : Although data on the cost of schizophrenia may vary slightly between different european countries, the general conclusion that can be drawn is that schizophrenia is a very costly disorder. Not only because of direct costs related to medical procedures, but also due to the non-medical (indirect) costs. Together this suggests the need to investigate cost-efficient strategies that could provide a better outcome for schizophrenic patients, as well as the people who care for them. PMID:26339474

  7. 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

  8. 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

  9. 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,…

  10. 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

  11. 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

  12. 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

    2015-08-10

    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.

  13. 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)

  14. [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

  15. 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.

  16. Empathy in electrodermal responsive and nonresponsive patients with schizophrenia.

    PubMed

    Ikezawa, Satoru; Corbera, Silvia; Liu, Jiacheng; Wexler, Bruce E

    2012-12-01

    Skin conductance response (SCR) to emotion-evoking stimuli has in previous studies suggested the existence of two subgroups of schizophrenia patients. One is characterized by absent SCR and the other by heightened or non-habituating SCR. These subgroups have also been shown to differ in symptoms, prognosis and social integration. The present project compared social cognition in the two subgroups. SCR from 28 patients with schizophrenia and 24 matched healthy controls was measured while they watched emotion-evoking and neutral video tapes. Assessments of symptoms, neurocognition, social cognition, and social function were also performed. Event related potentials (ERP) were recorded in response to pictures of people experiencing pain or not. Subjects were divided into "SCR non-responder" and "SCR responder" groups based on SCR frequency. Schizophrenia SCR responders had significantly higher self-reported personal distress in response to others in distress and lower P300 ERP responses to others in pain than schizophrenia SCR non-responders and healthy controls. SCR responsiveness is a potential marker of subgroups of patients with schizophrenia that differ in pathophysiology, function and prognosis. PMID:23058162

  17. Oxytocin administration enhances controlled social cognition in patients with schizophrenia

    PubMed Central

    Woolley, J.D.; Chuang, B.; Lam, O.; Lai, W.; O’Donovan, A.; Rankin, K.P.; Mathalon, D.H.; Vinogradov, S.

    2014-01-01

    Summary Background Individuals with schizophrenia have functionally significant deficits in automatic and controlled social cognition, but no currently available pharmacologic treatments reduce these deficits. The neuropeptide oxytocin has multiple prosocial effects when administered intranasally in humans and there is growing interest in its therapeutic potential in schizophrenia. Methods We administered 40 IU of oxytocin and saline placebo intranasally to 29 male subjects with schizophrenia and 31 age-matched, healthy controls in a randomized, double-blind, placebo-controlled, cross-over study. Social cognition was assessed with The Awareness of Social Inference Test (TASIT) and the Reading the Mind in the Eyes Test (RMET). We examined the effects of oxytocin administration on automatic social cognition (the ability to rapidly interpret and understand emotional cues from the voice, face, and body); controlled social cognition (the ability to comprehend indirectly expressed emotions, thoughts, and intentions through complex deliberations over longer time periods); and a control task (the ability to comprehend truthful dialog and perform general task procedures) in individuals with and without schizophrenia using mixed factorial analysis of variance models. Results Patients with schizophrenia showed significant impairments in automatic and controlled social cognition compared to healthy controls, and administration of oxytocin significantly improved their controlled, but not automatic, social cognition, F(1, 58) = 8.75; p = 0.004. Conversely, oxytocin administration had limited effects on social cognition in healthy participants. Patients and controls performed equally well and there were no effects of oxytocin administration on the control task. Discussion Intact social cognitive abilities are associated with better functional outcomes in individuals with schizophrenia. Our data highlight the potentially complex effects of oxytocin on some but not all aspects of

  18. 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

  19. 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

  20. Spirituality, schizophrenia, and state hospitals: program description and characteristics of self-selected attendees of a spirituality therapeutic group.

    PubMed

    Revheim, Nadine; Greenberg, William M; Citrome, Leslie

    2010-12-01

    Spiritual matters can be an important part in the recovery process of patients with schizophrenia. A spirituality-based therapeutic group was developed for patients hospitalized on a research specialty unit jointly operated by a state hospital and a research institute. This report offers a description of this program and examines potential associations between spirituality and coping in patients with schizophrenia who either attended or did not attend the inpatient spirituality group. We compared group attendees (n = 20) with non-attendees (n = 20) cross-sectionally, using measures of spirituality, self-efficacy (i.e. the confidence in one's ability), quality of life, and hopefulness, and religious/personal demographic profiles. For the total sample, spirituality status was significantly correlated with self-efficacy for both social functioning and negative symptoms. Significant differences were found between group attendees and non-attendees for spirituality status, but not for self-efficacy or quality of life. For group attendees, spirituality status was significantly correlated with self-efficacy for positive symptoms, negative symptoms and social functioning. Group attendees were significantly more hopeful than non-attendees and hopefulness was significantly associated with degree of spirituality status. These findings lend support for offering spirituality groups and positive coping during recovery from psychiatric disabilities.

  1. The metabolic syndrome and risk of coronary artery disease in patients with chronic schizophrenia or schizoaffective disorder in a chronic mental institute.

    PubMed

    Tseng, Ping-Tao; Wang, Hung-Yu; Cheng, Yu-Shian; Shen, Feng-Chih; Lin, Pao-Yen; Wu, Ching-Kuan

    2014-11-01

    The prevalence rate of metabolic syndrome (MS) and coronary artery disease (CAD) has been found to be high in patients with chronic schizophrenia. Current evidence shows that CAD is underdiagnosed in this group. Our study evaluated the prevalence of MS and the risk of CAD in patients with chronic schizophrenia in a chronic care mental hospital in southern Taiwan. We included all patients with the diagnosis of schizophrenia or schizoaffective disorder. We collected all laboratory, physical examination, psychiatric interview, and chart review data. We also evaluated the risk of CAD in these patients using the Framingham point system. There was no significant age difference in the MS prevalence rate in these patients. The young patients with schizophrenia in our study tended to have a higher prevalence of MS than the general population. In addition, female patients had a higher prevalence rate of MS than males. Based on the Framingham point system, we found the 10-year risk of CAD to be higher among the patients with schizophrenia than in the general population. Our study highlights the importance of the high risk of MS in both younger and older patients with schizophrenia, without a significant relationship to the use of antipsychotics. More complete cohort studies are needed to confirm these findings. Psychiatrists may want to establish more specific and detailed clinical guidelines for patients with chronic schizophrenia with comorbid physical diseases, especially MS and CAD.

  2. 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

  3. Aberrant Effective Connectivity in Schizophrenia Patients during Appetitive Conditioning

    PubMed Central

    Diaconescu, Andreea Oliviana; Jensen, Jimmy; Wang, Hongye; Willeit, Matthäus; Menon, Mahesh; Kapur, Shitij; McIntosh, Anthony R.

    2010-01-01

    It has recently been suggested that schizophrenia involves dysfunction in brain connectivity at a neural level, and a dysfunction in reward processing at a behavioral level. The purpose of the present study was to link these two levels of analyses by examining effective connectivity patterns between brain regions mediating reward learning in patients with schizophrenia and healthy, age-matched controls. To this aim, we used functional magnetic resonance imaging and galvanic skin recordings (GSR) while patients and controls performed an appetitive conditioning experiment with visual cues as the conditioned (CS) stimuli, and monetary reward as the appetitive unconditioned stimulus (US). Based on explicit stimulus contingency ratings, conditioning occurred in both groups; however, based on implicit, physiological GSR measures, patients failed to show differences between CS+ and CS− conditions. Healthy controls exhibited increased blood-oxygen-level dependent (BOLD) activity across striatal, hippocampal, and prefrontal regions and increased effective connectivity from the ventral striatum to the orbitofrontal cortex (OFC BA 11) in the CS+ compared to the CS− condition. Compared to controls, patients showed increased BOLD activity across a similar network of brain regions, and increased effective connectivity from the striatum to hippocampus and prefrontal regions in the CS− compared to the CS+ condition. The findings of increased BOLD activity and effective connectivity in response to the CS− in patients with schizophrenia offer insight into the aberrant assignment of motivational salience to non-reinforced stimuli during conditioning that is thought to accompany schizophrenia. PMID:21267430

  4. Perceived social stigma, self-concept, and self-stigmatization of patient with schizophrenia.

    PubMed

    Karidi, Maria Veroniki; Stefanis, Costas N; Theleritis, Christos; Tzedaki, Maria; Rabavilas, Andreas D; Stefanis, Nicholas C

    2010-01-01

    The advent of community-based mental health care in Greece emphasized clinicians' need to understand patients' attitudes and their experience of their illness. A 42-item self-administered questionnaire (Self-Stigmatization Questionnaire) with flexible format was designed and administered to 150 outpatients with schizophrenia who fulfilled the criteria for inclusion in the vocational rehabilitation program where the study took place. The patients participated voluntarily. Multivariate regression models were applied to each item to assess the degree of patients' self-stigmatization experience as well as the effect of potential factors such as age, sex, psychopathologic condition, hospitalization, and duration of illness. The options selected by the patients revealed stigmatized attitudes in most items. The odds of selecting these options were mainly influenced by the severity of the patients' psychopathologic condition and the duration of illness and less by sex, age, and hospitalization.

  5. Siblings of Schizophrenia Patients At Greater Risk for Same Diagnosis: Study

    MedlinePlus

    ... medlineplus.gov/news/fullstory_161091.html Siblings of Schizophrenia Patients at Greater Risk for Same Diagnosis: Study ... People who have a brother or sister with schizophrenia are 10 times more likely to develop the ...

  6. 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

  7. 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

  8. Movement disorder profile and treatment outcomes in a one-year study of patients with schizophrenia

    PubMed Central

    Chen, Lei; Ascher-Svanum, Haya; Lawson, Anthony; Stauffer, Virginia L; Nyhuis, Allen; Haynes, Virginia; Schuh, Kory; Kinon, Bruce J

    2013-01-01

    Background This study identified subgroups of patients with schizophrenia who differed on their movement disorder profile and compared their treatment outcomes. Methods Data from a randomized, open-label, one-year study of patients with schizophrenia who were treated with antipsychotics in usual clinical care settings were analyzed (n = 640). Five measures of movement disorder were incorporated into a single Movement Disorder Index (MDI). Subgroups that differed in their movement disorder profile over the one-year study period were compared on clinical and functional outcomes. Results Three subgroups were identified: a worsening of MDI in 15% of patients, an improvement in 33%, and no change in 53%. Compared with the other two subgroups, the MDI-worsened subgroup had poorer symptom improvement measured by the Positive and Negative Syndrome Scale (PANSS) total score (mean changes of −11.0, −18.4, and −16.8 for the patients who had a worsening of MDI, no change, and an improvement, respectively), poorer symptom improvement on the PANSS positive and anxiety/depression subscale scores, worsening on the 36-Item Short Form Health Survey (SF-36) physical component summary score, and a higher rate of hospitalization (P < 0.05). Conclusion Patients with schizophrenia who experience worsening of their MDI score appear to have poorer clinical and functional outcomes, suggesting that such worsening may be a marker of poorer prognosis. PMID:23807848

  9. The clinical utility of lurasidone in schizophrenia: patient considerations.

    PubMed

    Harvey, Philip D

    2015-01-01

    Lurasidone is a novel antipsychotic agent approved for the treatment of schizophrenia in a number of countries including the United Kingdom, other European countries, the United States, and Canada. In addition to full antagonist activity at the dopamine D2 (Ki, 1 nM) and serotonin 5-HT2A (Ki, 0.5 nM) receptors, the pharmacodynamic profile of lurasidone is notable for its high affinity for serotonin 5-HT7 receptors (0.5 nM) and its partial agonist activity at 5-HT1A receptors (Ki, 6.4 nM). Long-term treatment of schizophrenia with lurasidone has been shown to reduce the risk of relapse in patients with schizophrenia. Lurasidone appears to be associated with minimal effects on body weight, and low risk for clinically meaningful alterations in glucose, lipids, or electrocardiography parameters. Evidence from two randomized trials also suggests improvement in functional capacity and cognitive functioning in people with schizophrenia. A significant evidence base supports the use of lurasidone as a promising agent for the treatment of schizophrenia.

  10. 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

  11. Training of affect recognition in schizophrenia patients with violent offences: behavioral treatment effects and electrophysiological correlates.

    PubMed

    Luckhaus, Christian; Frommann, Nicole; Stroth, Sanna; Brinkmeyer, Jürgen; Wölwer, Wolfgang

    2013-01-01

    Violent offenders with schizophrenia have a particularly poor performance level in facial affect recognition. Nineteen male schizophrenia patients, who had been committed to psychiatric hospital detention because of violent offences and lack of criminal responsibility, were recruited to receive the Training of Affect Recognition (TAR). Performance in the Pictures of Facial Affect (PFA)-test and event-related potentials (ERPs) were registered in a pre-post-treatment design. TAR was feasible with a very high treatment effect (Cohen's d = 1.88), which persisted for 2 months post-treatment. ERPs remained unchanged post- vs. pre-treatment, while low resolution brain electromagnetic tomography (LORETA) revealed activation decreases in left-hemispheric parietal-temporal-occipital regions at 172 msec and activation increases in right dorsolateral prefrontal cortex and anterior cingulate at 250 msec. Possibly, violent offenders with schizophrenia are particularly amenable to TAR because of a high level of dysfunction at baseline. Post- vs. pre-treatment changes of neural activity (LORETA) may mirror a gain of efficiency in structural face decoding and a shift towards a more reflective mode of emotional face decoding, relying on increased frontal brain activity. Functional magnetic resonance imaging (BOLD-fMRI) -data from another study further supports this notion. TAR treatment might enable subjects with schizophrenia and a disposition to violence to reach a higher degree of deliberation of their reactive behavior to facial affect stimuli.

  12. Time to rehospitalization in patients with schizophrenia discharged on first generation antipsychotics, non-clozapine second generation antipsychotics, or clozapine.

    PubMed

    Werneck, Ana Paula; Hallak, Jaime Cecilio; Nakano, Eduardo; Elkis, Helio

    2011-08-15

    Rehospitalization is an important outcome of drug effectiveness in schizophrenia. In this study, the hypothesis that clozapine and some second generation antipsychotics (SGA) were superior to first generation antipsychotics (FGA) in preventing rehospitalization of patients with schizophrenia discharged from a university hospital in Brazil was tested. A retrospective observational study was conducted designed to evaluate time to rehospitalization of patients with schizophrenia discharged on a regimen of oral FGA, depot FGA, risperidone, olanzapine and amisulpride, other SGA, or clozapine, during a three-year follow-up period. Risk factors associated with rehospitalization were examined. Of the 464 patients with schizophrenia discharged from hospital, 242 met criteria for study entry. Higher rehospitalization rates were observed in patients treated with depot FGA (30%), risperidone (30%) and other SGA groups (28.5%), respectively. Clozapine was significantly associated with lower rehospitalization risk compared with risperidone. The risk of rehospitalization in patients on olanzapine and amisulpride, and oral FGA, was similar to that of patients in use of clozapine. These results however, are limited by the heterogeneity of illness severity across the groups. PMID:21596442

  13. 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

  14. 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

  15. Schizophrenia

    MedlinePlus

    ... people with schizophrenia. Behavioral techniques, such as social skills training, can help the person function better in social and work situations. Job training and relationship-building classes are ...

  16. 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 ...

  17. Serious mental illness and acute hospital readmission in diabetic patients.

    PubMed

    Albrecht, Jennifer S; Hirshon, Jon Mark; Goldberg, Richard; Langenberg, Patricia; Day, Hannah R; Morgan, Daniel J; Comer, Angela C; Harris, Anthony D; Furuno, Jon P

    2012-01-01

    Patients with serious mental illness (SMI), particularly those with other chronic illnesses, may be vulnerable to unplanned hospital readmission. The authors hypothesized that SMI would be associated with increased 30-day hospital readmission in a cohort of adult patients with comorbid diabetes admitted to a tertiary care facility from 2005 to 2009. SMI was defined by International Classification of Diseases, Ninth Revision, discharge diagnosis codes for schizophrenia, schizoaffective, bipolar, manic, or major depressive disorders, or other psychosis. The primary outcome was 30-day readmission to the index hospital. Among 26 878 eligible admissions, the prevalence of SMI was 6% and the incidence of 30-day hospital admission was 16%. Among patients aged <35 years, SMI was significantly associated with decreased odds of 30-day hospital readmission (odds ratio [OR] = 0.39; 95% confidence interval [CI] = 0.17, 0.91). However, among patients ≥35 years, SMI was not significantly associated with 30-day hospital readmission (OR = 1.11; 95% CI = 0.86, 1.42). SMI may not be associated with increased odds of 30-day hospital readmission in this population.

  18. Serious mental illness and acute hospital readmission in diabetic patients.

    PubMed

    Albrecht, Jennifer S; Hirshon, Jon Mark; Goldberg, Richard; Langenberg, Patricia; Day, Hannah R; Morgan, Daniel J; Comer, Angela C; Harris, Anthony D; Furuno, Jon P

    2012-01-01

    Patients with serious mental illness (SMI), particularly those with other chronic illnesses, may be vulnerable to unplanned hospital readmission. The authors hypothesized that SMI would be associated with increased 30-day hospital readmission in a cohort of adult patients with comorbid diabetes admitted to a tertiary care facility from 2005 to 2009. SMI was defined by International Classification of Diseases, Ninth Revision, discharge diagnosis codes for schizophrenia, schizoaffective, bipolar, manic, or major depressive disorders, or other psychosis. The primary outcome was 30-day readmission to the index hospital. Among 26 878 eligible admissions, the prevalence of SMI was 6% and the incidence of 30-day hospital admission was 16%. Among patients aged <35 years, SMI was significantly associated with decreased odds of 30-day hospital readmission (odds ratio [OR] = 0.39; 95% confidence interval [CI] = 0.17, 0.91). However, among patients ≥35 years, SMI was not significantly associated with 30-day hospital readmission (OR = 1.11; 95% CI = 0.86, 1.42). SMI may not be associated with increased odds of 30-day hospital readmission in this population. PMID:22539798

  19. 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.

  20. Is Gray Matter Volume an Intermediate Phenotype for Schizophrenia? A VBM Study of Patients with Schizophrenia and their Healthy Siblings

    PubMed Central

    Honea, Robyn A.; Meyer-Lindenberg, Andreas; Hobbs, Katherine B.; Pezawas, Lukas; Mattay, Venkata S.; Egan, Michael F.; Verchinski, Beth; Passingham, Richard E.; Weinberger, Daniel R.; Callicott, Joseph H.

    2008-01-01

    Objective: Shared neuropathological characteristics of patients with schizophrenia and their siblings may represent intermediate phenotypes that could be used to investigate genetic susceptibility to the illness. We sought to discover previously unidentified gray matter volume differences in patients with schizophrenia and their siblings using optimized Voxel-Based Morphometry (VBM). Methods: We studied 169 patients with schizophrenia, 213 of their unaffected siblings, and 212 healthy volunteers from the CBDB/NIMH Genetic Study of Schizophrenia with magnetic resonance imaging (MRI). Results: Patients with schizophrenia had significant regional gray matter decreases in the frontal, temporal, and parietal cortices compared with healthy volunteers. Their unaffected siblings tended to share gray matter decreases in the medial frontal, superior temporal and insular cortices, but these decreases were not significant after correction for multiple comparisons, even when we looked at a subgroup of siblings with a past history of mood disorder. As an exploratory analysis, we estimated heritability using regions of interest from the VBM analysis, as well as from the hippocampus. Hippocampal volume was significantly correlated within sibling-pairs. Conclusions: Our findings confirm and extend previous VBM analyses in ill subjects with schizophrenia. Furthermore, these data argue that while siblings may share some regional gray matter decreases with their affected siblings, the pattern of regional differences may be a weak intermediate phenotype for schizophrenia. PMID:17689500

  1. Impact of sociodemographic and clinical factors on subjective quality of life in schizophrenia patients in Beijing, China.

    PubMed

    Xiang, Yu-Tao; Weng, Yong-Zhen; Leung, Chi-Ming; Tang, Wai-Kwong; Ungvari, Gabor S

    2007-10-01

    The impact of sociodemographic and clinical factors on subjective quality of life (SQOL) in Chinese schizophrenia outpatients was explored. Randomly selected subjects with schizophrenia (N = 273) were assessed with respect to their sociodemographic, clinical characteristics, and SQOL. Compared with the Chinese general population, patients had significantly lower scores in the physical and social SQOL domains. Multiple regression analyses revealed that depressive symptoms inversely predicted all SQOL domains; positive symptoms negatively predicted psychological, social, and environmental SQOL domains whereas educational level, extrapyramidal side effects, anxiety, history of suicide attempts, employment status, monthly income, number of hospitalization, and length of illness all significantly contributed to 1 or 2 SQOL domains.

  2. 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

  3. 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

  4. 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

  5. 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

  6. Serum testosterone differences between patients with schizophrenia and those with affective disorder.

    PubMed

    Mason, J W; Giller, E L; Kosten, T R

    1988-02-15

    Serum testosterone levels (ng/dl) were measured at 2-week intervals during the course of hospitalization in 35 male inpatients in the following four diagnostic groups: undifferentiated schizophrenia, paranoid schizophrenia, bipolar I disorder-manic, and major depressive disorder (endogenous type). The mean (+/- SE) testosterone levels during hospitalization were significantly higher (p less than 0.001) in the schizophrenic patients (510 +/- 38) than in the affective disorder patients (347 +/- 25). This difference persisted throughout hospitalization, being present in the first sample following admission (p less than 0.03) and the final sample before discharge (p less than 0.01). The above group differences were largely due to high testosterone levels in the paranoid schizophrenic subgroup (mean +/- SE level of 559 +/- 41). A longitudinal, as well as cross-sectional, view of the hormonal and clinical data suggests that the testosterone system is linked to both state and trait psychological factors, and this issue is discussed in the light of prior basic psychoendocrine research on this system. The potential application of these findings for new approaches to the development of biological criteria for psychiatric diagnosis is discussed.

  7. Deinstitutionalization and schizophrenia in Finland II: discharged patients and their psychosocial functioning.

    PubMed

    Honkonen, T; Saarinen, S; Salokangas, R K

    1999-01-01

    Three representative cohorts of schizophrenia patients deinstitutionalized from psychiatric hospitals in 1982, 1986, and 1990 were followed up for 3 years in Finland. Patients of the last cohort were older, more disturbed, and had been ill for a longer time than those discharged at the beginning of the 1980s. Despite this, the mortality of patients deinstitutionalized in 1990 did not increase, and their psychosocial functioning seemed to become even better during the 3-year follow-up period compared with those deinstitutionalized during the previous decade. Patients who had been discharged in 1990 were more often living alone than those discharged in the 1980s. Homelessness was rare throughout the study period. In general, patients were more satisfied with their life situation at follow-up compared with that on discharge. Furthermore, most patients were satisfied with their treatment situation. Altogether, the psychiatric care system seemed to be able to meet schizophrenia patients' need for care fairly well during the rapid deinstitutionalization process in Finland. More attention, however, should be paid to the loneliness and social withdrawal of discharged patients as well as to other disabilities in their social functioning.

  8. 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

  9. Hospital contacts with infection and risk of schizophrenia: a population-based cohort study with linkage of Danish national registers.

    PubMed

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

    2014-11-01

    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.

  10. 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

  11. Minor physical anomalies are more common in schizophrenia patients with the history of homicide.

    PubMed

    Tényi, Tamás; Halmai, Tamás; Antal, Albert; Benke, Bálint; Jeges, Sára; Tényi, Dalma; Tóth, Ákos Levente; Csábi, Györgyi

    2015-02-28

    Minor physical anomalies may be external markers of abnormal brain development, so the more common appearance of these signs in homicidal schizophrenia might suggest the possibility of a more seriously aberrant neurodevelopment in this subgroup. The aim of the present study was to investigate the rate and topological profile of minor physical anomalies in patients with schizophrenia with the history of committed or attempted homicide comparing them to patients with schizophrenia without homicide in their history and to normal control subjects. Using a list of 57 minor physical anomalies, 44 patients with the diagnosis of schizophrenia were examined with the history of committed or attempted homicide, as a comparison 22 patients with the diagnosis of schizophrenia without the history of any kind of homicide and violence and 21 normal control subjects were examined. Minor physical anomalies are more common in homicidal schizophrenia patients compared to non-homicidal schizophrenia patients and normal controls, which could support a stronger neurodevelopmental component of etiology in this subgroup of schizophrenia. The higher rate of minor physical anomalies found predominantly in the head and mouth regions in homicidal schizophrenia patients might suggest the possibility of a more seriously aberrant brain development in the case of homicidal schizophrenia.

  12. 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.

  13. 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

  14. 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.

  15. 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

  16. 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

  17. Eye movements of patients with schizophrenia in a natural environment.

    PubMed

    Dowiasch, Stefan; Backasch, Bianca; Einhäuser, Wolfgang; Leube, Dirk; Kircher, Tilo; Bremmer, Frank

    2016-02-01

    Alterations of eye movements in schizophrenia patients have been widely described for laboratory settings. For example, gain during smooth tracking is reduced, and fixation patterns differ between patients and healthy controls. The question remains, whether such results are related to the specifics of the experimental environment, or whether they transfer to natural settings. Twenty ICD-10 diagnosed schizophrenia patients and 20 healthy age-matched controls participated in the study, each performing four different oculomotor tasks corresponding to natural everyday behavior in an indoor environment: (I) fixating stationary targets, (II) sitting in a hallway with free gaze, (III) walking down the hallway, and (IV) visually tracking a target on the floor while walking straight-ahead. In all conditions, eye movements were continuously recorded binocularly by a mobile lightweight eye tracker (EyeSeeCam). When patients looked at predefined targets, they showed more fixations with reduced durations than controls. The opposite was true when participants were sitting in a hallway with free gaze. During visual tracking, patients showed a significantly greater root-mean-square error (representing the mean deviation from optimal) of retinal target velocity. Different from previous results on smooth-pursuit eye movements obtained in laboratory settings, no such difference was found for velocity gain. Taken together, we have identified significant differences in fundamental oculomotor parameters between schizophrenia patients and healthy controls during natural behavior in a real environment. Moreover, our data provide evidence that in natural settings, patients overcome some impairments, which might be present only in laboratory studies, by as of now unknown compensatory mechanisms or strategies.

  18. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    PubMed

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department. PMID:26338391

  19. [Satisfaction of hospitalized patients in a hospital in Apurimac, Peru].

    PubMed

    Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro

    2015-01-01

    In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.

  20. Abnormal contextual modulation of visual contour detection in patients with schizophrenia.

    PubMed

    Schallmo, Michael-Paul; Sponheim, Scott R; Olman, Cheryl A

    2013-01-01

    Schizophrenia patients demonstrate perceptual deficits consistent with broad dysfunction in visual context processing. These include poor integration of segments forming visual contours, and reduced visual contrast effects (e.g. weaker orientation-dependent surround suppression, ODSS). Background image context can influence contour perception, as stimuli near the contour affect detection accuracy. Because of ODSS, this contextual modulation depends on the relative orientation between the contour and flanking elements, with parallel flankers impairing contour perception. However in schizophrenia, the impact of abnormal ODSS during contour perception is not clear. It is also unknown whether deficient contour perception marks genetic liability for schizophrenia, or is strictly associated with clinical expression of this disorder. We examined contour detection in 25 adults with schizophrenia, 13 unaffected first-degree biological relatives of schizophrenia patients, and 28 healthy controls. Subjects performed a psychophysics experiment designed to quantify the effect of flanker orientation during contour detection. Overall, patients with schizophrenia showed poorer contour detection performance than relatives or controls. Parallel flankers suppressed and orthogonal flankers enhanced contour detection performance for all groups, but parallel suppression was relatively weaker for schizophrenia patients than healthy controls. Relatives of patients showed equivalent performance with controls. Computational modeling suggested that abnormal contextual modulation in schizophrenia may be explained by suppression that is more broadly tuned for orientation. Abnormal flanker suppression in schizophrenia is consistent with weaker ODSS and/or broader orientation tuning. This work provides the first evidence that such perceptual abnormalities may not be associated with a genetic liability for schizophrenia.

  1. 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.…

  2. 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…

  3. Psychological Distress and Violence Towards Parents of Patients with Schizophrenia.

    PubMed

    Kageyama, Masako; Solomon, Phyllis; Yokoyama, Keiko

    2016-10-01

    The present study investigated the relationship between violence and psychological distress experienced by parents of patients with schizophrenia. Questionnaire data from 379 parents were analyzed. A total of 151 parents (39.8%) had not experienced violence in the past year, whereas 96 (25.3%) and 132 (34.8%) had experienced psychological violence only or physical violence, respectively. A total of 216 (57.0%) of parents reported being psychologically distressed. Multiple logistic regression revealed that the risk of psychological distress significantly increased with the experience of psychological and physical violence, lower household income, greater family stigma, and the increasing age of patients.

  4. Psychological Distress and Violence Towards Parents of Patients with Schizophrenia.

    PubMed

    Kageyama, Masako; Solomon, Phyllis; Yokoyama, Keiko

    2016-10-01

    The present study investigated the relationship between violence and psychological distress experienced by parents of patients with schizophrenia. Questionnaire data from 379 parents were analyzed. A total of 151 parents (39.8%) had not experienced violence in the past year, whereas 96 (25.3%) and 132 (34.8%) had experienced psychological violence only or physical violence, respectively. A total of 216 (57.0%) of parents reported being psychologically distressed. Multiple logistic regression revealed that the risk of psychological distress significantly increased with the experience of psychological and physical violence, lower household income, greater family stigma, and the increasing age of patients. PMID:27654247

  5. 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

  6. 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

  7. 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.

  8. 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

  9. 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

  10. Secretin in a patient with treatment-resistant schizophrenia and prominent autistic features.

    PubMed

    Alamy, Sayed S; Jarskog, L Fredrik; Sheitman, Brian B; Lieberman, Jeffrey A

    2004-02-01

    Secretin, a gastrointestinal (GI) peptide, may offer therapeutic benefit in autism. Autistic features can also be present in schizophrenia and a recent study suggested a role for adjunctive secretin in treatment-resistant schizophrenia. The current report describes one patient with undifferentiated schizophrenia and prominent autistic features who received a single dose of secretin and demonstrated substantial yet transient improvement. The case illustrates the potential role of secretin as a novel adjunctive treatment strategy in schizophrenic patients with autistic features.

  11. A brief neuropsychological testing battery for evaluating patients with schizophrenia.

    PubMed

    Savage, Robert M; Jackson, Warren T; Sourathathone, Choun M

    2003-06-01

    Current conceptualizations of schizophrenia include neurocognitive impairment, particularly in aspects of attention, memory, and executive functioning. Evaluation of these cognitive abilities typically involves use of comprehensive batteries which may take up to six hours to complete. The current study examined the effectiveness of a briefer battery to detect cognitive impairments usually seen in schizophrenia as established by previous studies using more lengthy and labor intensive protocols. The current study involved 61 outpatients with schizophrenia who were separated into three subgroups: paranoid type (n = 20), undifferentiated type (n = 21), and schizoaffective (n = 20). The majority of the patients were male (61%), African-American (52%), and of low socio-economic status. The mean age was 41.4 years (SD = 8.8), and the mean years of education was 11.7 (SD = 6.8). For the overall sample, results revealed mild to moderate impairments in memory, construction, concept formation, response set maintenance, psychomotor speed, and visual speed of information processing. Post-hoc analyses revealed significant differences between subgroups on Similarities and psychomotor speed, with the undifferentiated group performing more poorly than the paranoid or schizoaffective groups. In conclusion, the current brief battery minimized respondent burden in terms of both time demands and level of task complexity. However, it was also sensitive enough to capture many of the same cognitive weaknesses as those reported when using more labor-intensive neuropsychological test protocols.

  12. 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

  13. 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

  14. 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.

  15. Hyperkalaemia in patients in hospital.

    PubMed

    Moore, M L; Bailey, R R

    1989-10-25

    A survey of all laboratory blood specimens with a plasma potassium concentration greater than or equal to 5.5 mmol/L was conducted over a three month period. Of 331 specimens with hyperkalaemia, 71 were excluded because the specimens was haemolysed, old or contaminated. The laboratory served a population of 348,561 and during this time measured the plasma potassium on 25,016 occasions. Sixty-six outpatients and 20 neonates were not evaluated. The survey was undertaken on 86 of 102 inpatients (46 males), 48 of whom were over 66 years of age. Fifty-seven patients were admitted under a medical service and 29 under a surgical service. Fifty-nine had a single episode of hyperkalaemia. Thirty-two underwent a surgical procedure. The commonest contributing factor was impaired renal function which was present in 71 (83%) patients. Although a definitive causative role for drugs could be identified in only five patients, in 52 (60%) patients drugs were a contributing factor (potassium supplements 24, ACE inhibitors 16, nonsteroidal antiinflammatory drugs 12). Thirty-five of the 86 (41%) patients died during their hospital admission. Nineteen of the 35 deaths occurred within three days of the hyperkalaemia being recorded. A normal plasma potassium was eventually documented in 50 of the 86 patients. Of the remaining 36 patients, 25 (69%) subsequently died. In general the treatment of patients with hyperkalaemia focused on identifying and treating the underlying cause. Hyperkalaemia must always be considered seriously and regard given to the overall clinical status of the patient, with particular attention to drug therapy, renal and cardiac function, acid base status and the possibility of sepsis.

  16. 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

  17. Socioaffective factors modulate working memory in schizophrenia patients.

    PubMed

    Park, S; Gibson, C; McMichael, T

    2006-04-28

    Working memory deficit in schizophrenia is a core cognitive feature of the disorder and is reliably associated with abnormalities of the prefrontal circuitry. Working memory deficits are also associated with impaired social functioning and present a major obstacle toward successful rehabilitation in schizophrenia. Although the role of prefrontal cortex in working memory has been extensively investigated, the intricate relations among the prefrontal circuitry, working memory and social behaviors are not clearly understood. In this study, we manipulated social context and observed its effects on spatial working memory. In experiment 1, the effects of social and asocial reinforcements on spatial working memory were examined in schizophrenic patients and healthy controls. The results show that social but not asocial reinforcements facilitated spatial working memory in schizophrenic patients. In experiment 2, the effects of human voice reinforcements (with or without affect) on working memory was investigated. Voice reinforcements did not facilitate working memory relative to the no-reinforcement condition. There was no difference between high-affect vs flat-affect voice conditions. In experiment 3, the effects of direct and indirect social interactions on spatial working memory were studied. Direct but not indirect social interaction facilitated working memory in schizophrenic patients. These results suggest that social context might facilitate working memory in schizophrenic patients perhaps by activating frontal lobe systems. In addition, the possibility of improving cognitive functions such as working memory using seemingly non-cognitive methods might lead to potential remediation strategies.

  18. 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.

  19. 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

  20. Effects of smoking during antipsychotic withdrawal in patients with chronic schizophrenia.

    PubMed

    Apud, J A; Egan, M F; Wyatt, R J

    2000-12-15

    A number of studies have shown that patients with schizophrenia smoke more than other psychiatric patients and more than the general population. Also, medicated schizophrenics who smoke present more positive symptoms of schizophrenia than non-smokers. The objective of the present study was to assess the effect of smoking on ratings of psychopathology for 30 days following discontinuation of antipsychotic medication. The subjects were 101 treatment-resistant patients with schizophrenia who had been admitted to the inpatient service of Neuroscience Research Hospital (NRH), National Institute of Mental Health, between 1982 and 1994 to undergo studies involving discontinuation of antipsychotic medication. Patients were rated independently on a daily basis on the 22-item Psychiatric Symptom Assessment Scale (PSAS), an extended version of the Brief Psychiatric Rating Scale (BPRS). At baseline, ratings for Verbal Positive, Paranoia and Loss of Function were higher in smokers (n=65) than non-smokers (n=36), but a statistically significant difference was observed only for the Verbal Positive cluster. Analysis by gender revealed that male non-smokers had the lowest psychopathology ratings at baseline. There were no differences in Anxiety/depression, Behavior Positive, Deficit Symptoms or Mannerisms (a measure for abnormal involuntary movements). Following medication discontinuation, repeated-measure analysis demonstrated a 'time' effect for all the variables studied and a 'group' (smokers vs. non-smokers) effect for Verbal Positive, Paranoia, and Loss of Function. Post-hoc comparisons at individual time points showed significantly higher ratings for smokers at week 1 for Paranoia. No differences were observed at later time points. In conclusion, at baseline, smokers had more positive symptoms and were apparently more functionally impaired than non-smokers. This difference was no longer evident after a 30 day medication discontinuation period.

  1. Emotional prosody modulates attention in schizophrenia patients with hallucinations

    PubMed Central

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

    2012-01-01

    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

  2. Benzodiazepines, benzodiazepine-like drugs, and typical antipsychotics impair manual dexterity in patients with schizophrenia.

    PubMed

    Sasayama, Daimei; Hori, Hiroaki; Teraishi, Toshiya; Hattori, Kotaro; Ota, Miho; Matsuo, Junko; Kinoshita, Yukiko; Okazaki, Mitsutoshi; Arima, Kunimasa; Amano, Naoji; Higuchi, Teruhiko; Kunugi, Hiroshi

    2014-02-01

    Impaired dexterity is a major psychomotor deficit reported in patients with schizophrenia. In the present study, the Purdue pegboard test was used to compare the manual dexterity in patients with schizophrenia and healthy controls. We also examined the influence of antipsychotics, benzodiazepines, and benzodiazepine-like drugs on manual dexterity. Subjects were 93 patients with schizophrenia and 93 healthy controls, matched for sex and age distributions. Control subjects scored significantly higher on all scores of Purdue pegboard than patients with schizophrenia. Age, PANSS negative symptom scale, typical antipsychotic dose, and use of benzodiazepines and/or benzodiazepine-like drugs were negatively correlated with the pegboard scores in patients with schizophrenia. The present results indicate that patients with schizophrenia have impaired gross and fine fingertip dexterity compared to healthy controls. The use of typical antipsychotics and benzodiazepines and/or benzodiazepine-like drugs, but not atypical antipsychotics, had significant negative impact on dexterity in patients with schizophrenia. Psychiatrists should be aware that some psychotropic medications may enhance the disability caused by the impairment of dexterity in patients with schizophrenia.

  3. 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…

  4. 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

  5. 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

  6. [Social functioning of patients with schizophrenia: a follow-up study].

    PubMed

    Górna, K; Rybakowski, J

    1995-01-01

    The subject of this study was evaluation of social functioning of schizophrenic patients after a period of ten to twenty years of follow-up. 70 patients (29 men and 41 women) selected from the initial group of 303 patients (181 men and 122 women), with the diagnosis of schizophrenia were studied. They had been admitted for the first time to the Hospital for Mental and Nervous Diseases in Gniezno in the years 1975-76. Examinations were carried in household environment (interviews with patients and their relatives), based on of a standardized questionnaire. In the examination, six realms of social activity were considered: professional occupation, home occupation, self independence, participation in family life, care for a child, social relations and interests. The level of social functioning in the examined group of 70 schizophrenic patients several years after the first psychiatric hospitalization has been found satisfactory in 57% patients. Women were functioning better, especially in the scope of participation in family life and fulfilment of home duties. Better level of social functioning was related to lower family history of mental illness, lower degree of invalidization, activity attitude towards the illness and positive self evaluation of the state of health, advantageous family situation, better fulfilment of social needs and lower family burden caused by the patient. PMID:8577903

  7. A Computerized Hospital Patient Information Management System

    PubMed Central

    Wig, Eldon D.

    1982-01-01

    The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.

  8. 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

  9. 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

  10. 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

  11. 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).

  12. 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…

  13. [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.

  14. No difference in the prevalence of cavum septum pellucidum (CSP) between first-episode schizophrenia patients, offspring of schizophrenia patients and healthy controls.

    PubMed

    Rajarethinam, Rajaprabhakaran; Sohi, Jasdeep; Arfken, Cynthia; Keshavan, Matcheri S

    2008-08-01

    The reported prevalence of cavum septum pellucidum (CSP), is extremely variable (from 0.1% to 85%) depending upon the measurement method or imaging resolution. Higher prevalence of CSP has been found in schizophrenia. In this study, we examined the prevalence of CSP in a large number of first-episode schizophrenia patients, young relatives of schizophrenia patients and healthy controls. We manually measured CSP using 1.5 mm T1 MRI scans from ongoing studies at University of Pittsburgh in 89 first-episode patients with schizophrenia (age=23.8+/-7.4, M/F=61/28), 64 genetically at-risk individuals (offspring and siblings of schizophrenia patients, age 15.2+/-3.7, M/F=29/32) and 120 comparison subjects (n=120, age=22.1+/-7.9, M/F62/50). CSP was present in 64% of the first-episode patients (mean length 1.87+/-2.3 mm), 64.6% of the at-risk individuals (1.64+/-1.96 mm) and 64.2% of the normal controls (1.88+/-2.0 mm). There was no difference in the prevalence of CSP exceeding 4 mm. We also did not find any influence of the sex or age in the presence or size of CSP. Our data cast doubt on the significance of CSP as markers of neurodevelopmental pathology in schizophrenia.

  15. 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

  16. 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

  17. Improving quality of care among patients hospitalised with schizophrenia: a nationwide initiative

    PubMed Central

    Mainz, Jan; Svendsen, Marie Louise; Nordentoft, Merete; Voldsgaard, Inge; Baandrup, Lone; Bartels, Paul; Johnsen, Søren Paaske

    2015-01-01

    Background The effectiveness of systematic quality improvement initiatives in psychiatric care remains unclear. Aims To examine whether quality of care has changed following implementation of a systematic monitoring programme of hospital performance measures. Method In a nationwide population-based cohort study, we identified 14 228 patients admitted to psychiatric departments between 2004 and 2011 from The Danish Schizophrenia Registry. The registry systematically monitors the adherence to guideline recommended processes of care. Results The overall proportion of all relevant recommended processes of care increased from 64 to 76% between 2004 and 2011. The adherence to individual processes of care increased over time, including assessment of psychopathology using a diagnostic interview (relative risk (RR): 2.01, 95% CI: 1.51–2.68), contact with relatives (RR: 1.44, 95% CI: 1.27–1.62), psychoeducation (RR: 1.33, 95% CI: 1.19–1.48), psychiatric aftercare (RR: 1.06, 95% CI: 1.01–1.11) and suicide risk assessment (RR: 1.31, 95% CI: 1.21–1.42). Conclusions Quality of care improved from 2004 to 2011 among patients hospitalised with schizophrenia in Denmark. Declaration of interest None. Copyright and usage © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.

  18. Predictors of social cognition in patients with schizophrenia.

    PubMed

    Mirabilio, Daniela; Di Tommaso, Silvia; Riccardi, Ilaria; Marinelli, Massimo; Daneluzzo, Enrico; Stratta, Paolo; D'Albenzio, Luigi; Rossi, Alessandro

    2006-12-01

    The goal of this study is to explore neurocognitive, clinical and community functioning variables in order to predict "social reasoning" in a sample of patients with a diagnosis of schizophrenic disorder. Cognitive and community functioning, and social reasoning have been evaluated, together with the Positive and Negative Syndromes Scale (PANSS) and DSM-IV Global Assessment of Functioning (GAF), in a sample of 46 patients who met the DSM-IV criteria for schizophrenia. Our findings show that global functioning as reflected by GAF is the strongest predictor of the social reasoning as evaluated by the Wason's Selection Task (WST). Other community functioning variables such as the Life Skills Profile (LSP) sub-scores do not provide significant prediction of social reasoning. Similarly, neurocognitive measures, in terms of attention and contextual reasoning, have no predictive effect on social reasoning. Our findings show that social cognition should be considered as an additional cognitive domain more related to functional outcome.

  19. Antipsychotic monotherapy and adjuvant psychotropic therapies in schizophrenia patients: effect on time to readmission.

    PubMed

    Valevski, Avi; Gilat, Yaron; Olfson, Mark; Benaroya-Milshtein, Noa; Weizman, Abraham

    2012-05-01

    This study assessed the relationship between pharmacological regimens at hospital discharge and hospital readmission among schizophrenia patients. The records reviewed were all consecutive admissions (N=720) from a specific catchment area during the period 1991-2005. Two main groups were selected for analysis: the first group (N=537) included patients discharged with first-generation antipsychotics (FGA), and the second group (N=183) included patients with second-generation antipsychotics (SGA). Data on clinical and demographic characteristics at discharge, including a brief psychiatric rating scale and pharmacological treatment, were collected. The rate of readmission within 12 months was analyzed in relation to the specific pharmacological treatment at discharge. There was no significant difference in the risk of readmission in patients treated with SGA compared with FGA. Adjuvant psychotropic medications to either FGA or SGA did not attenuate the risk of readmission. The readmission rate in patients treated with clozapine (N=74) was significantly lower in comparison with depot FGA (N=293) medications (P=0.016). There was no advantage of SGA over FGA, with or without adjuvant psychotropic treatment, with regard to rehospitalization risk during the 12-month follow-up. Clozapine was found to reduce the risk for readmission in comparison with depot FGA. PMID:22466059

  20. 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…

  1. Neurocognitive functioning in parents of schizophrenia patients: Attentional and executive performance vary with genetic loading.

    PubMed

    Schulze-Rauschenbach, Svenja; Lennertz, Leonhard; Ruhrmann, Stephan; Petrovsky, Nadine; Ettinger, Ulrich; Pukrop, Ralf; Dreher, Jan; Klosterkötter, Joachim; Maier, Wolfgang; Wagner, Michael

    2015-12-30

    Neuropsychological deficits are candidate endophenotypes of schizophrenia which can assist to explain the neurocognitive impact of genetic risk variants. The identification of endophenotypes is often based on the familiality of these phenotypes. Several studies demonstrate neuropsychological deficits in unaffected biological relatives of schizophrenia patients without differentiating between genetic and non-genetic factors underlying these deficits. We assessed N=129 unaffected biological parents of schizophrenia patients, N=28 schizophrenia patients (paranoid subtype), and N=143 controls without a family history of schizophrenia with an extensive neuropsychological test battery. Direct comparison of N=22 parents with an ancestral history of schizophrenia (more likely carriers, MLC) and N=17 of their spouses without such a history (less likely carriers, LLC) allowed the separation of genetic and non-genetic aspects in cognition. Overall, parents showed significant deficits in neuropsychological tasks from all cognitive domains with medium effect sizes. Direct comparisons of MLC- and LLC-parents showed that attentional and executive tasks were most strongly affected by genetic loading. To conclude, unaffected parents of schizophrenia patients showed modest yet significant impairments in attention, memory, and executive functioning. In particular, attentional and executive impairments varied most strongly with genetic loading for schizophrenia, prioritising these dysfunctions for genotype-endophenotype analyses.

  2. 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…

  3. Spanish validation of the Brief Assessment in Cognition in Schizophrenia (BACS) in patients with schizophrenia and healthy controls.

    PubMed

    Segarra, N; Bernardo, M; Gutierrez, F; Justicia, A; Fernadez-Egea, E; Allas, M; Safont, G; Contreras, F; Gascon, J; Soler-Insa, P A; Menchon, J M; Junque, C; Keefe, R S E

    2011-03-01

    Neurocognitive impairment is a core feature of schizophrenia and is closely associated with functional outcome. The importance of cognitive assessment is broadly accepted today, and an easy-to-use, internationality validated cognitive assessment tool is needed by researchers and in daily clinical practice. The Brief Assessment of Cognition in Schizophrenia (BACS) has been validated in English, French, Japanese and Italian. It is as sensitive to cognitive dysfunction as a standard test battery, with the advantage of requiring less than 35minutes to complete. In our study, we tested the psychometric characteristics of a Spanish version of the BACS in 117 patients with schizophrenia-spectrum disorders and 36 healthy controls. All BACS cognitive subtests discriminated between patients and controls (P<.001), and the concurrent validity between the BACS and a traditional neuropsychological test battery was similar to that reported in other languages. We conclude that the BACS can facilitate the comparison of the cognitive performance of patients with schizophrenia in many different countries. PMID:20435446

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. Eight-Year Trends of Cardiometabolic Morbidity and Mortality in Patients with Schizophrenia

    PubMed Central

    Morden, Nancy E.; Lai, Zongshan; Goodrich, David E.; MacKenzie, Todd; McCarthy, John F.; Austin, Karen; Welsh, Deborah E.; Bartels, Stephen; Kilbourne, Amy M.

    2012-01-01

    Objective We examined cardiometabolic disease and mortality over eight years among individuals with and without schizophrenia. Method We compared 65,362 patients in the Veteran Affairs (VA) health system with schizophrenia to 65,362 VA patients without serious mental illness (non-SMI) matched on age, service access year, and location. The annual prevalence of diagnosed cardiovascular disease, diabetes, dyslipidemia, hypertension, obesity, and all-cause and cause-specific mortality were compared for fiscal years 2000–2007. Mean years of potential life lost (YPLL) was calculated annually. Results The cohort was mostly male (88%) with a mean age of 54 years. Cardiometabolic disease prevalence increased in both groups with non-SMI patients having higher disease prevalence in most years. Annual between-group differences ranged from < 1% to 6%. Annual mortality was stable over time for schizophrenia (3.1%) and non-SMI patients (2.6%). Annual mean YPLL increased from 12.8 to 15.4 in schizophrenia and from 11.8 to 14.0 for non-SMI groups. Conclusions VA patients with and without schizophrenia show increasing but similar prevalence rates of cardiometabolic diseases. YPLLs were high in both groups and only slightly higher among patients with schizophrenia. Findings highlight the complex population served by the VA while suggesting a smaller mortality impact from schizophrenia than previously reported. PMID:22516216

  9. Atypical antipsychotic use is an independent predictor for the increased mean platelet volume in patients with schizophrenia: A preliminary study

    PubMed Central

    Semiz, Murat; Yücel, Hasan; Kavakçı, Önder; Yıldırım, Osman; Zorlu, Ali; Yılmaz, Mehmet Birhan; Küçükdurmaz, Zekeriya; Canan, Fatih

    2013-01-01

    Background: Cardiovascular diseases, cardiovascular risk factors, and mortality due to these situations are more frequently encountered in schizophrenic patients when compared with the general population. The mean platelet volume (MPV) is a surrogate biomarker of the platelet activity and an useful prognostic test in cardiometabolic diseases. The aim of this study was to investigate what influenced MPV levels in patients with schizophrenia. Materials and Methods: We evaluated hospital records of 60 hospitalized schizophrenia patients. Thirty age- and sex-matched healthy control subjects were also included as a control group. Results: MPV levels were significantly higher in patients who were on atypical antipsychotic drugs than in patients who were not using any drug (9.2 ± 0.8 vs. 8.6 ± 0.8 fL, P = 0.016) and also higher than control group (9.2 ± 0.8 vs. 8.1 ± 0.9 fL, P < 0.001). Furthermore, patients who were not using antipsychotics had higher MPV than control group (8.6 ± 0.8 vs. 8.1 ± 0.9 fL, P = 0.036). Atypical antipsychotic use [Odds ratio (OR) =6.152, 95% confidence interval (CI,) P = 0.003)] and platelet distribution width (OR = 0.989, 95% CI, P = 0.032) were associated with high MPV levels in univariate analysis. In multivariate logistic regression model, only atypical antipsychotics use (OR = 6.152, 95% CI, P = 0.003) was found to be independent predictor of high MPV levels after adjustment of other potential confounders (age, gender, presence of hypertension, diabetes mellitus, hyperlipidemia, and smoking). Conclusion: MPV seems to be influenced not only by schizophrenia itself but also by atypical antipsychotic drugs. It might be concluded that schizophrenic patients are under increased risk for cardiometabolic diseases and risk factors and this risk is higher in patients on atypical antipsychotic treatment. PMID:24516487

  10. Discharging patients from acute care hospitals.

    PubMed

    Goodman, Helen

    2016-02-10

    Planning for patient discharge is an essential element of any admission to an acute setting, but may often be left until the patient is almost ready to leave hospital. This article emphasises why discharge planning is important and lists the essential principles that should be addressed to ensure that patients leave at an optimum time, feeling confident and safe to do so. Early assessment, early planning and co-ordination of all the teams involved in the patient's care are essential. Effective communication between the various teams and with the patient and their family or carer(s) is necessary. Patients should leave hospital with all the information, medications and equipment they require. Appropriate plans should have been developed and communicated to the receiving community or non-acute team. When patient discharge is effective, complications as a result of extended lengths of hospital stay are prevented, hospital beds are used efficiently and readmissions are reduced.

  11. Facial affect recognition in symptomatically remitted patients with schizophrenia and bipolar disorder.

    PubMed

    Yalcin-Siedentopf, Nursen; Hoertnagl, Christine M; Biedermann, Falko; Baumgartner, Susanne; Deisenhammer, Eberhard A; Hausmann, Armand; Kaufmann, Alexandra; Kemmler, Georg; Mühlbacher, Moritz; Rauch, Anna-Sophia; Fleischhacker, W Wolfgang; Hofer, Alex

    2014-02-01

    Both schizophrenia and bipolar disorder (BD) have consistently been associated with deficits in facial affect recognition (FAR). These impairments have been related to various aspects of social competence and functioning and are relatively stable over time. However, individuals in remission may outperform patients experiencing an acute phase of the disorders. The present study directly contrasted FAR in symptomatically remitted patients with schizophrenia or BD and healthy volunteers and investigated its relationship with patients' outcomes. Compared to healthy control subjects, schizophrenia patients were impaired in the recognition of angry, disgusted, sad and happy facial expressions, while BD patients showed deficits only in the recognition of disgusted and happy facial expressions. When directly comparing the two patient groups individuals suffering from BD outperformed those with schizophrenia in the recognition of expressions depicting anger. There was no significant association between affect recognition abilities and symptomatic or psychosocial outcomes in schizophrenia patients. Among BD patients, relatively higher depression scores were associated with impairments in both the identification of happy faces and psychosocial functioning. Overall, our findings indicate that during periods of symptomatic remission the recognition of facial affect may be less impaired in patients with BD than in those suffering from schizophrenia. However, in the psychosocial context BD patients seem to be more sensitive to residual symptomatology.

  12. Effectiveness and cost of atypical versus typical antipsychotic treatment in a nationwide cohort of patients with schizophrenia in Germany.

    PubMed

    Stargardt, Tom; Edel, Marc-Andreas; Ebert, Andreas; Busse, Reinhard; Juckel, Georg; Gericke, Christian A

    2012-10-01

    This study investigates the effectiveness and cost of typical versus atypical antipsychotics in a nationwide German cohort of patients with schizophrenia. The study sample consisted of patients insured with 4 sickness funds (n = 8,610) who were followed up for 12 months after hospital discharge with a diagnosis of schizophrenia in 2003. Multivariate regression models were fitted to assess the relationship between outcome variables (rehospitalization, bed-days, prescriptions against adverse effects, cost) and medication type, sex, age, and severity. Severity was assessed by prior bed-days due to schizophrenia during 2000 to 2002. Risk of rehospitalization did not differ between groups but within each group severity (P = 0.0003). Males (P = 0.0016) and patients younger than 35 years (P < 0.0001) had a higher risk of rehospitalization. Number of bed-days was lower for treatment with typicals compared with atypicals (P < 0.0001); furthermore, bed-days depended on severity of disease (P < 0.0001). Prescriptions of drugs against extrapyramidal symptoms, anxiety, and agitation were higher for patients treated with typicals (P < 0.0001 for each). Mean predicted treatment cost per year was € 6442 for atypicals versus € 4443 for typicals (P < 0.0001). This study does not support unconditional superiority of atypicals over typicals, neither in terms of effectiveness nor in terms of cost. PMID:22926592

  13. David Shakow and schizophrenia research at Worcester State Hospital: the roots of the scientist-practitioner model.

    PubMed

    Cautin, Robin L

    2008-01-01

    As Chief Psychologist and Director of Psychological Research at Worcester State Hospital (WSH), David Shakow (1901-1981) made substantial contributions to the scientific study of schizophrenia and by extension to the study of psychopathology in general. His methodological innovations--particularly on issues of diagnosis and conditions of testing-set a new standard for experimental rigor in the field. Shakow helped to establish many of what are considered basic facts about schizophrenia. His empirical work at WSH-specifically on the crossover effect--provided the scientific foundation for his theory of schizophrenic cognition, known as segmental set. Moreover, Shakow's schizophrenia work informed his developing ideas on the synergy between clinical practice and research.

  14. 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.

  15. 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

  16. 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

  17. 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

  18. Facial emotion perception in Chinese patients with schizophrenia and non-psychotic first-degree relatives.

    PubMed

    Li, Huijie; Chan, Raymond C K; Zhao, Qing; Hong, Xiaohong; Gong, Qi-Yong

    2010-03-17

    Although there is a consensus that patients with schizophrenia have certain deficits in perceiving and expressing facial emotions, previous studies of facial emotion perception in schizophrenia do not present consistent results. The objective of this study was to explore facial emotion perception deficits in Chinese patients with schizophrenia and their non-psychotic first-degree relatives. Sixty-nine patients with schizophrenia, 56 of their first-degree relatives (33 parents and 23 siblings), and 92 healthy controls (67 younger healthy controls matched to the patients and siblings, and 25 older healthy controls matched to the parents) completed a set of facial emotion perception tasks, including facial emotion discrimination, identification, intensity, valence, and corresponding face identification tasks. The results demonstrated that patients with schizophrenia performed significantly worse than their siblings and younger healthy controls in accuracy in a variety of facial emotion perception tasks, whereas the siblings of the patients performed as well as the corresponding younger healthy controls in all of the facial emotion perception tasks. Patients with schizophrenia also showed significantly reduced speed than younger healthy controls, while siblings of patients did not demonstrate significant differences with both patients and younger healthy controls in speed. Meanwhile, we also found that parents of the schizophrenia patients performed significantly worse than the corresponding older healthy controls in accuracy in terms of facial emotion identification, valence, and the composite index of the facial discrimination, identification, intensity and valence tasks. Moreover, no significant differences were found between the parents of patients and older healthy controls in speed after controlling the years of education and IQ. Taken together, the results suggest that facial emotion perception deficits may serve as potential endophenotypes for schizophrenia.

  19. Platelet parameters (PLT, MPV, P-LCR) in patients with schizophrenia, unipolar depression and bipolar disorder.

    PubMed

    Wysokiński, Adam; Szczepocka, Ewa

    2016-03-30

    There are no studies comparing platelet parameters platelet parameters (platelet count (PLT), mean platelet volume (MPV) and platelet large cell ratio (P-LCR)) between patients with schizophrenia, bipolar disorder and unipolar depression. Therefore, the aim of this study was to determine and compare differences in PLT, MPV and P-LCR in patients with schizophrenia, unipolar depression and bipolar disorder. This was a retrospective, cross-sectional, naturalistic study of 2377 patients (schizophrenia n=1243; unipolar depression n=791; bipolar disorder n=343, including bipolar depression n=259 and mania n=84). There were significant differences for PLT, MPV and P-LCR values between study groups. A significant percentage of patients with bipolar disorder had abnormal (too low or too high) number of platelets. Negative correlation between PLT and age was found in all study groups and positive correlation between age and MPV and P-LCR was found in patients with schizophrenia.

  20. 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

  1. Neural correlates of planning performance in patients with schizophrenia--relationship with apathy.

    PubMed

    Liemburg, Edith J; Dlabac-De Lange, Jozarni J L A S; Bais, Leonie; Knegtering, Henderikus; van Osch, Matthias J P; Renken, Remco J; Aleman, André

    2015-02-01

    Patients with schizophrenia often suffer from apathy: a quantitative reduction of voluntary, goal-directed behaviors that impairs daily functioning. We hypothesized that schizophrenia patients with high levels of apathy would show decreased activation in brain regions involved in planning and goal-directed behavior. Patients with schizophrenia or psychotic spectrum disorder (n=47) and healthy controls (n=20) performed the Tower of London (ToL) task during fMRI scanning using arterial spin labeling. To investigate the relationship between apathy and planning in patients, a proxy measure of apathy based on the Positive and Negative syndrome Scale was regressed against the task-related brain activation. Brain activation was also compared between patients and healthy controls. Higher levels of apathy were associated with less task-related activation within the inferior parietal lobule precuneus and thalamus. Compared to controls, patients showed lower activation in lateral prefrontal regions, parietal and motor areas, and a higher activation of medial frontal areas. Apathy was related to abnormal activation in thalamus and parietal regions during the ToL task. This supports the hypothesis that impaired function of brain regions involved in planning and goal-directed behavior may underlie apathy in schizophrenia. Moreover, impaired lateral prefrontal activation in schizophrenia patients compared to controls is consistent with the hypofrontality model of schizophrenia. In contrast, stronger medial frontal activation in patients may be related to increased effort to perform a task with conflicting task solutions.

  2. 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

  3. Early visual processing deficits in patients with schizophrenia during spatial frequency-dependent facial affect processing.

    PubMed

    Kim, Do-Won; Shim, Miseon; Song, Myeong Ju; Im, Chang-Hwan; Lee, Seung-Hwan

    2015-02-01

    Abnormal facial emotion recognition is considered as one of the key symptoms of schizophrenia. Only few studies have considered deficits in the spatial frequency (SF)-dependent visual pathway leading to abnormal facial emotion recognition in schizophrenia. Twenty-one patients with schizophrenia and 19 matched healthy controls (HC) were recruited for this study. Event-related potentials (ERP) were measured during presentation of SF-modulated face stimuli and their source imaging was analyzed. The patients showed reduced P100 amplitude for low-spatial frequency (LSF) pictures of fearful faces compared with the HC group. The P100 amplitude for high-spatial frequency (HSF) pictures of neutral faces was increased in the schizophrenia group, but not in the HC group. The neural source activities of the LSF fearful faces and HSF neutral faces led to hypo- and hyperactivation of the frontal lobe of subjects from the schizophrenia group and HC group, respectively. In addition, patients with schizophrenia showed enhanced N170 activation in the right hemisphere in the LSF condition, while the HC group did not. Our results suggest that deficits in the LSF-dependent visual pathway, which involves magnocellular neurons, impair early visual processing leading to dysfunctional facial emotion recognition in schizophrenia. Moreover, it suggests impaired bottom-up processing rather than top-down dysfunction for facial emotion recognition in these patients.

  4. 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

  5. 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…

  6. Latex allergies - for hospital patients

    MedlinePlus

    ... hospital; Contact dermatitis - latex allergy; Allergy - latex; Allergic reaction - latex ... You can have a reaction to latex if your skin, mucous membranes (eyes, mouth, or other moist areas), or bloodstream (during surgery) come into contact ...

  7. Factors influencing warfarin response in hospitalized patients

    PubMed Central

    Abdel-Aziz, Mahmoud I.; Ali, Mostafa A. Sayed; Hassan, Ayman K.M.; Elfaham, Tahani H.

    2015-01-01

    The objective of this study was to investigate the influence of simultaneous factors that potentially keep patients far from achieving target INR range at discharge in hospitalized patients. Prospective cross-sectional observational study conducted at the Cardiology Department and Intensive Care Unit (ICU) of the Assiut University Hospitals. One-hundred and twenty patients were enrolled in the study from July 2013 to January 2014. Outcome measures were discharge INRs, bleeding and thromboembolic episodes. Bivariate analysis and multinomial logistic regression were conducted to determine independent risk factors that can keep patients outside target INR range. Patients who were newly initiated warfarin on hospital admission were given low initiation dose (2.8 mg ± 0.9). They were more likely to have INR values below 1.5 during hospital stay, 13 (27.7%) patients compared with 9 (12.3%) previously treated patients, respectively (p = .034). We found that the best predictors of achieving below target INR range relative to within target INR range were; shorter hospital stay periods (OR, 0.82 for every day increase [95% CI, 0.72–0.94]), being a male patient (OR, 2.86 [95% CI, 1.05–7.69]), concurrent infection (OR, 0.21 [95% CI, 0.07–0.59]) and new initiation of warfarin therapy on hospital admission (OR, 3.73 [95% CI, 1.28–10.9]). Gender, new initiation of warfarin therapy on hospital admission, shorter hospital stay periods and concurrent infection can have a significant effect on discharge INRs. Initiation of warfarin without giving loading doses increases the risk of having INRs below 1.5 during hospital stay and increases the likelihood of a patient to be discharged with INR below target range. Following warfarin dosing nomograms and careful monitoring of the effect of various factors on warfarin response should be greatly considered. PMID:26702259

  8. 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.

  9. 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

  10. 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

  11. 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

  12. Increased morbid risk for schizophrenia-related disorders in relatives of schizotypal personality disordered patients.

    PubMed

    Siever, L J; Silverman, J M; Horvath, T B; Klar, H; Coccaro, E; Keefe, R S; Pinkham, L; Rinaldi, P; Mohs, R C; Davis, K L

    1990-07-01

    To evaluate whether probands from a clinical sample diagnosed as having DSM-III schizotypal and/or paranoid personality disorder have a familial relationship to the schizophrenia-related disorders, the morbid risk for schizophrenia-related disorders and other psychiatric disorders were evaluated in the first-degree relatives of patients with schizotypal and/or paranoid personality disorder and compared with the corresponding risk for these disorders in the first-degree relatives of patients with other non-schizophrenia-related personality disorders. The morbid risk for all schizophrenia-related disorders, and specifically for schizophrenia-related personality disorders, was significantly greater among the relatives of the probands with schizotypal and/or paranoid personality disorder than among the relatives of probands with other personality disorder. The morbid risk for other psychiatric disorders did not differ significantly between the first-degree relatives of the schizotypal/paranoid personality disorder and the other personality disorder control proband samples. These results suggest a specific familial association between schizophrenia-related disorders, particularly schizophrenia-related personality disorders, and clinically diagnosed schizotypal patients.

  13. 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

  14. Internalized stigma among patients with schizophrenia in Ethiopia: a cross-sectional facility-based study

    PubMed Central

    2012-01-01

    Background Despite the potential impact on treatment adherence and recovery, there is a dearth of data on the extent and correlates of internalized stigma in patients with schizophrenia in low income countries. We conducted a study to determine the extent, domains and correlates of internalized stigma amongst outpatients with schizophrenia in Ethiopia. Methods The study was a cross-sectional facility-based survey conducted at a specialist psychiatric hospital in Addis Ababa, Ethiopia. Consecutive consenting individuals with a diagnosis of schizophrenia were recruited and assessed using an Amharic version of the Internalized Stigma of Mental Illness (ISMI) scale. Results Data were collected from 212 individuals, who were mostly single (71.2%), unemployed (70.3%) and male (65.1%). Nearly all participants (97.4%) expressed agreement to at least one stigma item contained in the ISMI; 46.7% had a moderate to high mean stigma score. Rural residence (OR = 5.67; 95% CI = 2.30, 13.00; p < 0.001), single marital status (OR = 3.39; 95% CI = 1.40, 8.22; p = 0.019) and having prominent psychotic symptoms (OR = 2.33; 95% CI = 1.17, 4.61; p = 0.016) were associated independently with a higher stigma score. Almost half of those who discontinued their treatment reported that they had done so because of perceived stigma. Those who had attempted suicide (45.3%) were more likely to have a high stigma score (OR = 2.29; 95% CI = 1.27, 4.11; p = 0.006). Over 60% of the variation in the experience of stigma was explained by four factors: social withdrawal (16.7%), perceived discrimination (14.1%), alienation (13.9%) and stereotype endorsement (12.7%). Conclusion Internalized stigma is a major problem among persons with schizophrenia in this outpatient setting in Ethiopia. Internalized stigma has the potential to substantially affect adherence to medication and is likely to affect the recovery process. PMID:23272796

  15. Temporal lobe structures and facial emotion recognition in schizophrenia patients and nonpsychotic relatives.

    PubMed

    Goghari, Vina M; Macdonald, Angus W; Sponheim, Scott R

    2011-11-01

    Temporal lobe abnormalities and emotion recognition deficits are prominent features of schizophrenia and appear related to the diathesis of the disorder. This study investigated whether temporal lobe structural abnormalities were associated with facial emotion recognition deficits in schizophrenia and related to genetic liability for the disorder. Twenty-seven schizophrenia patients, 23 biological family members, and 36 controls participated. Several temporal lobe regions (fusiform, superior temporal, middle temporal, amygdala, and hippocampus) previously associated with face recognition in normative samples and found to be abnormal in schizophrenia were evaluated using volumetric analyses. Participants completed a facial emotion recognition task and an age recognition control task under time-limited and self-paced conditions. Temporal lobe volumes were tested for associations with task performance. Group status explained 23% of the variance in temporal lobe volume. Left fusiform gray matter volume was decreased by 11% in patients and 7% in relatives compared with controls. Schizophrenia patients additionally exhibited smaller hippocampal and middle temporal volumes. Patients were unable to improve facial emotion recognition performance with unlimited time to make a judgment but were able to improve age recognition performance. Patients additionally showed a relationship between reduced temporal lobe gray matter and poor facial emotion recognition. For the middle temporal lobe region, the relationship between greater volume and better task performance was specific to facial emotion recognition and not age recognition. Because schizophrenia patients exhibited a specific deficit in emotion recognition not attributable to a generalized impairment in face perception, impaired emotion recognition may serve as a target for interventions.

  16. 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

  17. 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

  18. Good's Syndrome Patients Hospitalized for Infections

    PubMed Central

    Sun, Xuefeng; Shi, Juhong; Wang, Mengzhao; Xu, Kaifeng; Xiao, Yi

    2015-01-01

    Abstract Good's syndrome (GS) is a rare combination of thymoma and hypogammaglobulinemia, resulting in immunodeficiency. Patients with GS are highly susceptible to bacterial infection, particularly encapsulated bacterial infection in upper and lower respiratory tracts. Good's syndrome patients with moderate-to- severe infection are often hospitalized. Clinical features of GS patients remain to be characterized. Patients with the discharge diagnosis of GS and simultaneous infection from Peking Union Medical College Hospital between January 2001 and July 2015 were retrospectively analyzed. Among 14 hospitalized GS patients, 12 of them were admitted for severe infections. Mean patient age was 56.7 + 10.1 years. Average concentrations of serum IgG, IgA, and IgM were 2.3 + 1.9 g/L, 0.28 + 0.28 g/L, and 0.06 + 0.07 g/L, respectively. Respiratory and intestinal tracts were the most common sites for infection, which occurred in 7 and 4 patients, respectively. Pathogens identified in 10 patients included cytomegalovirus in 5 patients, Pneumocystis jirovecii, Clostridium difficile in 2 patients, Klebsiella pneumonia in 2 patients, and Streptococcus pneumonia and Hemophilus influenza in 1 patient. Ten patients were treated with antibiotics and immunoglobulin replacement. Only 1 patient who was on immunosuppressant therapy died from P. jirovecii pneumonia. Infection was the most frequent cause for hospitalization of GS patients. Both respiratory and intestinal tracts were the most common sites of infection. Cytomegalovirus and P. jirovecii represented 2 common opportunistic pathogens isolated from hospitalized GS patients with infections. PMID:26632723

  19. Effects of the Nursing Psychoeducation Program on the Acceptance of Medication and Condition-Specific Knowledge of Patients with Schizophrenia.

    PubMed

    Matsuda, Mitsunobu; Kohno, Ayumi

    2016-10-01

    The objective of this study was to evaluate the clinical utility of the nursing psychoeducation program (NPE) for improving the acceptance of medication of inpatients with schizophrenia as well as their knowledge regarding their illness and the effects of medication on it. This study was a quasi-experimental study involving a convenience sample and was performed at the acute treatment units of two Japanese psychiatric hospitals. The subjects were recruited from among the inpatients being treated at the acute treatment units and were assigned to either the experimental or control group. The experimental group took part in the NPE, and the control group received the standard treatments for schizophrenia. Data were collected using structured questionnaires; i.e., the Medication Perception Scale for Patients with Schizophrenia (MPS), Drug Attitude Inventory-10 Questionnaire (DAI-10), and Knowledge of Illness and Drugs Inventory. Forty-three patients (13 men and 30 women) agreed in writing to participate in this study. During pre-/postintervention comparisons, the total MPS score, the 'efficacy of medication' subscale score, and the total DAI-10 score exhibited significant group×time interactions.

  20. Effects of the Nursing Psychoeducation Program on the Acceptance of Medication and Condition-Specific Knowledge of Patients with Schizophrenia.

    PubMed

    Matsuda, Mitsunobu; Kohno, Ayumi

    2016-10-01

    The objective of this study was to evaluate the clinical utility of the nursing psychoeducation program (NPE) for improving the acceptance of medication of inpatients with schizophrenia as well as their knowledge regarding their illness and the effects of medication on it. This study was a quasi-experimental study involving a convenience sample and was performed at the acute treatment units of two Japanese psychiatric hospitals. The subjects were recruited from among the inpatients being treated at the acute treatment units and were assigned to either the experimental or control group. The experimental group took part in the NPE, and the control group received the standard treatments for schizophrenia. Data were collected using structured questionnaires; i.e., the Medication Perception Scale for Patients with Schizophrenia (MPS), Drug Attitude Inventory-10 Questionnaire (DAI-10), and Knowledge of Illness and Drugs Inventory. Forty-three patients (13 men and 30 women) agreed in writing to participate in this study. During pre-/postintervention comparisons, the total MPS score, the 'efficacy of medication' subscale score, and the total DAI-10 score exhibited significant group×time interactions. PMID:27654241

  1. 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

  2. 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

    2016-02-17

    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.

  3. Associations between components of metabolic syndrome and cognition in patients with schizophrenia.

    PubMed

    Goughari, Ali S; Mazhari, Shahrzad; Pourrahimi, Ali M; Sadeghi, Mohammad M; Nakhaee, Nouzar

    2015-05-01

    The metabolic syndrome and cognitive dysfunctions are common in patients with schizophrenia, yet there is no general consensus concerning the effects of the components of the metabolic syndrome on various cognitive domains. The goal of this study was to investigate the relationship between components of the metabolic syndrome and cognition in patients with schizophrenia. Components of the metabolic syndrome and neurocognitive functioning were assessed in 68 patients with schizophrenia. The Brief Assessment of Cognition in Schizophrenia (BACS) was used to assess neurocognition. Hyperglycemia and hypertension were the only components of the metabolic syndrome found to be associated with cognitive functioning. Patients with schizophrenia who were hypertensive showed cognitive impairments in 2 domains, with a negative association found between hypertension and verbal memory (P=0.047) and verbal fluency (P=0.007). Hyperglycemia was associated with higher scores on verbal memory (P=0.01) and verbal fluency (P<0.001). It appears that medical treatment of certain components of the metabolic syndrome could affect cognitive performance in patients with schizophrenia.

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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

  12. Disrupted action monitoring in recent-onset psychosis patients with schizophrenia and bipolar disorder

    PubMed Central

    Minzenberg, Michael J.; Gomes, Glenn C.; Yoon, Jong H.; Swaab, Tamara Y.; Carter, Cameron S.

    2014-01-01

    Schizophrenia patients experience cognitive control disturbances, manifest in altered neural signatures during action monitoring. It remains unclear whether error- and conflict-monitoring disturbances co-occur, and whether they are observed in recent-onset psychosis patients with schizophrenia or bipolar disorder. We tested electrophysiological measures of action monitoring in these patients. 73 schizophrenia patients (SZ), 26 bipolar disorder type I patients (BP), each within one year of psychosis onset, and 54 healthy control subjects (HC) underwent EEG during Stroop task performance. In the trial-averaged EEG at three midline scalp electrodes, the error-related negativity (ERN), error positivity (Pe) and conflict-related N450 were measured. Compared to HC, 1) SZ exhibited an attenuated ERN and N450, and Pe unchanged, and 2) BP exhibited an attenuated ERN but normal Pe and N450. Between patient groups, SZ showed an attenuated N450; ERN and Pe were not significantly different. A small (n=10) SZ subgroup that was not receiving antipsychotic medication showed normal ERPs. Altered error- and conflict-monitoring occur together in first-episode schizophrenia patients, and these measures are comparable in patients with first-episode bipolar disorder. Antipsychotic medication may be associated with altered measures of error-monitoring in schizophrenia. PMID:24314907

  13. Proactive response inhibition abnormalities in the sensorimotor cortex of patients with schizophrenia

    PubMed Central

    Mayer, Andrew R.; Hanlon, Faith M.; Dodd, Andrew B.; Yeo, Ronald A.; Haaland, Kathleen Y.; Ling, Josef M.; Ryman, Sephira G.

    2016-01-01

    Background Previous studies of response inhibition in patients with schizophrenia have focused on reactive inhibition tasks (e.g., stop-signal, go/no-go), primarily observing lateral prefrontal cortex abnormalities. However, recent studies suggest that purposeful and sustained (i.e., proactive) inhibition may also be affected in these patients. Methods Patients with chronic schizophrenia and healthy controls underwent fMRI while inhibiting motor responses during multisensory (audiovisual) stimulation. Resting state data were also collected. Results We included 37 patients with schizophrenia and 37 healthy controls in our study. Both controls and patients with schizophrenia successfully inhibited the majority of overt motor responses. Functional results indicated basic inhibitory failure in the lateral premotor and sensorimotor cortex, with opposing patterns of positive (schizophrenia) versus negative (control) activation. Abnormal activity was associated with independently assessed signs of psychomotor retardation. Patients with schizophrenia also exhibited unique activation of the pre–supplementary motor area (pre-SMA)/SMA and precuneus relative to baseline as well as a failure to deactivate anterior nodes of the default mode network. Independent resting-state connectivity analysis indicated reduced connectivity between anterior (task results) and posterior regions of the sensorimotor cortex for patients as well as abnormal connectivity between other regions (cerebellum, thalamus, posterior cingulate gyrus and visual cortex). Limitations Aside from rates of false-positive responses, true proactive response inhibition tasks do not provide behavioural metrics that can be independently used to quantify task performance. Conclusion Our results suggest that basic cortico-cortico and intracortical connections between the sensorimotor cortex and adjoining regions are impaired in patients with schizophrenia and that these impaired connections contribute to inhibitory

  14. The prevalence of antinuclear antibodies in patients with schizophrenia spectrum disorders: results from a large cohort study

    PubMed Central

    van Mierlo, Hans C; de Witte, Lot; Derksen, Ronald HWM; Otten, Henny G

    2015-01-01

    Background: An increased prevalence of autoantibodies has been found in patients with schizophrenia, suggesting a role for autoimmunity in schizophrenia pathogenesis. Methods: We examined the presence of antinuclear antibodies (ANAs), with further determination of specific antibodies, in 368 patients with a schizophrenia spectrum disorder and 283 healthy controls. Results: No significant difference in prevalence of ANAs between patients (8%) and controls (11%) was found. Conclusion: We did not find an association between ANAs and schizophrenia spectrum disorders. We discuss potential reasons for the discrepancy with some previous studies, such as inclusion of patients using chlorpromazine, which can induce ANAs. PMID:27336030

  15. Structural Brain Abnormalities in Patients with Schizophrenia and 22q11 Deletion Syndrome

    PubMed Central

    Chow, Eva W.C.; Zipursky, Robert B.; Mikulis, David J.; Bassett, Anne S.

    2012-01-01

    Background 22q11 Deletion Syndrome is a genetic syndrome associated with an increased risk for developing schizophrenia. Brain abnormalities have been reported in 22q11 Deletion Syndrome, but little is known about whether differences in brain structure underlie the psychotic disorders associated with this syndrome. In the current study, we used magnetic resonance imaging to characterize the structural brain abnormalities found in adults who have both 22q11 Deletion Syndrome and schizophrenia. Methods Magnetic resonance imaging brain scans of 14 adults (7 male, 7 female) with 22q11 Deletion Syndrome and schizophrenia and 14 age- and gender-matched healthy volunteers were analyzed to derive measures of gray matter, white matter, and cerebrospinal fluid. Differences between the two groups were tested using student t tests. Results 22q11 Deletion Syndrome and schizophrenia subjects had significantly smaller total gray matter volume (t = 2.88, p < .01) and larger lateral ventricles (t = 4.08, p < .001) than healthy controls. Gray matter deficits were most prominent in the frontal and temporal lobes. Total white matter volumes did not differ between the two groups. Conclusions Findings from this 22q11 Deletion Syndrome and schizophrenia study are similar to those reported in other patients with schizophrenia, but only partially consistent with those reported in nonpsychotic children with 22q11 Deletion Syndrome. 22q11 Deletion Syndrome may provide a valuable genetic neurodevelop-mental model for investigating the relationship between abnormalities in brain development and the expression of schizophrenia. PMID:11839363

  16. Improving recreational, residential, and vocational outcomes for patients with schizophrenia.

    PubMed

    Roder, V; Zorn, P; Müller, D; Brenner, H D

    2001-11-01

    As Roder and colleagues propose, we have seen three eras in the development and refinement of social skills training for individuals with schizophrenia. In the 1960s, skills training relied on the use of operant conditioning, as exemplified by the token economy. Reinforcement contingencies succeeded in activating patients with negative symptoms and in improving their social behavior. Contemporary psychiatric rehabilitation can profit from the identification and use of reinforcers to motivate anergic individuals who lack insight to participate actively in community-based programs. During the second era, in the 1970s, social learning through modeling, coaching, role playing, and behavioral assignments was introduced into skills training. These techniques were used to improve nonverbal skills, such as eye contact, fluency of speech, gestures, and facial expression, as well as conversational skills, assertiveness, and emotional expressiveness. Intervention programs of the third and current era are incorporating cognitive methods into the skills training enterprise. For example, in the modules for training social and independent living skills developed and validated by Liberman and his colleagues at the University of California at Los Angeles (1), the deficits in attention, memory, and verbal learning often experienced by persons with schizophrenia are overcome by repetition, shaping of incremental behavioral improvements, video modeling, and feedback for galvanizing attention. Procedural learning techniques that do not rely on the brain capacities that mediate verbal awareness and insight are also used. In this month's Rehab Rounds column, Roder and his colleagues present another example of a skills training approach of the third era that includes elements of cognitive remediation. As autonomous offsprings of integrated psychological therapy (IPT), which was originally developed by Hans Brenner and Volker Roder and their colleagues at the University of Bern in

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. Aberrant Interference of Auditory Negative Words on Attention in Patients with Schizophrenia

    PubMed Central

    Iwashiro, Norichika; Yahata, Noriaki; Kawamuro, Yu; Kasai, Kiyoto; Yamasue, Hidenori

    2013-01-01

    Previous research suggests that deficits in attention-emotion interaction are implicated in schizophrenia symptoms. Although disruption in auditory processing is crucial in the pathophysiology of schizophrenia, deficits in interaction between emotional processing of auditorily presented language stimuli and auditory attention have not yet been clarified. To address this issue, the current study used a dichotic listening task to examine 22 patients with schizophrenia and 24 age-, sex-, parental socioeconomic background-, handedness-, dexterous ear-, and intelligence quotient-matched healthy controls. The participants completed a word recognition task on the attended side in which a word with emotionally valenced content (negative/positive/neutral) was presented to one ear and a different neutral word was presented to the other ear. Participants selectively attended to either ear. In the control subjects, presentation of negative but not positive word stimuli provoked a significantly prolonged reaction time compared with presentation of neutral word stimuli. This interference effect for negative words existed whether or not subjects directed attention to the negative words. This interference effect was significantly smaller in the patients with schizophrenia than in the healthy controls. Furthermore, the smaller interference effect was significantly correlated with severe positive symptoms and delusional behavior in the patients with schizophrenia. The present findings suggest that aberrant interaction between semantic processing of negative emotional content and auditory attention plays a role in production of positive symptoms in schizophrenia. (224 words) PMID:24376662

  4. 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

  5. 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.

  6. Soluble Urokinase-Type Plasminogen Activator Receptor Levels in Patients With Schizophrenia

    PubMed Central

    Nielsen, Jimmi; Røge, Rasmus; Pristed, Sofie Gry; Viuff, Anne Grethe; Ullum, Henrik; Thørner, Lise Wegner; Werge, Thomas; Vang, Torkel

    2015-01-01

    Background: The etiology of schizophrenia remains largely unknown but alterations in the immune system may be involved. In addition to the psychiatric symptoms, schizophrenia is also associated with up to 20 years reduction in life span. Soluble urokinase-type plasminogen activator receptor (suPAR) is a protein that can be measured in blood samples and reflects the levels of inflammatory activity. It has been associated with mortality and the development of type 2 diabetes and cardiovascular disease. Methods: suPAR levels in patients with schizophrenia were compared to healthy controls from the Danish Blood Donor Study. SuPAR levels were dichotomized at >4.0 ng/ml, which is considered the threshold for low grade inflammation. A multiple logistic regression model was used and adjusted for age, sex, and current smoking. Results: In total we included 1009 subjects, 105 cases with schizophrenia (10.4%) and 904 controls (89.6%). The mean suPAR values were 4.01 ng/ml (SD = 1.43) for the cases vs 1.91 ng/ml (SD = 1.35) for the controls (P < .001). Multiple logistic regression with odds ratio (OR) for suPAR levels >4.0 ng/ml yielded: schizophrenia, OR: 46.15 95% CI 22.69–93.87, P < .001; age, OR: 1.02 95% CI 0.99–1.02, P = .15; male sex, OR: 0.70 95% CI 0.35–1.36, P = .29; and current smoking, OR: 3.51 95% CI 1.78–6.94, P < .001. Conclusions: Patients with schizophrenia had significantly higher suPAR levels than healthy controls. Further studies are warranted to clarify if elevated suPAR levels are involved in the pathophysiology of schizophrenia and/or the increased mortality found in patients with schizophrenia. PMID:25154621

  7. The effect of deviance predictability on mismatch negativity in schizophrenia patients.

    PubMed

    Horacek, Magdalena; Kärgel, Christian; Scherbaum, Norbert; Müller, Bernhard W

    2016-03-23

    Mismatch negativity (MMN) is an electrophysiological index of prediction error processing and recently has been considered an endophenotype marker in schizophrenia. While the prediction error is a core concept in the MMN generation, predictability of deviance occurrence has rarely been assessed in MMN research and in schizophrenia patients. We investigated the MMN to 12% temporally predictable or unpredictable duration decrement deviant stimuli in two runs in 29 healthy controls and 31 schizophrenia patients. We analyzed MMN amplitudes and latencies and its associations with clinical symptoms at electrode Fz. With a stimulus onset asynchronicity of 500 ms in the regular predictable condition, a deviant occurred every 4s while it varied randomly in the unpredictable condition. In the random condition we found diminished MMN amplitudes in patients which normalized in the regular deviance condition, resulting in an analysis of variance main effect of predictability and a predictability x group interaction. Deviance predictability did not affect the MMN of control subjects and we found no relevant results with regard to MMN latencies. Our results indicate that MMN amplitudes in patients normalize to the level of the control subjects in the case of a temporally fixed regular deviant. In schizophrenia patients the detection of deviance is basically intact. However, the temporal uncertainty of deviance occurrence may be of substantial relevance to the highly replicated MMN deficit in schizophrenia patients.

  8. Me, myself and I: temporal dysfunctions during self-evaluation in patients with schizophrenia.

    PubMed

    Pauly, Katharina D; Kircher, Tilo T J; Schneider, Frank; Habel, Ute

    2014-11-01

    Self-concept is deeply affected in schizophrenia. Positive symptoms in particular are related to disturbed self/other distinctions. The neural networks underlying self-evaluation in schizophrenia have barely been investigated. The study reported here involved 13 patients with schizophrenia and 13 matched controls. During functional MRI, participants decided in three conditions whether the presented positive and negative personality traits characterized themselves, an intimate person, or included a certain letter. Based on the responses, each experimental condition was designed using a flexible factorial model. Controls and patients showed a similar behavioral pattern during self-evaluation, with group comparison revealing decreased activation in patients in the left inferior temporal gyrus and both temporal poles during self-ascription of traits, and in the anterior medial prefrontal cortex during evaluation of an intimate person. In patients, positive symptoms correlated positively with brain activation in the left parahippocampus during trait self-ascription. Hence, while evaluating themselves, schizophrenia patients revealed decreased activation in areas related to self-awareness overlapping with networks involved in theory of mind, empathy and social knowledge. Moreover, patients' brain activation during self-reflection was affected by the current positive symptomatology. The close interaction between self and other highlights the clinical and social relevance of self-processing deficits in schizophrenia. PMID:24369435

  9. Ten-year outcomes in first episode psychotic major depression patients compared with schizophrenia and bipolar patients.

    PubMed

    Heslin, M; Lappin, J M; Donoghue, K; Lomas, B; Reininghaus, U; Onyejiaka, A; Croudace, T; Jones, P B; Murray, R M; Fearon, P; Doody, G A; Dazzan, P; Craig, T J; Morgan, C

    2016-10-01

    We aimed to investigate long-term outcomes in psychotic major depression patients compared to schizophrenia and bipolar/manic psychosis patients, in an incidence sample, while accounting for diagnostic change. Based on Aetiology and Ethnicity in Schizophrenia and Other Psychoses (ÆSOP and ÆSOP-10), a first episode psychosis cohort was followed-up 10years after first presentation. The Schedules for Clinical Assessment in Neuropsychiatry, WHO Life Chart and Global Assessment of Functioning were used to assess clinical, social and service use outcomes. Seventy-two PMD patients, 218 schizophrenia patients and 70 psychotic bipolar disorder/mania patients were identified at baseline. Differences in outcome between PMD and bipolar patients based on baseline and lifetime diagnosis were minimal. Differences in clinical, social and service use outcomes between PMD and schizophrenia were more substantial with PMD patients showing better outcomes on most variables. However, there was some weak evidence (albeit not quite statistically significant at p<0.05) based on lifetime diagnoses that PMD patients were more likely to attempt suicide (OR 2.31, CI 0.98-5.42, p0.055) and self-harm (OR 2.34, CI 0.97-5.68, p0.060). PMD patients have better social and service use outcomes compared to people with schizophrenia, but may be more likely to attempt suicide or self-harm. This unique profile is important for clinicians to consider in any risk assessment.

  10. 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.

  11. Relationship between mean daily ambient temperature range and hospital admissions for schizophrenia: Results from a national cohort of psychiatric inpatients.

    PubMed

    Sung, Tzu-I; Chen, Mu-Jean; Lin, Chuan-Yao; Lung, Shih-Chun; Su, Huey-Jen

    2011-12-01

    Environmental temperature is known to correlate with schizophrenia, but little is known about the association with changes in temperature. This 12-year study aimed to evaluate the relationship between the mean daily range of ambient temperature and schizophrenia admissions in a national cohort of psychiatric inpatients in Taiwan. Meteorological data provided by the Central Weather Bureau of Taiwan were interpolated to create representative estimates. Psychiatric inpatient admissions in all hospitals with medical services enrolled in the current health care insurance system were retrieved from the 1996-2007 Psychiatric Inpatient Medical Claim dataset of the National Health Insurance Research Database. Generalized linear models with Poisson distributions were used to analyze the impact of mean diurnal change of temperature on schizophrenia admissions, controlling for internal correlations and demographic covariates. The daily temperature range varied between 1.7°C and 12.1°C (1st to 99th percentile). The relative risk of schizophrenia admission was significantly increased at a temperature range of 3.2°C (10th percentile), and the maximum was at 12.1°C (99th percentile); however, no such association was found with schizoaffective disorder. When restricted to the capital and largest city, the effects of temperature range were prominent and may correlate with temperature itself. The joint effect of temperature and temperature range was associated with elevated risk, particularly at cooler temperatures. A positive correlation was found between increasing temperature range and schizophrenia admissions. The increase in morbidity at high percentiles suggests that the increasing dynamics of temperature range are a valid reflection of risk, highlighting the need for precautionary action. PMID:22018962

  12. 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

  13. 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

  14. 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

  15. Impaired automatization of a cognitive skill in first-degree relatives of patients with schizophrenia

    PubMed Central

    Wagshal, Dana; Knowlton, Barbara Jean; Cohen, Jessica Rachel; Poldrack, Russell Alan; Bookheimer, Susan Yost; Bilder, Robert Martin; Asarnow, Robert Franklin

    2014-01-01

    We studied healthy, first-degree relatives of patients with schizophrenia to test the hypothesis that deficits in cognitive skill learning are associated with genetic liability to schizophrenia. Using the Weather Prediction Task (WPT), 23 healthy controls and 10 adult first-degree Relatives Of Schizophrenia (ROS) patients were examined to determine the extent to which cognitive skill learning was automated using a dual-task paradigm to detect subtle impairments in skill learning. Automatization of a skill is the ability to execute a task without the demand for executive control and effortful behavior and is a skill in which schizophrenia patients possess a deficit. ROS patients did not differ from healthy controls in accuracy or reaction time on the WPT either during early or late training on the single-task trials. In contrast, the healthy control and ROS groups were differentially affected during the dual-task trials. Our results demonstrate that the ROS group did not automate the task as well as controls and continued to rely on controlled processing even after extensive practice. This suggests that adult ROS patients may engage in compensatory strategies to achieve normal levels of performance and support the hypothesis that impaired cognitive skill learning is associated with genetic risk for schizophrenia. PMID:24359887

  16. Impact of antipsychotic medication on transcranial direct current stimulation (tDCS) effects in schizophrenia patients.

    PubMed

    Agarwal, Sri Mahavir; Bose, Anushree; Shivakumar, Venkataram; Narayanaswamy, Janardhanan C; Chhabra, Harleen; Kalmady, Sunil V; Varambally, Shivarama; Nitsche, Michael A; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2016-01-30

    Transcranial direct current stimulation (tDCS) has generated interest as a treatment modality for schizophrenia. Dopamine, a critical pathogenetic link in schizophrenia, is also known to influence tDCS effects. We evaluated the influence of antipsychotic drug type (as defined by dopamine D2 receptor affinity) on the impact of tDCS in schizophrenia. DSM-IV-TR-diagnosed schizophrenia patients [N=36] with persistent auditory hallucinations despite adequate antipsychotic treatment were administered add-on tDCS. Patients were divided into three groups based on the antipsychotic's affinity to D2 receptors. An auditory hallucinations score (AHS) was measured using the auditory hallucinations subscale of the Psychotic Symptom Rating Scales (PSYRATS). Add-on tDCS resulted in a significant reduction inAHS. Antipsychotic drug type had a significant effect on AHS reduction. Patients treated with high affinity antipsychotics showed significantly lesser improvement compared to patients on low affinity antipsychotics or a mixture of the two. Furthermore, a significant sex-by-group interaction occurred; type of medication had an impact on tDCS effects only in women. Improvement differences could be due to the larger availability of the dopamine receptor system in patients taking antipsychotics with low D2 affinity. Sex-specific differences suggest potential estrogen-mediated effects. This study reports a first-time observation on the clinical utility of antipsychotic drug type in predicting tDCS effects in schizophrenia.

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

    PubMed

    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

  18. 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.

  19. 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

  20. Abnormal neural processing during emotional salience attribution of affective asymmetry in patients with schizophrenia.

    PubMed

    Lee, Seon-Koo; Chun, Ji Won; Lee, Jung Suk; Park, Hae-Jeong; Jung, Young-Chul; Seok, Jeong-Ho; Kim, Jae-Jin

    2014-01-01

    Aberrant emotional salience attribution has been reported to be an important clinical feature in patients with schizophrenia. Real life stimuli that incorporate both positive and negative emotional traits lead to affective asymmetry such as negativity bias and positivity offset. In this study, we investigated the neural correlates of emotional salience attribution in patients with schizophrenia when affective asymmetry was processed. Fifteen patients with schizophrenia and 14 healthy controls were scanned using functional magnetic resonance imaging (fMRI) while performing an emotion judgment task in which two pictures were juxtaposed. The task consisted of responding to affective asymmetry condition (ambivalent and neutral) and affective symmetry conditions (positive and negative), and group comparisons were performed for each condition. Significantly higher activity in the medial prefrontal cortex and inferior frontal gyrus was observed for the ambivalent condition than for the other conditions in controls, but not in patients. Compared with controls, patients showed decreased activities in the dorsolateral prefrontal cortex, dorsal anterior cingulate cortex, insula, and putamen for the ambivalent condition, but no changes were observed for the neutral condition. Multiple prefrontal hypoactivities during salience attribution of negativity bias in schizophrenia may underlie deficits in the integrative processing of emotional information. Regional abnormalities in the salience network may be the basis of defective emotional salience attribution in schizophrenia, which is likely involved in symptom formation and social dysfunction.

  1. Me, myself and I: temporal dysfunctions during self-evaluation in patients with schizophrenia

    PubMed Central

    Kircher, Tilo T. J.; Schneider, Frank; Habel, Ute

    2014-01-01

    Self-concept is deeply affected in schizophrenia. Positive symptoms in particular are related to disturbed self/other distinctions. The neural networks underlying self-evaluation in schizophrenia have barely been investigated. The study reported here involved 13 patients with schizophrenia and 13 matched controls. During functional MRI, participants decided in three conditions whether the presented positive and negative personality traits characterized themselves, an intimate person, or included a certain letter. Based on the responses, each experimental condition was designed using a flexible factorial model. Controls and patients showed a similar behavioral pattern during self-evaluation, with group comparison revealing decreased activation in patients in the left inferior temporal gyrus and both temporal poles during self-ascription of traits, and in the anterior medial prefrontal cortex during evaluation of an intimate person. In patients, positive symptoms correlated positively with brain activation in the left parahippocampus during trait self-ascription. Hence, while evaluating themselves, schizophrenia patients revealed decreased activation in areas related to self-awareness overlapping with networks involved in theory of mind, empathy and social knowledge. Moreover, patients’ brain activation during self-reflection was affected by the current positive symptomatology. The close interaction between self and other highlights the clinical and social relevance of self-processing deficits in schizophrenia. PMID:24369435

  2. Lamotrigine augmentation in schizophrenia and schizoaffective patients with obsessive-compulsive symptoms.

    PubMed

    Poyurovsky, M; Glick, I; Koran, L M

    2010-06-01

    Obsessive-compulsive symptoms (OCS) are clinically important phenomena in schizophrenia patients. Lamotrigine has a modulating effect on glutamatergic neurotransmission relevant to pathophysiology of both schizophrenia and OCD. Efficacy and tolerability of lamotrigine in schizophrenia and schizoaffective patients with comorbid OCS were evaluated. In an 8-week, open-label trial, lamotrigine (25 mg/day for 1 week, 50 mg for 2 weeks, 100 mg for 2 weeks, 200 mg for 3 weeks) was added to ongoing psychotropic drug regimens in schizophrenia (N = 5) and schizoaffective disorder (N = 6) patients with clinically significant OCS [Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) score > 16]. The Y-BOCS score for nine completers decreased significantly from baseline to week 8 (22.9 +/- 6.1 vs 17.4 +/- 3.6; t = 2.33, df = 1, P = 0.033). Five patients, all with schizoaffective disorder, were responders (>or=35% decrease in Y-BOCS score). No significant changes were detected in schizophrenia symptom severity. Depressive symptoms, assessed with the Calgary Depression Rating Scale, improved significantly (6.4 +/- 1.5 vs 4.0 +/- 2.5; t = 3.19, df = 1, P = 0.013); this change positively correlated with OCS improvement (r = 0.69, P = 0.04). Lamotrigine was safe and well tolerated. Explicit evaluation of therapeutic efficacy of adjunctive lamotrigine in schizoaffective disorder patients with comorbid OCS merits further investigation.

  3. SERUM PROLACTIN LEVEL AND SEVERITY OF PSYCHOPATHOLOGY IN PATIENTS OF SCHIZOPHRENIA

    PubMed Central

    Shrivastava, Amresh; Tamhane, Manoj

    2000-01-01

    Serum prolactin level was measured in 20 male and 11 female drug naive patients of schizophrenia Subsequently, these patients were treated with antipsychotics and ECTs. The severity of psychopathology at the baseline rind subsquent improvement at the end of 3 weeks and 6 weeks was assessed on modifies brief asychiatric rating scale (BPRS). Contrary to the expectations, a two fold increase in serum prolactin level was observed in drug naive male and female patients of schizophrenia The difference was found to be statictically significant in males No correlation was observed between the baseline serum prolactin level and the severity of baseline psychopathology and subsequent improvement in psychopathology at the end of 3 weeks and 6 weeks From the present study it seems that baseline serum prolactine level in drug naive patients of schizophrenia may not be a reliable indicator of psychopathology and prognosis. PMID:21407907

  4. 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

  5. An evidence for lack of pseudoneglect in patients with schizophrenia: an ERP study.

    PubMed

    Pourrahimi, Ali Mohammad; Mazhari, Shahrzad; Shabani, Mohammad; Sheibani, Vahid

    2014-02-21

    Studies have reported an altered expression of pseudoneglect in patients with schizophrenia, but no study has examined pseudoneglect in schizophrenia at the neural level. We investigated pseudoneglect using the visual P3 event-related potential and the mental number bisection (MNB) task in 21 patients and 25 controls. Using an oddball task, participants were asked to discriminate an infrequent ('one' or 'nine') from a frequent written number ('five'). The P3 ERP components were delayed to the targets on the right of the MNL ('nine') compared to the targets on the left ('one') in controls. The effect of number magnitude on the P3 latency was not observed in the patients. In MNB task, the patients did not show the normal leftward bias observed in healthy individuals. Our findings indicate a lack of pseudoneglect and the presence of an anomalous brain asymmetry in schizophrenia.

  6. 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

  7. Review of treatments that can ameliorate nonadherence in patients with schizophrenia.

    PubMed

    Kane, John M

    2006-01-01

    Nonadherence to medication is one of the major problems in treating patients with schizophrenia. Clinicians can use a variety of assessment strategies to identify patients who are nonadherent, although none of these is completely reliable. Interventions to improve adherence include psychosocial strategies, second-generation oral antipsychotics, and long-acting injectable antipsychotics. Because of the potential for reduced relapse and rehospitalization rates and the availability of second-generation antipsychotics in injectable form, a case is made for using long-acting injectable second-generation antipsychotics, when appropriate, to treat patients with schizophrenia. PMID:16822091

  8. 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

  9. Study of the inferior colliculus in patients with schizophrenia by magnetic resonance spectroscopy.

    PubMed

    Martinez-Granados, B; Martinez-Bisbal, M C; Sanjuan, J; Aguilar, E J; Marti-Bonmati, L; Molla, E; Celda, B

    2014-07-01

    INTRODUCTION. Previous studies have suggested morphometric and functional abnormalities in the inferior colliculus in patients with schizophrenia. Auditory hallucinations are one of the central symptoms in schizophrenia. In this complex and multidimensional event both attention and emotion are thought to play a key role. AIM. To study metabolic changes in the inferior colliculus, a nucleus integrated in the auditory pathway, in patients with schizophrenia and the possible relationship with auditory hallucinations. SUBJECTS AND METHODS. Magnetic resonance spectroscopic imaging studies were performed in 30 right-handed patients with chronic schizophrenia (19 of them with auditory hallucinations) and 28 controls. A magnetic resonance spectroscopic imaging 2D slice was acquired and the voxels representative of both inferior colliculi were selected. N-acetylaspartate (NAA), creatine (Cr) and choline (Cho) peak areas were measured. RESULTS. The patients with schizophrenia showed a NAA/Cr significant reduction in the right inferior colliculus compared to the control subjects. The metabolic data in the right inferior colliculus were correlated with emotional auditory hallucinations items. CONCLUSIONS. The contribution of the inferior colliculus on neural underpinnings of auditory hallucinations is particularly relevant for the right inferior colliculus and is centered on attention-emotional component of this symptom.

  10. Hippocampal and amygdalar local structural differences in elderly patients with schizophrenia

    PubMed Central

    Prestia, Annapaola; Cavedo, Enrica; Boccardi, Marina; Muscio, Cristina; Adorni, Andrea; Geroldi, Cristina; Bonetti, Matteo; Thompson, Paul M.; Frisoni, Giovanni B.

    2015-01-01

    Objectives Morphological abnormalities have been reported for the hippocampi and amygdalae in young schizophrenia patients, but very little is known about the pattern of abnormalities in elderly schizophrenia patients. Here we investigated local structural differences in the hippocampi and amygdalae of elderly schizophrenia patients compared to healthy elderly subjects. We also related these differences to clinical symptom severity. Design 20 schizophrenia patients (mean age: 67.4±6.2 years, MMSE 22.8±4.4) and 20 healthy elderly subjects (70.3±7.5, 29.0±1.1) underwent high resolution magnetic resonance imaging of the brain. The Radial Atrophy Mapping technique was used to reconstruct the 3D shape of the amygdala and the hippocampus. Local differences in tissue reductions were computed between groups and permutation tests were run to correct for multiple comparisons, in statistical maps thresholded at p=0.05. Results Significant tissue reduction was observed bilaterally in the amygdala and hippocampus of schizophrenia patients. The basolateral-ventral-medial amygdalar nucleus showed the greatest involvement, with over 30% local tissue reduction. The centro-medial, cortical, and lateral nuclei were also atrophic in patients. The hippocampus showed significant tissue loss in the medio-caudal and antero-lateral aspects of CA1, and in medial section of its left head (pre- and para-subiculum;). In the left amygdala and hippocampus, local tissue volumes were significantly correlated with negative symptoms. Conclusions Tissue losses and altered morphology were found in elderly schizophrenia patients. Tissue loss mapped to amygdalo-hippocampal subregions known to have bidirectional and specific connections with frontal cortical and limbic structures and was related to clinical severity. PMID:24534522

  11. 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

  12. 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

  13. 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

  14. Implications of epigenetic modulation for novel treatment approaches in patients with schizophrenia.

    PubMed

    Cha, Danielle S; Kudlow, Paul A; Baskaran, Anusha; Mansur, Rodrigo B; McIntyre, Roger S

    2014-02-01

    Schizophrenia is a heterogeneous and complex mental disorder with high rates of disability, non-recovery, and relapse. The primary pharmacological treatments for schizophrenia are antipsychotics. Notwithstanding the efficacy of antipsychotics in ameliorating positive symptoms and reducing relapse rates, cognitive deficits and negative symptoms are not sufficiently treated with available pharmaceutical agents. Moreover, schizophrenia is associated with consistent, replicable, and clinically significant deficits in cognition. The importance of cognitive deficits in schizophrenia is emphasized by reports indicating that the severity of cognitive deficits is predictive of treatment compliance, adherence, and risk of relapse among first-episode individuals. Taken together, this review highlights epigenetic modulations involving histone deacetylase (HDAC) inhibitors as a potential avenue for novel treatment toward improvements in cognition and functional outcomes in patients with schizophrenia. The combination of epigenetic modulation with pharmacological interventions that engage multiple disparate physiological systems implicated in schizophrenia are discussed, and may represent a more effective strategy in ameliorating cognitive deficits and mitigating symptoms for improved functionality.

  15. Bad tidings and the hospitalized patient.

    PubMed

    Lerer, B; Avni, J; Wiesel, D

    1976-01-01

    The physician in hospital practice may be faced with a situation in which a patient under his care suffers a bereavement or some other unexpected tragedy but is unaware of the fact. Three such cases encountered in the context of our psychiatric sonsultation service are presented. Factors influencing the decision as to whether, when and how the patient should be informed are considered. The complex psychodynamic situation which arises and involves the patient, his family and the medical staff is described. Stress is laid on the role played by archaic fears of being the bearer of evil tidings. The situation is seen as being ideally handled by the direct treating physician in conjunction with the family, the extent of psychiatric intervention being dictated by the needs of each of the parties concerned. Ideally the patient should be told as soon as his physical and mental condition are seen as conducive and preferably before he leave hospital.

  16. [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

  17. The assessment of quality of life in clinical practice in patients with schizophrenia.

    PubMed

    Karow, Anne; Wittmann, Linus; Schöttle, Daniel; Schäfer, Ingo; Lambert, Martin

    2014-06-01

    The aim of the present article is to review QoL scales used in studies investigating patients with schizophrenia over the past 5 years, and to summarize the results of QoL assessment in clinical practice in these patients. Literature available from January 2009 to December 2013 was identified in a PubMed search using the key words "quality of life" and "schizophrenia" and in a cross-reference search for articles that were particularly relevant. A total of n=432 studies used 35 different standardized generic and specific QoL scales in patients with schizophrenia. Affective symptoms were major obstacles for QoL improvement in patients with schizophrenia. Though positive symptoms, negative symptoms, and cognitive functioning may be seen as largely independent parameters from subjective QoL, especially in cross-sectional trials, long-term studies confirmed a critical impact of early QoL improvement on long-term symptomatic and functional remission, as well as of early symptomatic response on long-term QoL. Results of the present review suggest that QoL is a valid and useful outcome criterion in patients with schizophrenia. As such, it should be consistently applied in clinical trials. Understanding the relationship between symptoms and functioning with QoL is important because interventions that focus on symptoms of psychosis or functioning alone may fail to improve subjective QoL to the same level. However, the lack of consensus on QoL scales hampers research on its predictive validity. Future research needs to find a consensus on the concept and measures of QoL and to test whether QoL predicts better outcomes with respect to remission and recovery under consideration of different treatment approaches in patients with schizophrenia.

  18. 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

  19. 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

  20. An Open Study of Sulforaphane-rich Broccoli Sprout Extract in Patients with Schizophrenia

    PubMed Central

    Shiina, Akihiro; Kanahara, Nobuhisa; Sasaki, Tsuyoshi; Oda, Yasunori; Hashimoto, Tasuku; Hasegawa, Tadashi; Yoshida, Taisuke; Iyo, Masaomi; Hashimoto, Kenji

    2015-01-01

    Objective Schizophrenia is a mental disorder characterized by severe cognitive impairment. Accumulating evidence suggests a role for oxidative stress in the pathophysiology of schizophrenia. Sulforaphane (SFN) extracted from broccoli sprout is an agent with potent anti-oxidant and anti-inflammatory activity. In this study, we attempted to evaluate the effect of SFN on cognitive impairment in medicated patients with schizophrenia. Methods We recruited a total of 10 outpatients with schizophrenia, all of whom gave informed consent. Participants took 3 tablets of SFN, consisting of 30 mg of SFN-glucosinolate per day, for 8 weeks. Clinical symptoms using the Positive and Negative Syndrome Scale (PANSS) and cognitive function using the Japanese version of CogState battery were evaluated at the beginning of the study and at week 8. Results A total of 7 patients completed the trial. The mean score in the Accuracy component of the One Card Learning Task increased significantly after the trial. However, we detected no other significant changes in participants. Conclusion This result suggests that SFN has the potential to improve cognitive function in patients with schizophrenia. PMID:25912539

  1. 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…

  2. Comparative study of sexual dysfunction and serum prolactin level associated with olanzapine, risperidone, and clozapine in patients with remitted schizophrenia

    PubMed Central

    Sathish Kumar, S. V.; Sinha, Vinod Kumar

    2015-01-01

    Background: Sexual dysfunctions have been a major side effect of the second generation anti-psychotic drugs which often affects treatment compliance in patients with schizophrenia. There is no/few systematic review or research addressing sexual dysfunction and their effect on serum prolactin level among different atypical antipsychotics in India. Aims: To determine and compare the frequency of sexual dysfunction associated with olanzapine, risperidone, and clozapine and their effect on serum prolactin level in remitted patients with schizophrenia. Settings and Design: Cross-sectional hospital-based study. Recruitment by purposive sampling. Estimation of serum prolactin was done using enzyme-linked immunosorbent assay technique. Materials and Methods: The total sample size was 103, consisting of 31, 23, and 19 patients in olanzapine, risperidone, and clozapine groups, respectively and 30 controls. A Brief Psychiatric Rating Scale, Udvalg for Kliniske Undersogelser (UKU) Side Effect Rating Scale and Sexual Functioning Questionnaire were administered. Analysis of variance was used to compare clinical variables. Chi-square test was used to identify the frequency of sexual dysfunction. Kruskal–Wallis test was used to compare UKU side effect, sexual dysfunction, and blood parameters across the study groups. Results and Conclusion: Eighty-six percentage reported sexual dysfunction in one or more domains of sexual functioning in risperidone group as compared to 48.3% in olanzapine and 31% in clozapine groups, respectively. Prolactin level elevation was statistically significant in risperidone group followed by clozapine and olanzapine groups, respectively. PMID:26816428

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. Stigmatization by nurses against schizophrenia in Turkey: a questionnaire survey.

    PubMed

    Kukulu, K; Ergün, G

    2007-05-01

    Individuals who have been diagnosed with schizophrenia face discrimination, exclusion and stigmatization by society. Nurses who work on psychiatric wards frequently face individuals diagnosed with schizophrenia throughout their careers. This study was conducted for the purpose of evaluating nurses' opinions about individuals who had been diagnosed with schizophrenia. A total of 543 nurses working on the psychiatric wards of 27 university hospitals (164), six training and research hospitals (21) and six psychiatric hospitals (358) in Turkey completed the questionnaire. The majority of the nurses stated that schizophrenia is caused by social problems, that they would be able to work with someone who has schizophrenia, that they would not be able to marry someone with schizophrenia, that they would not be bothered by having a neighbour with schizophrenia, that schizophrenia cannot be completely cured, that it can be improved with psychotherapy, that schizophrenic patients are aggressive and that medications used to treat schizophrenia have serious side effects and are addictive. It is important for nurses to avoid stigmatizing patients in order to promote a therapeutic environment--particularly on the wards--and also to improve individual awareness and perceptions in society.

  10. Factors influencing subjective quality of life in patients with schizophrenia and other mental disorders: a pooled analysis.

    PubMed

    Priebe, Stefan; Reininghaus, Ulrich; McCabe, Rosemarie; Burns, Tom; Eklund, Mona; Hansson, Lars; Junghan, Ulrich; Kallert, Thomas; van Nieuwenhuizen, Chijs; Ruggeri, Mirella; Slade, Mike; Wang, Duolao

    2010-08-01

    Subjective quality of life (SQOL) is an important outcome in the treatment of patients with schizophrenia. However, there is only limited evidence on factors influencing SQOL, and little is known about whether the same factors influence SQOL in patients with schizophrenia and other mental disorders. This study aimed to identify the factors associated with SQOL and test whether these factors are equally important in schizophrenia and other disorders. For this we used a pooled data set obtained from 16 studies that had used either the Lancashire Quality of Life Profile or the Manchester Short Assessment of Quality of Life for assessing SQOL. The sample comprised 3936 patients with schizophrenia, mood disorders, and neurotic disorders. After controlling for confounding factors, within-subject clustering, and heterogeneity of findings across studies in linear mixed models, patients with schizophrenia had more favourable SQOL scores than those with mood and neurotic disorders. In all diagnostic groups, older patients, those in employment, and those with lower symptom scores had higher SQOL scores. Whilst the strength of the association between age and SQOL did not differ across diagnostic groups, symptom levels were more strongly associated with SQOL in neurotic than in mood disorders and schizophrenia. The association of employment and SQOL was stronger in mood and neurotic disorders than in schizophrenia. The findings may inform the use and interpretation of SQOL data for patients with schizophrenia.

  11. Acculturation and expressed emotion in Caucasian, Latino, and black relatives of patients with schizophrenia.

    PubMed

    Koneru, Vamsi K; de Mamani, Amy G Weisman

    2007-11-01

    High expressed emotion (high EE) in family members (high levels of criticism, emotional overinvolvement, and/or hostility) has been found to be predictive of a poorer course of illness for patients with schizophrenia in many different cultures. Acculturation has also been found to relate to symptom severity and clinical course in a number of disorders (e.g., substance abuse, schizophrenia). There is reason to believe that acculturation may interact with EE, however, this relationship has yet to be examined systematically. The present study evaluated the relationship between acculturation and EE in a sample of 57 Caucasian, Latino, and black caregivers of patients with schizophrenia. Drawing from earlier research, it was hypothesized that more acculturated Caucasian and Latino relatives and less acculturated black relatives would be designated as high EE. Hypotheses were partially supported as results demonstrated that greater acculturation was associated with high EE for Latinos and low EE for blacks. PMID:18000456

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

    PubMed

    Chen, Yue; McBain, Ryan; Norton, Daniel

    2015-02-28

    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.

  13. 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

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

    PubMed

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

    2015-12-03

    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.

  15. Correlates of Caregiver Burden among Family Members of Patients with Schizophrenia in Lagos, Nigeria

    PubMed Central

    Adeosun, Increase Ibukun

    2013-01-01

    Family members of patients with schizophrenia have enormous roles in the care of their patients, which could negatively impact their well being. Development of interventions targeted at alleviating the burden of informal care giving is hinged on the recognition of the factors associated with the various dimensions of burden. This study determined the correlates of caregiver burden among family members of patients with schizophrenia in Lagos, Nigeria. The study instruments included the Zarit burden interview (ZBI) and the positive and negative syndrome scale for schizophrenia (PANSS). Exploratory factor analysis of the ZBI produced a five-factor structure with “financial/physical strain”, “time/dependence strain”, “emotional strain”, “uncertainty”, and “self-criticism” domains. On multiple regression analyses, total PANSS scores, poor social support, and lower educational levels of caregivers were predictive of higher burden scores on the “financial/physical strain”, “time/dependence”, and “emotional strain” domains. Longer duration of illness, shorter patient-caregiver contact time, and being a female caregiver were predictive of higher burden scores on the “uncertainty”, “self-criticism”, and “emotional strain” domains, respectively. There is need for interventions to alleviate the burden on caregivers of patients with schizophrenia in Nigeria. These strategies must include comprehensive social support and improve access to services for patients and their caregivers. PMID:24222848

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

    PubMed

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

  17. Evidence of some strategic preservation of episodic learning in patients with schizophrenia.

    PubMed

    Thuaire, Flavien; Izaute, Marie; Bacon, Elisabeth

    2012-01-30

    The aim of this study was to gain a better understanding of schizophrenia patients' strategic use of learning time allocation during encoding, and determine whether they are able to use their monitoring and previous performances to adapt their learning behavior efficiently. Schizophrenia is considered to be a pathology of consciousness as well as being associated with impaired awareness of cognitive processes. In this study, after a learning session, individuals may express a Judgment of Learning (JOL), which reflects their sense of being able to retrieve the information later and which forms the basis for their decision whether or not to carry on learning. The introspective abilities of schizophrenia patients and subsequent strategic control of study time during the encoding of easy or difficult word pairs were investigated in 23 patients and 23 healthy comparison subjects. In spite of their memory impairment, patients were able to judge the difficulty of the word pairs with accuracy and adapt their learning time accordingly. Schizophrenia patients are sensitive to difficulty when rating JOLs and afterwards controlling study time. Monitoring their knowledge at the start helped patients to adapt their learning efficiently. These findings may be of value for cognitive remediation.

  18. Correlates of Caregiver Burden among Family Members of Patients with Schizophrenia in Lagos, Nigeria.

    PubMed

    Adeosun, Increase Ibukun

    2013-01-01

    Family members of patients with schizophrenia have enormous roles in the care of their patients, which could negatively impact their well being. Development of interventions targeted at alleviating the burden of informal care giving is hinged on the recognition of the factors associated with the various dimensions of burden. This study determined the correlates of caregiver burden among family members of patients with schizophrenia in Lagos, Nigeria. The study instruments included the Zarit burden interview (ZBI) and the positive and negative syndrome scale for schizophrenia (PANSS). Exploratory factor analysis of the ZBI produced a five-factor structure with "financial/physical strain", "time/dependence strain", "emotional strain", "uncertainty", and "self-criticism" domains. On multiple regression analyses, total PANSS scores, poor social support, and lower educational levels of caregivers were predictive of higher burden scores on the "financial/physical strain", "time/dependence", and "emotional strain" domains. Longer duration of illness, shorter patient-caregiver contact time, and being a female caregiver were predictive of higher burden scores on the "uncertainty", "self-criticism", and "emotional strain" domains, respectively. There is need for interventions to alleviate the burden on caregivers of patients with schizophrenia in Nigeria. These strategies must include comprehensive social support and improve access to services for patients and their caregivers.

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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.

  8. Irony and Proverb Comprehension in Schizophrenia: Do Female Patients “Dislike” Ironic Remarks?

    PubMed Central

    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

  9. 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

  10. Neuropsychological impairment in patients with schizophrenia and evidence of hyponatremia and polydipsia.

    PubMed

    Torres, Ivan J; Keedy, Sarah; Marlow-O'Connor, Megan; Beenken, Beth; Goldman, Morris B

    2009-05-01

    Patients with schizophrenia and water imbalance may represent a subset of patients with distinct pathophysiological abnormalities and susceptibility to cognitive impairment. Specifically, patients with polydipsia and hyponatremia have been shown to have smaller anterior hippocampal volumes, which are also associated with various impairments in neuroendocrine function. To determine whether abnormalities in patients with water imbalance extend to the cognitive realm, the present study evaluated neuropsychological functioning in three groups of patients with schizophrenia: polydipsic hyponatremic, polydipsic normonatremic, and nonpolydipsic normonatremic. Participants were administered cognitive tests assessing intelligence, attention, learning/memory (verbal, nonverbal, emotional), and facial discrimination. Hyponatremic patients showed poorer overall neuropsychological functioning relative to all other patients, and polydipsic normonatremic patients performed intermediate to the other two groups. Results indicate that patients with schizophrenia and polydipsia, and particularly those with hyponatremia, show prominent cognitive deficits relative to patients without water imbalance. The clinical, neuroendocrine, and cognitive abnormalities in these patients may arise from pathology within the anterior hippocampus and associated prefrontal/limbic brain regions. PMID:19413445

  11. In Vivo Measurement of GABA Transmission in Healthy Subjects and Schizophrenia Patients

    PubMed Central

    Frankle, W. Gordon; Cho, Raymond Y.; Prasad, Konasale M.; Mason, N. Scott; Paris, Jennifer; Himes, Michael L.; Walker, Christopher; Lewis, David A.; Narendran, Rajesh

    2016-01-01

    Objective Postmortem studies in schizophrenia reveal alterations in gene products that regulate the release and extracellular persistence of GABA. However, results of in vivo studies of schizophrenia measuring total tissue GABA with magnetic resonance spectroscopy (MRS) have been inconsistent. Neither the postmortem nor the MRS studies directly address the physiological properties of GABA neurotransmission. The present study addresses this question through an innovative positron emission tomography (PET) paradigm. Method The binding of [11C]flumazenil, a benzodiazepine-specific PET radiotracer, was measured before and after administration of tiagabine (0.2 mg/kg of body weight), a GABA membrane transporter (GAT1) blocker, in 17 off-medication patients with schizophrenia and 22 healthy comparison subjects. Increased extracellular GABA, through GAT1 blockade, enhances the affinity of GABAA receptors for benzodiazepine ligands, detected as an increase in [11C]flumazenil tissue distribution volume (VT). Results [11C]Flumazenil VT was significantly increased across all cortical brain regions in the healthy comparison group but not in the schizophrenia group. This lack of effect was most prominent in the antipsychotic-naive schizophrenia group. In this subgroup, [11C]flumazenil ΔVT in the medial temporal lobe was correlated with positive symptoms, and baseline [11C] flumazenil VT in the medial temporal lobe was negatively correlated with visual learning. In the healthy comparison group but not the schizophrenia group, [11C]flumazenil ΔVT was positively associated with gamma-band oscillation power. Conclusions This study demonstrates, for the first time, an in vivo impairment in GABA transmission in schizophrenia, most prominent in antipsychotic-naive individuals. The impairment in GABA transmission appears to be linked to clinical symptoms, disturbances in cortical oscillations, and cognition. PMID:26133962

  12. [What information do patients with schizophrenia have about their illness and treatment?].

    PubMed

    Ferreri, M; Rouillon, F; Nuss, P; Bazin, N; Farah, S; Djaballah, K; Gerard, D

    2000-01-01

    Improved compliance with antipsychotic medication is a major issue in schizophrenic management. For this purpose educational programs have been used, but up to now, little or no information has been gathered or published in France concerning schizophrenic patients' opinion on information they have about their disease and their treatment. Thus we conducted a survey in concert with 78 psychiatrists from the French psychiatric health service. From this cross sectional survey we assessed 336 outpatients (male: 72%; mean age: 36 +/- 10.4 years) with schizophrenia according to the DSM IV (paranoid sub type: 57%, disorganized: 12%, catatonic: 1%, undifferentiated: 12%, residual: 18%). The mean duration of the illness was 11.6 years (sd: 8.5) and the mean duration of the follow up with the same psychiatrist was 5.4 years (sd: 5.1). Patients completed a questionnaire which assessed their level of information on mental illness and treatment. The diagnosis of schizophrenia has been told to their patients by 39% of the psychiatrists, and treatment has been explained to the patients by 96% of the practitioners. Results indicate less than half of the patients (45%) felt ill, only 46% thought they knew their illness well or very well (nevertheless only 31% of them named spontaneously the diagnosis of schizophrenia or psychosis), and 61% considered that they had been given sufficient information. Most of the patients (79%) were persuaded that their treatment was useful, and 75% of patient were completely satisfied with their treatment. Surprisingly 92% reported taking their medication regularly. Most patients think that a high level of information about their illness (74%) and treatment (79%) help them to cope better with their schizophrenia. Analysis performed according to patients characteristics indicated that paranoid patients felt more ill (p = 0.035) than others, thought to know less about their illness (p = 0.0065), and were less satisfied with their treatment (p = 0

  13. 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

  14. 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

  15. [Nursing iatrogenic events in hospitalized elderly patients].

    PubMed

    dos Santos, Jussara Carvalho; Ceolim, Maria Filomena

    2009-12-01

    The purpose of this cross-sectional quantitative study was to identify iatrogenic nursing events involving elderly patients hospitalized in two nursing wards of a university hospital (Campinas, São Paulo, Brazil). Data was collected among 100 patient records (50 men, 50 women) using an instrument created by the authors. Data analysis was performed using descriptive statistics in addition to Mann-Whitney and Kruskal-Wallis tests. Results were significant at p < 0.05. Latrogenic events in the 26 files included: loss of intravenous site (14), pressure ulcers (8) and falls (2), among others. Reports were not detailed and failed to indicate interventions to prevent new occurrences. The findings suggest the importance of creating ways to encourage nursing professionals to accurately report iatrogenic events, as well as creating wards specifically for the elderly population.

  16. Identification of Subgroups of Schizophrenia Patients With Changes in Either Immune or Growth Factor and Hormonal Pathways

    PubMed Central

    Schwarz, Emanuel; van Beveren, Nico J. M.; Ramsey, Jordan; Leweke, F. Markus; Rothermundt, Matthias; Bogerts, Bernhard; Steiner, Johann; Guest, Paul C.; Bahn, Sabine

    2014-01-01

    Schizophrenia is a heterogeneous disorder normally diagnosed using the Diagnostic and Statistical Manual of Mental Disorders criteria. However, these criteria do not necessarily reflect differences in underlying molecular abnormalities of the disorder. Here, we have used multiplexed immunoassay analyses to measure immune molecules, growth factors, and hormones important to schizophrenia in acutely ill antipsychotic-naive patients (n = 180) and matched controls (n = 398). We found that using the resulting molecular profiles, we were capable of separating schizophrenia patients into 2 significantly distinct subgroups with predominant molecular abnormalities in either immune molecules or growth factors and hormones. These molecular profiles were tested using an independent cohort, and this showed the same separation into 2 subgroups. This suggests that distinct abnormalities occur in specific molecular pathways in schizophrenia patients. This may be of relevance for intervention studies that specifically target particular molecular mechanisms and could be a first step to further define the complex schizophrenia syndrome based on molecular profiles. PMID:23934781

  17. 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

  18. 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

  19. 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

  20. 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,…

  1. [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

  2. Investigating relationships between cortical thickness and cognitive performance in patients with schizophrenia and healthy adults.

    PubMed

    Hartberg, Cecilie Bhandari; Lawyer, Glenn; Nyman, Håkan; Jönsson, Erik G; Haukvik, Unn K; Saetre, Peter; Bjerkan, Petr S; Andreassen, Ole A; Hall, Håkan; Agartz, Ingrid

    2010-05-30

    Relationships between prefrontal and temporal lobe grey matter volumes as assessed by magnetic resonance imaging and neurocognitive test results have been reported in schizophrenia. This investigation aimed to localize brain regions where cortical thickness and neurocognitive performance were related, and investigate if such relationships might differ in schizophrenia patients and healthy controls. Sixty-seven patients with schizophrenia and 69 healthy controls were characterized by neurocognitive testing and by brain cortical thickness maps. Putative cortical thickness/cognitive score relationships were investigated with contrast analyses of general linear models for the combined sample. Regions in which relationships were present were further investigated for diagnostic interaction. In the combined sample, significant positive relationships were found between frontal, temporal and occipital regions and tests for verbal IQ, verbal learning and executive functions. Diagnostic interaction was found for the relationships between verbal IQ and the right temporo-occipital junction and the left middle occipital gyrus. In conclusion, the significant relationships between cortical thickness and neurocognitive performances were localized in brain areas known to be involved in cognition. The relationships were similar in patients and controls, except for the right temporo-occipital and left occipital cortical areas, indicating a disrupted structure-function relationship in patients with schizophrenia compared to healthy control subjects.

  3. 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

  4. 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

  5. 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…

  6. Theory of mind correlates with clinical insight but not cognitive insight in patients with schizophrenia.

    PubMed

    Zhang, Qi; Li, Xu; Parker, Giverny J; Hong, Xiao-Hong; Wang, Yi; Lui, Simon S Y; Neumann, David L; Cheung, Eric F C; Shum, David H K; Chan, Raymond C K

    2016-03-30

    Research on the relationship between insight and social cognition, in particular Theory of Mind (ToM), in schizophrenia has yielded mixed findings to date. Very few studies, however, have assessed both clinical insight and cognitive insight when examining their relationships with ToM in schizophrenia. The current study thus investigated the relationship between clinical insight, cognitive insight, and ToM in a sample of 56 patients with schizophrenia and 30 healthy controls. Twenty-seven patients were classified as low in clinical insight according to their scores on the 'insight' item (G12) of the Positive and Negative Syndrome Scale (PANSS). Moreover, cognitive insight and ToM were assessed with the Beck Cognitive Insight Scale (BCIS) and the Yoni task, respectively. The results indicated that patients with poor clinical insight performed worse on tasks of second-order cognitive and affective ToM, while the ToM performance of patients with high clinical insight was equivalent to that of healthy controls. Furthermore, while clinical insight was correlated with ToM and clinical symptoms, cognitive insight did not correlate with clinical insight, ToM, or clinical symptoms. Clinical insight thus appears to be an important factor related to ToM in schizophrenia. PMID:26833279

  7. Theory of mind correlates with clinical insight but not cognitive insight in patients with schizophrenia.

    PubMed

    Zhang, Qi; Li, Xu; Parker, Giverny J; Hong, Xiao-Hong; Wang, Yi; Lui, Simon S Y; Neumann, David L; Cheung, Eric F C; Shum, David H K; Chan, Raymond C K

    2016-03-30

    Research on the relationship between insight and social cognition, in particular Theory of Mind (ToM), in schizophrenia has yielded mixed findings to date. Very few studies, however, have assessed both clinical insight and cognitive insight when examining their relationships with ToM in schizophrenia. The current study thus investigated the relationship between clinical insight, cognitive insight, and ToM in a sample of 56 patients with schizophrenia and 30 healthy controls. Twenty-seven patients were classified as low in clinical insight according to their scores on the 'insight' item (G12) of the Positive and Negative Syndrome Scale (PANSS). Moreover, cognitive insight and ToM were assessed with the Beck Cognitive Insight Scale (BCIS) and the Yoni task, respectively. The results indicated that patients with poor clinical insight performed worse on tasks of second-order cognitive and affective ToM, while the ToM performance of patients with high clinical insight was equivalent to that of healthy controls. Furthermore, while clinical insight was correlated with ToM and clinical symptoms, cognitive insight did not correlate with clinical insight, ToM, or clinical symptoms. Clinical insight thus appears to be an important factor related to ToM in schizophrenia.

  8. 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.

  9. Levels of processing effects on recognition memory in patients with schizophrenia.

    PubMed

    Paul, Brianna M; Elvevåg, Brita; Bokat, Christina E; Weinberger, Daniel R; Goldberg, Terry E

    2005-04-01

    This study sought to characterize the performance of patients with schizophrenia, as compared with healthy participants, on a memory task that required encoding of items to different depths. Participants included 21 individuals with schizophrenia and 26 healthy controls. During the encoding phase of the study, participants processed successively presented words in two ways: perceptually (by making a decision as to whether the letter "a" was present in the word) or semantically (by making a living/nonliving decision for each word). During the recognition phase of the study, participants were presented with a list of words containing items that had been presented during the encoding phase (during either the letter decision task or the semantic decision task), as well as items that had not been seen before (foils). Though patients with schizophrenia performed more poorly overall on the recognition task, recognition was facilitated by semantic encoding to an equivalent degree in both groups. In other words, while significant main effects were present for group and encoding, no groupxencoding condition was present. This result is consistent with previous findings of a lack of qualitative differences in performance on learning and memory tasks between patients with schizophrenia and healthy controls. It also suggests that strategies that place constraints on the encoding processes used by patients may help improve the efficiency with which they learn and remember information. PMID:15694759

  10. Immunomodulatory Effects of Probiotic Supplementation in Schizophrenia Patients: A Randomized, Placebo-Controlled Trial.

    PubMed

    Tomasik, Jakub; Yolken, Robert H; Bahn, Sabine; Dickerson, Faith B

    2015-01-01

    Although peripheral immune system abnormalities have been linked to schizophrenia pathophysiology, standard antipsychotic drugs show limited immunological effects. Thus, more effective treatment approaches are required. Probiotics are microorganisms that modulate the immune response of the host and, therefore, may be beneficial to schizophrenia patients. The aim of this study was to examine the possible immunomodulatory effects of probiotic supplementation in chronic schizophrenia patients. The concentrations of 47 immune-related serum proteins were measured using multiplexed immunoassays in samples collected from patients before and after 14 weeks of adjuvant treatment with probiotics (Lactobacillus rhamnosus strain GG and Bifidobacterium animalis subsp. lactis strain Bb12; n = 31) or placebo (n = 27). Probiotic add-on treatment significantly reduced levels of von Willebrand factor (vWF) and increased levels of monocyte chemotactic protein-1 (MCP-1), brain-derived neurotrophic factor (BDNF), RANTES, and macrophage inflammatory protein-1 beta (MIP-1) beta with borderline significance (P ≤ 0.08). In silico pathway analysis revealed that probiotic-induced alterations are related to regulation of immune and intestinal epithelial cells through the IL-17 family of cytokines. We hypothesize that supplementation of probiotics to schizophrenia patients may improve control of gastrointestinal leakage. PMID:26052224

  11. Immunomodulatory Effects of Probiotic Supplementation in Schizophrenia Patients: A Randomized, Placebo-Controlled Trial

    PubMed Central

    Tomasik, Jakub; Yolken, Robert H; Bahn, Sabine; Dickerson, Faith B

    2015-01-01

    Although peripheral immune system abnormalities have been linked to schizophrenia pathophysiology, standard antipsychotic drugs show limited immunological effects. Thus, more effective treatment approaches are required. Probiotics are microorganisms that modulate the immune response of the host and, therefore, may be beneficial to schizophrenia patients. The aim of this study was to examine the possible immunomodulatory effects of probiotic supplementation in chronic schizophrenia patients. The concentrations of 47 immune-related serum proteins were measured using multiplexed immunoassays in samples collected from patients before and after 14 weeks of adjuvant treatment with probiotics (Lactobacillus rhamnosus strain GG and Bifidobacterium animalis subsp. lactis strain Bb12; n = 31) or placebo (n = 27). Probiotic add-on treatment significantly reduced levels of von Willebrand factor (vWF) and increased levels of monocyte chemotactic protein-1 (MCP-1), brain-derived neurotrophic factor (BDNF), RANTES, and macrophage inflammatory protein-1 beta (MIP-1) beta with borderline significance (P ≤ 0.08). In silico pathway analysis revealed that probiotic-induced alterations are related to regulation of immune and intestinal epithelial cells through the IL-17 family of cytokines. We hypothesize that supplementation of probiotics to schizophrenia patients may improve control of gastrointestinal leakage. PMID:26052224

  12. 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.

  13. Sense of agency and mentalizing: dissociation of subdomains of social cognition in patients with schizophrenia.

    PubMed

    Schimansky, Jenny; David, Nicole; Rössler, Wulf; Haker, Helene

    2010-06-30

    The sense of agency, i.e., the sense that "I am the one who is causing an action", and mentalizing, the ability to understand the mental states of other individuals, are key domains of social cognition. It has been hypothesized that an intact sense of agency is an important precondition for higher-level mentalizing abilities. A substantial body of evidence shows that both processes rely on similar brain areas and are severely impaired in schizophrenia, suggesting a close link between agency and mentalizing. Yet this relationship has not been explicitly tested. We investigated 40 individuals with schizophrenia and 40 healthy controls on an agency and mentalizing task. On the agency task, participants carried out simple mouse movements and judged the partially manipulated visual feedback as either self- or other-generated. On the mentalizing task, participants inferred mental states from pictures that depicted others' eyes ("Reading the mind in the eyes test"). Neuropsychological, psychopathological and social functioning levels were also evaluated. Both sense of agency and mentalizing were impaired in schizophrenia patients compared to healthy controls. However, testing for a relationship revealed no significant correlations between the two processes, either in the schizophrenia or the control group. The present findings demonstrate a dissociation of agency and mentalizing deficits in schizophrenia, suggesting that the multifaceted construct of social cognition consists of independent subdomains in healthy and psychiatrically ill individuals. PMID:20452061

  14. Sense of agency and mentalizing: dissociation of subdomains of social cognition in patients with schizophrenia.

    PubMed

    Schimansky, Jenny; David, Nicole; Rössler, Wulf; Haker, Helene

    2010-06-30

    The sense of agency, i.e., the sense that "I am the one who is causing an action", and mentalizing, the ability to understand the mental states of other individuals, are key domains of social cognition. It has been hypothesized that an intact sense of agency is an important precondition for higher-level mentalizing abilities. A substantial body of evidence shows that both processes rely on similar brain areas and are severely impaired in schizophrenia, suggesting a close link between agency and mentalizing. Yet this relationship has not been explicitly tested. We investigated 40 individuals with schizophrenia and 40 healthy controls on an agency and mentalizing task. On the agency task, participants carried out simple mouse movements and judged the partially manipulated visual feedback as either self- or other-generated. On the mentalizing task, participants inferred mental states from pictures that depicted others' eyes ("Reading the mind in the eyes test"). Neuropsychological, psychopathological and social functioning levels were also evaluated. Both sense of agency and mentalizing were impaired in schizophrenia patients compared to healthy controls. However, testing for a relationship revealed no significant correlations between the two processes, either in the schizophrenia or the control group. The present findings demonstrate a dissociation of agency and mentalizing deficits in schizophrenia, suggesting that the multifaceted construct of social cognition consists of independent subdomains in healthy and psychiatrically ill individuals.

  15. 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

  16. A systematic review of genetic variants associated with metabolic syndrome in patients with schizophrenia.

    PubMed

    Malan-Müller, Stefanie; Kilian, Sanja; van den Heuvel, Leigh L; Bardien, Soraya; Asmal, Laila; Warnich, Louise; Emsley, Robin A; Hemmings, Sîan M J; Seedat, Soraya

    2016-01-01

    Metabolic syndrome (MetS) is a cluster of factors that increases the risk of cardiovascular disease (CVD), one of the leading causes of mortality in patients with schizophrenia. Incidence rates of MetS are significantly higher in patients with schizophrenia compared to the general population. Several factors contribute to this high comorbidity. This systematic review focuses on genetic factors and interrogates data from association studies of genes implicated in the development of MetS in patients with schizophrenia. We aimed to identify variants that potentially contribute to the high comorbidity between these disorders. PubMed, Web of Science and Scopus databases were accessed and a systematic review of published studies was conducted. Several genes showed strong evidence for an association with MetS in patients with schizophrenia, including the fat mass and obesity associated gene (FTO), leptin and leptin receptor genes (LEP, LEPR), methylenetetrahydrofolate reductase (MTHFR) gene and the serotonin receptor 2C gene (HTR2C). Genetic association studies in complex disorders are convoluted by the multifactorial nature of these disorders, further complicating investigations of comorbidity. Recommendations for future studies include assessment of larger samples, inclusion of healthy controls, longitudinal rather than cross-sectional study designs, detailed capturing of data on confounding variables for both disorders and verification of significant findings in other populations. In future, big genomic datasets may allow for the calculation of polygenic risk scores in risk prediction of MetS in patients with schizophrenia. This could ultimately facilitate early, precise, and patient-specific pharmacological and non-pharmacological interventions to minimise CVD associated morbidity and mortality.

  17. 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

  18. Emotion processing and theory of mind in schizophrenia patients and their unaffected first-degree relatives.

    PubMed

    de Achával, Delfina; Costanzo, Elsa Y; Villarreal, Mirta; Jáuregui, Ignacio O; Chiodi, Araceli; Castro, Mariana N; Fahrer, Rodolfo D; Leiguarda, Ramón C; Chu, Elvina M; Guinjoan, Salvador M

    2010-04-01

    Previous studies have suggested that social cognition is affected in individuals with schizophrenia. The purpose of this study was to explore to what extent social cognition deficits are shared by unaffected first-degree relatives, and the nature of the relationship between performance in different paradigms of social cognition. 20 Schizophrenia patients (7 females, 31+/-10 years), 20 healthy age- and gender-matched individuals, 20 unaffected first-degree relatives of the schizophrenia patients (11 females, 50+/-20 years), and 20 healthy individuals matched for age and gender were recruited. Patients showed deficits in the detection of social Faux Pas (0.80+/-0.17 vs. controls: 0.94+/-0.09, p=0.025) and the correct identification of Theory of Mind stories (0.71+/-0.13 vs. controls: 0.82+/-0.12, p=0.038). Relatives performed poorly in the Faces Test (0.83+/-0.14 vs. controls: 0.9+/-0.08, p=0.048), the Reading the Mind in the Eyes Test (0.59+/-0.17 vs. controls: 0.71+/-0.14, p=0.046) and the detection of social Faux Pas (0.8+/-0.2 vs. controls: 0.93+/-0.09, p=0.024). Abnormalities were independent of age, years of education, and general cognitive performance in patients and their relatives. Performance in an Emotion Processing task (Faces Test) was correlated with performance in theory of mind tests in healthy individuals and relatives of patients with schizophrenia only. These results suggest that schizophrenia patients and their unaffected first-degree relatives display similar but nonidentical patterns of social cognition processing.

  19. 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

  20. 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

  1. 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

  2. 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.

  3. 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

  4. Long-term cariprazine treatment for the prevention of relapse in patients with schizophrenia: A randomized, double-blind, placebo-controlled trial.

    PubMed

    Durgam, Suresh; Earley, Willie; Li, Rui; Li, Dayong; Lu, Kaifeng; Laszlovszky, István; Fleischhacker, W Wolfgang; Nasrallah, Henry A

    2016-10-01

    Cariprazine, a dopamine D3/D2 receptor partial agonist with preference for D3 receptors, has demonstrated efficacy in randomized controlled trials in schizophrenia. This multinational, randomized, double-blind, placebo-controlled, parallel-group study evaluated the efficacy, safety, and tolerability of cariprazine for relapse prevention in adults with schizophrenia; total study duration was up to 97weeks. Schizophrenia symptoms were treated/stabilized with cariprazine 3-9mg/d during 20-week open-label treatment consisting of an 8-week, flexible-dose run-in phase and a 12-week fixed-dose stabilization phase. Stable patients who completed open-label treatment could be randomized to continued cariprazine (3, 6, or 9mg/d) or placebo for double-blind treatment (up to 72weeks). The primary efficacy parameter was time to relapse (worsening of symptom scores, psychiatric hospitalization, aggressive/violent behavior, or suicidal risk); clinical measures were implemented to ensure safety in case of impending relapse. A total of 264/765 patients completed open-label treatment; 200 eligible patients were randomized to double-blind placebo (n=99) or cariprazine (n=101). Time to relapse was significantly longer in cariprazine- versus placebo-treated patients (P=.0010, log-rank test). Relapse occurred in 24.8% of cariprazine- and 47.5% of placebo-treated patients (hazard ratio [95% CI]=0.45 [0.28, 0.73]). Akathisia (19.2%), insomnia (14.4%), and headache (12.0%) were reported in ≥10% of patients during open-label treatment; there were no cariprazine adverse events ≥10% during double-blind treatment. Long-term cariprazine treatment was significantly more effective than placebo for relapse prevention in patients with schizophrenia. The long-term safety profile in this study was consistent with the safety profile observed in previous cariprazine clinical trials. ClincalTrials.gov identifier: NCT01412060.

  5. Long-term cariprazine treatment for the prevention of relapse in patients with schizophrenia: A randomized, double-blind, placebo-controlled trial.

    PubMed

    Durgam, Suresh; Earley, Willie; Li, Rui; Li, Dayong; Lu, Kaifeng; Laszlovszky, István; Fleischhacker, W Wolfgang; Nasrallah, Henry A

    2016-10-01

    Cariprazine, a dopamine D3/D2 receptor partial agonist with preference for D3 receptors, has demonstrated efficacy in randomized controlled trials in schizophrenia. This multinational, randomized, double-blind, placebo-controlled, parallel-group study evaluated the efficacy, safety, and tolerability of cariprazine for relapse prevention in adults with schizophrenia; total study duration was up to 97weeks. Schizophrenia symptoms were treated/stabilized with cariprazine 3-9mg/d during 20-week open-label treatment consisting of an 8-week, flexible-dose run-in phase and a 12-week fixed-dose stabilization phase. Stable patients who completed open-label treatment could be randomized to continued cariprazine (3, 6, or 9mg/d) or placebo for double-blind treatment (up to 72weeks). The primary efficacy parameter was time to relapse (worsening of symptom scores, psychiatric hospitalization, aggressive/violent behavior, or suicidal risk); clinical measures were implemented to ensure safety in case of impending relapse. A total of 264/765 patients completed open-label treatment; 200 eligible patients were randomized to double-blind placebo (n=99) or cariprazine (n=101). Time to relapse was significantly longer in cariprazine- versus placebo-treated patients (P=.0010, log-rank test). Relapse occurred in 24.8% of cariprazine- and 47.5% of placebo-treated patients (hazard ratio [95% CI]=0.45 [0.28, 0.73]). Akathisia (19.2%), insomnia (14.4%), and headache (12.0%) were reported in ≥10% of patients during open-label treatment; there were no cariprazine adverse events ≥10% during double-blind treatment. Long-term cariprazine treatment was significantly more effective than placebo for relapse prevention in patients with schizophrenia. The long-term safety profile in this study was consistent with the safety profile observed in previous cariprazine clinical trials. ClincalTrials.gov identifier: NCT01412060. PMID:27427558

  6. 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

  7. The Relationship between Symptom Severity and Low Vitamin D Levels in Patients with Schizophrenia

    PubMed Central

    Doğan Bulut, Süheyla; Bulut, Serdar; Görkem Atalan, Dicle; Berkol, Tonguç; Gürçay, Eda; Türker, Türker; Aydemir, Çiğdem

    2016-01-01

    Background In recent years, the relationship between schizophrenia and environmental factors has come into prominence. This study investigated the relationship between vitamin D levels and the positive and negative symptoms of schizophrenia by comparing vitamin D levels between patients with schizophrenia and a healthy control group. Methods The study included 80 patients diagnosed with schizophrenia and 74 age- and sex-matched controls. The Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS) were used to evaluate symptom severity. The 25-hydroxyvitamin D (25OHD) levels of all subjects both patients and healthy controls were analyzed in relation to measurements of symptom severity. Results There were no significant differences between the groups in terms of age, sex, or physical activity. Their mean 25OHD levels were also similar (23.46±13.98ng/mL for the patient group and 23.69±9.61ng/mL for the control group). But when patients with schizophrenia were grouped based on their vitamin D levels, the results indicated a statistically significant differences between their vitamin D levels and their total SANS, affective flattening, and total SAPS, bizarre behavior and positive formal thought disorder scores (p = 0.019, p = 0.004, p = 0.015, p = 0.009 and p = 0.019, respectively). There is a negative correlation between 25OHD levels and SANS total points (r = -0.232, p = 0.038); a negative correlation for attention points (r = -0.227, p = 0.044) and negative correlation with positive formal thoughts (r = -0.257, p = 0.021). Conclusion The results of this study show a relationship between lower levels of vitamin D and the occurrence of positive and negative symptoms, along with increased severity of symptoms at lower levels of vitamin D, suggesting that treatment for schizophrenia should include assessment of patients’ vitamin D levels. We recommend that patients with schizophrenia should be assessed with

  8. 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

  9. 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

  10. 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

  11. 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.

  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. Basic visual dysfunction allows classification of patients with schizophrenia with exceptional accuracy.

    PubMed

    González-Hernández, J A; Pita-Alcorta, C; Padrón, A; Finalé, A; Galán, L; Martínez, E; Díaz-Comas, L; Samper-González, J A; Lencer, R; Marot, M

    2014-10-01

    Basic visual dysfunctions are commonly reported in schizophrenia; however their value as diagnostic tools remains uncertain. This study reports a novel electrophysiological approach using checkerboard visual evoked potentials (VEP). Sources of spectral resolution VEP-components C1, P1 and N1 were estimated by LORETA, and the band-effects (BSE) on these estimated sources were explored in each subject. BSEs were Z-transformed for each component and relationships with clinical variables were assessed. Clinical effects were evaluated by ROC-curves and predictive values. Forty-eight patients with schizophrenia (SZ) and 55 healthy controls participated in the study. For each of the 48 patients, the three VEP components were localized to both dorsal and ventral brain areas and also deviated from a normal distribution. P1 and N1 deviations were independent of treatment, illness chronicity or gender. Results from LORETA also suggest that deficits in thalamus, posterior cingulum, precuneus, superior parietal and medial occipitotemporal areas were associated with symptom severity. While positive symptoms were more strongly related to sensory processing deficits (P1), negative symptoms were more strongly related to perceptual processing dysfunction (N1). Clinical validation revealed positive and negative predictive values for correctly classifying SZ of 100% and 77%, respectively. Classification in an additional independent sample of 30 SZ corroborated these results. In summary, this novel approach revealed basic visual dysfunctions in all patients with schizophrenia, suggesting these visual dysfunctions represent a promising candidate as a biomarker for schizophrenia.

  14. Antipsychotics--the future of schizophrenia treatment.

    PubMed

    Beaumont, G

    2000-01-01

    Schizophrenia is a debilitating mental disorder affecting up to five in every thousand people. Although specialist psychiatrists are initially responsible for treating patients suffering from acute schizophrenia, the current structure of mental healthcare in the U.K. puts the onus for the delivery of maintenance therapy of discharged patients on to the general practitioner. It is crucial, therefore, that the general practitioner is aware of all available therapies for the effective, long-term, community-based treatment of patients with schizophrenia. The so-called typical antipsychotics effectively treat the positive but not the negative symptoms of schizophrenia, and up to 40% of patients are nonresponders. These antipsychotics, however, are associated with high levels of extrapyramidal side-effects (EPS), which are the main cause of patient non-compliance and their subsequent relapse and hospital readmission. Clozapine, the first atypical antipsychotic, may cause severe agranulocytosis and patients must undergo regular haematological monitoring, which is both costly and a factor unlikely to foster patient compliance. In contrast, newly developed atypical antipsychotics, such as olanzapine and quetiapine, are not only efficacious in treating the symptoms of schizophrenia, but also give rise to fewer EPS and are generally better tolerated than clozapine. In particular, olanzapine and quetiapine are not associated with severe agranulocytosis. Atypical antipsychotics, therefore, have the potential to enhance patient compliance and thus ease the general practitioner's problems of providing long-term and effective treatment for patients with schizophrenia. PMID:16422033

  15. Precentral and inferior prefrontal hypoactivation during facial emotion recognition in patients with schizophrenia: A functional near-infrared spectroscopy study.

    PubMed

    Watanuki, Toshio; Matsuo, Koji; Egashira, Kazuteru; Nakashima, Mami; Harada, Kenichiro; Nakano, Masayuki; Matsubara, Toshio; Takahashi, Kanji; Watanabe, Yoshifumi

    2016-01-01

    Although patients with schizophrenia demonstrate abnormal processing of emotional face recognition, the neural substrates underlying this process remain unclear. We previously showed abnormal fronto-temporal function during facial expression of emotions, and cognitive inhibition in patients with schizophrenia using functional near-infrared spectroscopy (fNIRS). The aim of the current study was to use fNIRS to identify which brain regions involved in recognizing emotional faces are impaired in patients with schizophrenia, and to determine the neural substrates underlying the response to emotional facial expressions per se, and to facial expressions with cognitive inhibition. We recruited 19 patients with schizophrenia and 19 healthy controls, statistically matched on age, sex, and premorbid IQ. Brain function was measured by fNIRS during emotional face assessment and face identification tasks. Patients with schizophrenia showed lower activation of the right precentral and inferior frontal areas during the emotional face task compared to controls. Further, patients with schizophrenia were slower and less accurate in completing tasks compared to healthy participants. Decreasing performance was associated with increasing severity of the disease. Our present and prior studies suggest that the impaired behavioral performance in schizophrenia is associated with different mechanisms for processing emotional facial expressions versus facial expressions combined with cognitive inhibition.

  16. Disruptions in small-world cortical functional connectivity network during an auditory oddball paradigm task in patients with schizophrenia.

    PubMed

    Shim, Miseon; Kim, Do-Won; Lee, Seung-Hwan; Im, Chang-Hwan

    2014-07-01

    P300 deficits in patients with schizophrenia have previously been investigated using EEGs recorded during auditory oddball tasks. However, small-world cortical functional networks during auditory oddball tasks and their relationships with symptom severity scores in schizophrenia have not yet been investigated. In this study, the small-world characteristics of source-level functional connectivity networks of EEG responses elicited by an auditory oddball paradigm were evaluated using two representative graph-theoretical measures, clustering coefficient and path length. EEG signals from 34 patients with schizophrenia and 34 healthy controls were recorded while each subject was asked to attend to oddball tones. The results showed reduced clustering coefficients and increased path lengths in patients with schizophrenia, suggesting that the small-world functional network is disrupted in patients with schizophrenia. In addition, the negative and cognitive symptom components of positive and negative symptom scales were negatively correlated with the clustering coefficient and positively correlated with path length, demonstrating that both indices are indicators of symptom severity in patients with schizophrenia. Our study results suggest that disrupted small-world characteristics are potential biomarkers for patients with schizophrenia.

  17. Distinct inter-hemispheric dysconnectivity in schizophrenia patients with and without auditory verbal hallucinations.

    PubMed

    Chang, Xiao; Xi, Yi-Bin; Cui, Long-Biao; Wang, Hua-Ning; Sun, Jin-Bo; Zhu, Yuan-Qiang; Huang, Peng; Collin, Guusje; Liu, Kang; Xi, Min; Qi, Shun; Tan, Qing-Rong; Miao, Dan-Min; Yin, Hong

    2015-01-01

    Evidence from behavioral, electrophysiological and diffusion-weighted imaging studies suggest that schizophrenia patients suffer from deficiencies in bilateral brain communication, and this disruption may be related to the occurrence of auditory verbal hallucinations (AVH). To increase our understanding of aberrant inter-hemispheric communication in relation to AVH, we recruited two groups of first-episode schizophrenia patients: one group with AVH (N = 18 AVH patients) and one without hallucinations (N = 18 Non-AVH patients), and 20 healthy controls. All participants received T1 structural imaging and resting-state fMRI scanning. We adopted a newly developed index, voxel-mirrored homotopic connectivity (VMHC), to quantitatively describe bilateral functional connectivity. The whole-brain VMHC measure was compared among the three groups and correlation analyses were conducted between symptomology scores and neurological measures. Our findings suggest all patients shared abnormalities in parahippocampus and striatum. Aberrant bilateral connectivity of default mode network (DMN), inferior frontal gyrus and cerebellum only showed in AVH patients, whereas aberrances in superior temporal gyrus and precentral gyrus were specific to Non-AVH patients. Meanwhile, inter-hemispheric connectivity of DMN correlated with patients' symptomatology scores. This study corroborates that schizophrenia is characterized by inter-hemispheric dysconnectivity, and suggests the localization of such abnormalities may be crucial to whether auditory verbal hallucinations develop. PMID:26053998

  18. 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.

  19. 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…

  20. Serum soluble urokinase-type plasminogen activator receptor levels in male patients with acute exacerbation of schizophrenia.

    PubMed

    Genc, Abdullah; Kalelioglu, Tevfik; Karamustafalioglu, Nesrin; Tasdemir, Akif; Genc, Esra Sena; Akkus, Mustafa; Emul, Murat

    2016-02-28

    Inflammatory abnormalities have been shown in the pathogenesis of schizophrenia. Soluble urokinase-type plasminogen activator receptor (suPAR) is a protein that is measurable in the circulating blood and reflects the inflammation in the body. We aimed to investigate serum suPAR levels in patients with schizophrenia who were in acute state and to compare with healthy controls. Forty five patients and 43 healthy controls were included in the study. We found no significant difference in suPAR levels between patients and controls, suggesting that suPAR as an inflammatory marker does not have a role in the inflammatory process of acute schizophrenia.

  1. 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.

  2. 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

  3. Bedding, not boarding. Psychiatric patients boarded in hospital EDs create crisis for patient care and hospital finances.

    PubMed

    Kutscher, Beth

    2013-11-18

    As the supply of psychiatric beds dwindles, hospitals are devising innovative ways handle psych patients who come through the emergency department. Some collaborate with other hospitals, use separate pysch EDs or refer patients to residential treatment centers.

  4. The effects of clozapine on levels of total cholesterol and related lipids in serum of patients with schizophrenia: a prospective study.

    PubMed Central

    Dursun, S M; Szemis, A; Andrews, H; Reveley, M A

    1999-01-01

    OBJECTIVE: To investigate the effects of 12 weeks of clozapine treatment on levels of cholesterol and related lipids in patients with schizophrenia. DESIGN: Prospective study. SETTING: University department associated with a teaching hospital. PARTICIPANTS: Eight patients (6 women and 2 men) with a clinical diagnosis of schizophrenia consistent with DSM-IV criteria. The patients were classified as treatment-resistant and had not responded to treatment with at least 2 conventional antipsychotics. INTERVENTIONS: Current antipsychotic medications were tapered and treatment with clozapine was initiated. OUTCOME MEASURES: Cholesterol and serum lipid levels, as well as Brief Psychiatric Rating Scale (BPRS) scores were measured before and after 12 weeks of treatment with clozapine. RESULTS: Clozapine treatment significantly improved the BPRS scores but did not significantly alter serum lipid levels, except triglyceride levels, which increased. CONCLUSION: The previously reported lower levels of cholesterol in treatment-resistant patients with schizophrenia cannot be attributed to the effects of clozapine administration. Further research is required to support and clarify the effects of antipsychotic drugs on lipid levels. Images Fig. 1 PMID:10586536

  5. A prospective study of patients absconding from a general hospital psychiatry unit in a developing country.

    PubMed

    Khisty, N; Raval, N; Dhadphale, M; Kale, K; Javadekar, A

    2008-08-01

    Characteristics of patients absconding from an open psychiatry ward in a developing country may be different from both those in developed countries and a mental hospital setting. The aim of this paper is to study the incidence and characteristics of patients absconding from an open psychiatric ward in a general hospital-based psychiatric unit in India. We studied patients consecutively admitted to an open psychiatric ward over a 2-month period. We compared those who absconded with those who did not. Out of 231 patients admitted, 33 absconded. Among those who absconded, 15 had bipolar disorder, 11 had schizophrenia and five had substance-related disorders. Nine had indicated their intention to do so at admission. Ten patients had absconded by the second day. The treatment cost was the likely influencing factor for seven patients who absconded after deemed fit for discharge on clinical grounds. Only 10 patients were readmitted to the hospital within 2 weeks of absconding. The risk of absconding is highest in the early days following. Absconding patients did not differ significantly from others in many socio-demographic and clinical features. Treatment costs are an important consideration in India. PMID:18638205

  6. 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

  7. 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

  8. 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.

  9. 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

  10. Randomised trial of personalised computer based information for patients with schizophrenia

    PubMed Central

    Jones, Ray B; Atkinson, Jacqueline M; Coia, Denise A; Paterson, Lesley; Morton, A Ross; McKenna, Kate; Craig, Neil; Morrison, Jillian; Gilmour, W Harper

    2001-01-01

    Objectives To compare use, effect, and cost of personalised computer education with community psychiatric nurse education for patients with schizophrenia. Design Randomised trial of three interventions. Modelling of costs of alternatives. Participants 112 patients with schizophrenia in contact with community services; 67 completed the intervention. Interventions Three interventions of five educational sessions: (a) computer intervention combining information from patient's medical record with general information about schizophrenia; (b) sessions with a community psychiatric nurse; (c) “combination” (first and last sessions with nurse and remainder with computer). Main outcome measures Patients' attendance, opinions, change in knowledge, and psychological state; costs of interventions and patients' use of NHS community services; modelling of costs for these three, and alternative, interventions. Results Rates of completion of intervention did not differ significantly (71% for combination intervention, 61% for computer only, 46% for nurse only). Computer sessions were shorter than sessions with nurse (14 minutes v 60 minutes). More patients given nurse based education thought the information relevant. Of 20 patients in combination group, 13 preferred the sessions with the nurse and seven preferred the computer. There were no significant differences between groups in psychological outcomes. Because of the need to transport patients to the computer for their sessions, there was no difference between interventions in costs, but computer sessions combined with other patient contacts would be substantially cheaper. Conclusions The computer based patient education offered no advantage over sessions with a community psychiatric nurse. Investigation of computer use combined with other health service contacts would be worth while. What is already known on this topicEducation of patients with schizophrenia has limited but positive outcomesComputer based approaches have not

  11. 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

  12. Interactions between dietary supplements in hospitalized patients.

    PubMed

    Levy, Ilana; Attias, Samuel; Ben Arye, Eran; Goldstein, Lee; Schiff, Elad

    2016-10-01

    Inpatient consumption of dietary and herbal supplements (DHS) has recently received research attention, particularly due to potential DHS-drug interactions. Nevertheless, DHS-DHS interactions have seldom been evaluated among hospitalized patients. We evaluated potential DHS-DHS interactions among inpatients. The study was a cross-sectional prospective study, conducted at Bnai Zion Medical Center (Haifa, Israel) in 2009-2014. A multi-disciplinary team of researchers constructed a questionnaire aimed at detecting DHS use among inpatients. The Natural Medicine Database was used to examine identified DHS for potential DHS-DHS interactions. Then, medical files were reviewed to identify side effects potentially caused by such interactions and rate of documentation of DHS use. Univariate and multivariate logistic regression analyses were conducted to characterize potential risk factors for DHS-DHS interactions among hospitalized DHS users. Of 927 patients who agreed to answer the questionnaire, 458 (49.4 %) reported the use of 89 different DHS. Potential DHS-DHS interactions were identified in 12.9 % of DHS users. Three interactions were associated with the actual occurrence of adverse events. Patients at risk of DHS-DHS interactions included females (p = 0.026) and patients with greater numbers of concomitant medications (p < 0.0001) and of consumed DHS (p < 0.0001). In 88.9 % of DHS users, DHS use was not reported in medical files and only 18 % of the DHS involved in interactions were documented. Potential DHS-DHS interactions are common in inpatients, and may lead to hospitalization or worsen existing medical conditions. The causal relationship between potential interactions and actual adverse events requires further study.

  13. Interactions between dietary supplements in hospitalized patients.

    PubMed

    Levy, Ilana; Attias, Samuel; Ben Arye, Eran; Goldstein, Lee; Schiff, Elad

    2016-10-01

    Inpatient consumption of dietary and herbal supplements (DHS) has recently received research attention, particularly due to potential DHS-drug interactions. Nevertheless, DHS-DHS interactions have seldom been evaluated among hospitalized patients. We evaluated potential DHS-DHS interactions among inpatients. The study was a cross-sectional prospective study, conducted at Bnai Zion Medical Center (Haifa, Israel) in 2009-2014. A multi-disciplinary team of researchers constructed a questionnaire aimed at detecting DHS use among inpatients. The Natural Medicine Database was used to examine identified DHS for potential DHS-DHS interactions. Then, medical files were reviewed to identify side effects potentially caused by such interactions and rate of documentation of DHS use. Univariate and multivariate logistic regression analyses were conducted to characterize potential risk factors for DHS-DHS interactions among hospitalized DHS users. Of 927 patients who agreed to answer the questionnaire, 458 (49.4 %) reported the use of 89 different DHS. Potential DHS-DHS interactions were identified in 12.9 % of DHS users. Three interactions were associated with the actual occurrence of adverse events. Patients at risk of DHS-DHS interactions included females (p = 0.026) and patients with greater numbers of concomitant medications (p < 0.0001) and of consumed DHS (p < 0.0001). In 88.9 % of DHS users, DHS use was not reported in medical files and only 18 % of the DHS involved in interactions were documented. Potential DHS-DHS interactions are common in inpatients, and may lead to hospitalization or worsen existing medical conditions. The causal relationship between potential interactions and actual adverse events requires further study. PMID:26837208

  14. 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

  15. Eyeblink conditioning in unmedicated schizophrenia patients: A positron emission tomography study

    PubMed Central

    Parker, Krystal L.; Andreasen, Nancy C.; Liu, Dawei; Freeman, John H.; O’Leary, Daniel S.

    2014-01-01

    Previous studies suggest that patients with schizophrenia exhibit dysfunctions in a widely distributed circuit—the cortico-cerebellar-thalamic-cortical circuit, or CCTCC—and that this may explain the multiple cognitive deficits observed in the disorder. This study uses positron emission tomography (PET) with O15 H2O to measure regional cerebral blood flow (rCBF) in response to a classic test of cerebellar function, the associative learning that occurs during eyeblink conditioning, in a sample of 20 unmedicated schizophrenia patients and 20 closely matched healthy controls. The PET paradigm examined three phases of acquisition and extinction (early, middle and late). The patients displayed impaired behavioral performance during both acquisition and extinction. The imaging data indicate that, compared to the control subjects, the patients displayed decreases in rCBF in all three components of the CCTCC during both acquisition and extinction. Specifically, patients had less rCBF in the middle and medial frontal lobes, anterior cerebellar lobules I/V and VI, as well as the thalamus during acquisition and although similar areas were found in the frontal lobe, ipsilateral cerebellar lobule IX showed consistently less activity in patients during extinction. Thus this study provides additional support for the hypothesis that patients with schizophrenia have a cognitive dysmetria—an inability to smoothly coordinate many different types of mental activity—that affects even a very basic cognitive task that taps into associative learning. PMID:24090512

  16. Asymmetric dimethylarginine (ADMA) and treatment response relationship in male patients with first-episode schizophrenia: a controlled study.

    PubMed

    Zincir, Serkan; Zincir, Selma Bozkurt; Doruk, Ali; Erdem, Murat; Celik, Cemil; Ak, Mehmet; Garip, Beyazıt; Yükselir, Cihad; Karaahmetoğlu, Bülent

    2014-12-15

    Nitric oxide (NO) is thought to be involved in the pathogenesis of schizophrenia as well as many neuropsychiatric disease. Asymmetric dimethylarginine (ADMA) reduces the level of NO by inhibiting nitric oxide synthase (NOS) enzyme. In this study it is aimed to be investigated ADMA in patients with first-episode schizophrenia. In this study, according to DSM-IV diagnostic criteria for schizophrenia-like psychotic disorder, 49 male first-episode schizophrenia patients-whose mean age was 23.4±3.5 year-and age and education matched 30 healthy male subjects were included for comparison. ADMA levels of the patients were measured before and after 2 months of therapy. In order to rule out the conditions that may affect the levels of ADMA, people whose physical examination and laboratory findings were within normal range were included in the study. In this study plasma ADMA levels of first-episode schizophrenia patients and control group were 3.6±1.5 µmol/L and 1.02±1.02 respectively. After 2 months of antipsychotic treatment plasma ADMA levels of the schizophrenia patients decreased compared to baseline. There was no relationship between the ADMA levels and the clinical severity of the disease. It is considered to be the role of ADMA in the etiopathogenesis of schizophrenia.

  17. Current and future forecasts of service use and expenditures of Medicaid-eligible schizophrenia patients in the state of Georgia.

    PubMed

    Miller, L Stephen; Martin, Bradley C

    2004-01-01

    This study linked all claims data for reimbursable medical services and drugs of a cohort of 16,227 Medicaid-eligible recipients diagnosed with schizophrenia residing in the State of Georgia, with the treatment history file and Hospital Medical Information System file of each of the ten Georgia State psychiatric hospitals (Georgia Department of Human Resources [DHR]), which do not routinely bill Medicaid for services rendered. This provided a comprehensive picture of the medical resources consumed for each schizophrenia patient, allowing determination of expenditure use patterns, as well as forecast of future medical costs. Patient-level data were aggregated by category of service and reported as costs per member per month (PMPM). Autoregressive integrated moving average time series models described the temporal pattern of expenditures for 8 years of total cost data and were used to forecast expenditures 5 years into the future. From 1990 to 1997, total cumulative expenditures were over 1.09 billion dollars, expressed in 1995 constant dollars. DHR institutional care dominated the cost of care, but expenditures significantly decreased over time. Apparently offsetting this decrease was an increase in prescription drug cost between 1990 and 1995, from 5.7 percent of total expenditures to 10.5 percent. Total Medicaid and Medicare expenditures in 1995 dollars were relatively constant at approximately 700 dollars PMPM. Prescription expenditures increased from 50 dollars in 1990 to 100 dollars PMPM in 1997 and were projected to increase to 150 dollars in 2002. Expenditures were lower for persons continuously eligible for Medicaid than for the total cohort. Trends include a significant increase in prescription expenditures over time concurrent with decreases in inpatient expenditures and relatively stable changes in community mental health center expenditures.

  18. 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

  19. Refeeding syndrome in hospitalized pediatric patients.

    PubMed

    Dunn, Rebecca L; Stettler, Nicolas; Mascarenhas, Maria R

    2003-08-01

    Refeeding syndrome has been well documented over the years, primarily through case reports and literature reviews. Awareness of refeeding syndrome is crucial in preventing the occurrence of, and the metabolic and physiologic complications associated with, aggressive nutrition support in malnourished populations. Once compromised patients have been identified to be at risk of refeeding syndrome, nutrition rehabilitation should be cautiously initiated. We have found a lack of clinical validation for instituting nutrition support in high-risk pediatric patients who may develop refeeding syndrome. The purposes of our investigation were to determine the incidence of refeeding syndrome in pediatric hospitalized patients beginning on parenteral nutrition and to determine how consistently the Department of Clinical Nutrition standards of care for screening and prevention were followed at our institution.

  20. Aripiprazole (ABILIFY MAINTENA®): a review of its use as maintenance treatment for adult patients with schizophrenia.

    PubMed

    Shirley, Matt; Perry, Caroline M

    2014-07-01

    Aripiprazole (ABILIFY(®)) is an atypical antipsychotic drug that is proposed to act via partial agonism of dopamine D2 receptors. Trials with oral aripiprazole have shown that, compared with some other atypical antipsychotics, aripiprazole is associated with fewer metabolic disturbances and has a favourable cardiovascular tolerability profile. Recently, an intramuscular long-acting injectable (LAI) depot formulation of aripiprazole (ABILIFY MAINTENA(®)) (aripiprazole LAI) has been approved for use as a treatment for schizophrenia in adults. The efficacy of aripiprazole LAI as a maintenance treatment for schizophrenia has been demonstrated in randomized clinical trials. In the trials, aripiprazole LAI was more effective than placebo, and noninferior to oral aripiprazole, in delaying relapse and in reducing relapse rates in schizophrenia. Aripiprazole LAI was generally well tolerated, with a tolerability profile consistent with that of oral aripiprazole. Thus, aripiprazole LAI is a valuable new treatment option for adult patients with schizophrenia. It may be of particular use for patients stable on oral aripiprazole who would prefer, or are likely to benefit from, a long-acting formulation.

  1. 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

  2. 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

  3. Burden, interdependence, ethnicity, and mental health in caregivers of patients with schizophrenia.

    PubMed

    Suro, Giulia; Weisman de Mamani, Amy G

    2013-06-01

    Caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health. Using a sample of 176 caregivers of patients with schizophrenia, the present study examined how two components of burden (objective and subjective) interacted with interdependence and ethnicity to influence relatives' overall mental health. In line with study hypotheses, and with the stress-appraisal-coping model developed by Lazurus and Folkman (1984), we found that subjective burden mediated the relationship between objective burden and mental health. In other words, subjective appraisals of caregiving appeared to partially underlie the association between the concrete costs of caregiving and psychological outcomes in schizophrenia caregivers. Also as hypothesized, we found that interdependence, or the perceived interconnectedness of individuals within a group, moderated the relationship between objective burden and subjective burden. In other words, when levels of interdependence were high, the objective components of burden appeared to have a weaker relationship with subjective burden. When interdependence was low, on the other hand, objective burden was more likely to be associated with subjective burden. This finding suggests that helping caregivers to value harmony and connection with others over individual self-interests may reduce the likelihood that objective stressors (which are often inevitable in schizophrenia) will result in subjective distress. On the basis of prior research, we also tested several hypotheses regarding the role of ethnicity and its association with burden, interdependence, and mental health. However, contrary to expectations, no ethnic patterns were observed. PMID:23763688

  4. 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

  5. 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

  6. 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.

  7. Schizophrenia Patients Demonstrate Both Inter-Voxel Level and Intra-Voxel Level White Matter Alterations

    PubMed Central

    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

  8. Metabolic syndrome in schizophrenia: Differences between antipsychotic-naïve and treated patients

    PubMed Central

    Chadda, Rakesh K.; Ramshankar, Prashanth; Deb, Koushik S.; Sood, Mamta

    2013-01-01

    Metabolic syndrome (MetS) has been recognized as a risk factor for cardiovascular morbidity and mortality in general population and in patients with severe mental illnesses like schizophrenia. This paper reviews studies on MetS in schizophrenia and related psychotic disorders, and assesses the contribution of antipsychotics toward the development of MetS. Databases of Medline (PubMed), PsycINFO, and Scopus were searched for MetS, psychotic disorders, and antipsychotic drugs from inception till present. Prevalence of MetS in patients with schizophrenia was found to be ranging from 3.3% to 68.0%. Prevalence in antipsychotic-naïve and antipsychotic-treated patients ranged between 3.3-26.0% and 32.0-68.0% respectively, and was higher in younger patients, female gender and Hispanics, and lower in African-Americans and Orientals. Prevalence of metabolic abnormalities was higher in patients receiving second generation antipsychotics (SGAs), especially with clozapine, olanzapine, and risperidone, as compared to first generation antipsychotics (FGAs). Antipsychotic-induced changes on metabolic indices became evident after 2 weeks and reached maximum at 3 months of treatment. There is a need to sensitize the mental health professionals at all levels about the need of screening and monitoring for MetS in patients receiving antipsychotics. PMID:23960422

  9. Subtle deficits of cognitive theory of mind in unaffected first-degree relatives of schizophrenia patients.

    PubMed

    Montag, Christiane; Neuhaus, Kathrin; Lehmann, Anja; Krüger, Katja; Dziobek, Isabel; Heekeren, Hauke R; Heinz, Andreas; Gallinat, Jürgen

    2012-04-01

    Alterations of theory of mind (ToM) and empathy were implicated in the formation of psychotic experiences, and deficits in psychosocial functioning of schizophrenia patients. Inspired by concepts of neurocognitive endophenotypes, the existence of a distinct, potentially neurobiologically based social-cognitive vulnerability marker for schizophrenia is a matter of ongoing debate. The fact that previous research on social-cognitive deficits in individuals at risk yielded contradictory results may partly be due to an insufficient differentiation between qualitative aspects of ToM. Thirty-four unaffected first-degree relatives of schizophrenia patients (21 parents, 8 siblings, 5 children; f/m: 30/4; mean age: 48.1 ± 12.7 years) and 34 controls subjects (f/m: 25/9; mean age: 45.9 ± 10.9 years) completed the 'Movie for the Assessment of Social Cognition'-a video-based ToM test-and an empathy questionnaire (Interpersonal Reactivity Index, IRI). Outcome parameters comprised (1) 'cognitive' versus 'emotional' ToM, (2) error counts representing 'undermentalizing' versus 'overmentalizing', (3) empathic abilities and (4) non-social neurocognition. MANCOVA showed impairments in cognitive but not emotional ToM in the relatives' group, when age, gender and neurocognition were controlled for. Relatives showed elevated error counts for 'undermentalizing' but not for 'overmentalizing'. No alterations were detected in self-rated dimensions of empathy. Of all measures of ToM and empathy, only the IRI subscale 'fantasy' was associated with measures of psychotic risk, i.e. a history of subclinical delusional ideation. The present study confirmed subtle deficits in cognitive, but not emotional ToM in first-degree relatives of schizophrenia patients, which were not explained by global cognitive deficits. Findings corroborate the assumption of distinct social-cognitive abilities as an intermediate phenotype for schizophrenia.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. Patients' perceptions of care are associated with quality of hospital care: a survey of 4605 hospitals.

    PubMed

    Stein, Spencer M; Day, Michael; Karia, Raj; Hutzler, Lorraine; Bosco, Joseph A

    2015-01-01

    Favorable patient experience and low complication rates have been proposed as essential components of patient-centered medical care. Patients' perception of care is a key performance metric and is used to determine payments to hospitals. It is unclear if there is a correlation between technical quality of care and patient satisfaction. The study authors correlated patient perceptions of care measured by the Hospital Consumer Assessment of Healthcare Providers and Systems scores with accepted quality of care indicators. The Hospital Compare database (4605 hospitals) was used to examine complication rates and patient-reported experience for hospitals across the nation in 2011. The majority of the correlations demonstrated an inverse relationship between patient experience and complication rates. This negative correlation suggests that reducing these complications can lead to a better hospital experience. Overall, these results suggest that patient experience is generally correlated with the quality of care provided.

  17. 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.

  18. [Management of hyperglycemia in hospitalized patients].

    PubMed

    Gracia-Ramos, Abraham Edgar; Cruz-Domínguez, María Pilar; Madrigal-Santillán, Eduardo Osiris; Morales-González, José Antonio; Vera-Lastra, Olga Lidia

    2015-01-01

    Diabetes is a global health problem and Mexico rank sixth in prevalence of this entity. In our country, is the leading cause of death and is a major cause of hospital care being responsible for about 1 in 5 discharges. In the hospital setting, it has been observed that hyperglycemia, both diabetic and non-diabetic patients, is associated with an increased risk of complications, disability and death, and that adequate control in the blood glucose level produces a reduction in these complications. With these bases, several associations have recommended the treatment of hospital hyperglycemia through insulin administration, with the therapeutic goal of maintaining a fasting blood glucose level between 100-140 mg/dL and glucose at any time of day less than 180 mg/dL. The insulin application method most recommended consisting in a basal-bolus regimen which has shown efficacy with a low risk of hypoglycemia. The usual practice of the application of insulin through a correction scheme should be abandoned because it is inefficient and involves risks.

  19. Assessment of motivation to change substance use in dually-diagnosed schizophrenia patients.

    PubMed

    Kinnaman, Joanna E Strong; Bellack, Alan S; Brown, Clayton H; Yang, Ye

    2007-09-01

    Assessment of motivation to change substance use can be helpful in evaluating treatment readiness and outcome. However, the utility of self-report measures of motivation with schizophrenia patients is questionable. In the current study patients with schizophrenia and either concurrent cocaine dependence or remitted dependence completed the University of Rhode Island Change Assessment-Maryland (URICA-M), a self-report inventory that assesses motivation, and an analogous cartoon instrument at baseline and 6-months follow-up. Results demonstrate that the cartoon readiness to change score was related to increased treatment utilization and decreased substance use; results were not as favorable for the URICA-M. Findings suggest that the cartoon measure may be a suitable alternative to assess motivation to change substance use with cognitively impaired patients.

  20. Do patients "like" good care? measuring hospital quality via Facebook.

    PubMed

    Timian, Alex; Rupcic, Sonia; Kachnowski, Stan; Luisi, Paloma

    2013-01-01

    With the growth of Facebook, public health researchers are exploring the platform's uses in health care. However, little research has examined the relationship between Facebook and traditional hospital quality measures. The authors conducted an exploratory quantitative analysis of hospitals' Facebook pages to assess whether Facebook "Likes" were associated with hospital quality and patient satisfaction. The 30-day mortality rates and patient recommendation rates were used to quantify hospital quality and patient satisfaction; these variables were correlated with Facebook data for 40 hospitals near New York, NY. The results showed that Facebook "Likes" have a strong negative association with 30-day mortality rates and are positively associated with patient recommendation. These exploratory findings suggest that the number of Facebook "Likes" for a hospital may serve as an indicator of hospital quality and patient satisfaction. These findings have implications for researchers and hospitals looking for a quick and widely available measure of these traditional indicators.

  1. [The effects of antipsychotic treatment on the hypothalamo-pituitary-gonadal (HPG) axis in patients with schizophrenia].

    PubMed

    Wyszogrodzka-Kucharska, Anna; Rabe-Jabłońska, Jolanta; Kostulski, Adrian

    2003-01-01

    The functioning of Hypothalamic-Pituitary-Gonadal axis is commonly affected during a course of antipsychotic therapy. This paper presents epidemiology, possible cause and management of hormonal disturbances during antipsychotic treatment in patients with schizophrenia.

  2. 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

  3. [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

  4. Attentional and emotional functioning in schizophrenia patients treated with conventional and atypical antipsychotic drugs

    PubMed Central

    Kucharska-Pietura, Katarzyna; Tylec, Aneta; Czernikiewicz, Andrzej; Mortimer, Ann

    2012-01-01

    Summary Background Effectiveness of antipsychotics in treating emotional and cognitive deficits in schizophrenia still remains controversial. The aim of our study was to assess emotional and cognitive functioning in schizophrenic inpatients currently treated with typical antipsychotics (perphenazine, perazine, fluphenazine, and haloperidol) and in another group of schizophrenic inpatients currently on atypical antipsychotics (olanzapine, risperidone, amisulpride, and quetiapine). Material/Methods One hundred patients with DSM-IV schizophrenia or schizoaffective disorders (39 treated using typical antipsychotics and 61 treated with atypical antipsychotics) under naturalistic treatment conditions, and 50 healthy controls were given the following: Test of Everyday Attention, Facial Emotion Recognition Test, Facial Memory Recognition Test, and “Reading the mind in the eyes” Test. Results Patients with a diagnosis of schizophrenia revealed the following deficits: facial emotion perception, empathy/theory of mind, visual selective attention/speed, attentional switching, and auditory-verbal working memory. Our results show a significant difference between schizophrenic and healthy controls in all tasks, with schizophrenic patients performing worse than controls. Interestingly, our patients on atypical neuroleptics performed similarly compared to schizophrenic patients treated with conventional neuroleptics on all tasks provided. There were some significant relationships between emotional and cognitive deficits and clinical variables. Conclusions Our findings remain consistent with other recent studies in which atypical antipsychotics did not show a clear advantage over typical antipsychotics on both emotional and cognitive functioning. PMID:22207119

  5. 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

  6. 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

  7. Cigarette smoking modulates medication-associated deficits in a monetary reward task in patients with schizophrenia.

    PubMed

    Lernbass, Birgit; Grön, Georg; Wolf, Nadine D; Abler, Birgit

    2013-09-01

    Imaging studies of reward processing have demonstrated a mesolimbic-mesocortical dopaminergic dysfunction in schizophrenia. Such studies on reward processing in patients and also in healthy controls showed that differential activations of dopaminergic brain areas are associated with adaptive changes in response speed related to different reward values. Given this relationship, we investigated reward processing on the behavioural level in a larger sample of 49 medicated patients with a diagnosis of schizophrenia (ICD-10 F20) and 49 healthy controls. Subjects were instructed to react by button press upon two different stimuli in order to retain a 60 % chance winning a previously announced high (1$) or low (20¢) amount of money paid to participants after the experiment. Concordant with previous reports on deficits in reward processing, acceleration of reaction times in patients upon low rewards differed significantly (p < 0.05) from healthy controls in our present behavioural study. This effect was pronounced in the non-smoking subgroup of patients (n = 24). In this subgroup, we also observed a significant (p < 0.05) positive correlation with medication type (relatively high vs. low D2 receptor affinity) and with the PANSS score, the latter with a trend to significance (p = 0.08). Our study demonstrates that reaction time measures in a monetary reward task might constitute a feasible behavioural proxy for dopaminergic dysfunction and its different dimensions regarding psychopathology but also medication in patients with schizophrenia. In line with clinical observations, our findings support the notion that smoking modulates medication-associated side effects on reward processing in patients with schizophrenia.

  8. [Discharge Dynamics and Related Factors of Long-stay Patients in Psychiatric Hospitals].

    PubMed

    Kono, Toshiaki; Shiraishi, Hiromi; Tachimori, Hisateru; Koyama, Asuka; Naganuma, Yoichi; Takeshima, Tadashi

    2015-01-01

    A longstanding challenge in Japan is prolonged psychiatric hospitalization and the associated difficulty of discharge, lost opportunities for patients' social participation, and stagnant reallocation of medical resources. Although the length of stay has been shortened recently on average, its distribution tends to be polarized into high-turnover and long-stay groups. To resolve these problems, we must understand the discharge dynamics of long-stay patients. Three questionnaires were sent to 733 randomly selected psychiatric hospitals (response rate: 24.3%; 178 hospitals, 2,480 patients). One questionnaire was on hospitalized patient numbers for one-year or longer stays as at the end of June 2007, recording each combination of Group (A or B), diagnosis, and hospitalization type. Group A referred to patients continuously hospitalized as at the end of June 2008; Group B referred to those discharged between July 2007 and June 2008. The second questionnaire was on hospital characteristics (founder, bed number, medical function, etc.), and the third questionnaire was on detailed patient characteristics (residential setting post-discharge, etc., for each Group B patient; a maximum of 20 patients per hospital consecutively in order of discharge). Valid data were obtained from 171 hospitals and 2,419 patients, with the latter increasing to 3,543 after weighting. The annual discharge rate (ADR; B/[A+B]) for the entire sample was 16.3%. Regarding the diagnosis, dementia showed the highest ADR (27.8%) and schizophrenia the lowest (13.5%). The ADRs for depression, bipolar disorder, and alcoholism were 23.9, 20.6, and 23.7% respectively. Regarding the hospitalization type, voluntary hospitalization (16.0%) and hospitalization for medical care and protection (16.8%) showed similar ADRs. Regarding the district, ADRs were high in Kinki (19.9%) and Kyushu (18.8%), and low in Kanto (14.1%) and Chugoku/Shikoku (14.2%). Multivariate analyses revealed that discharge within one year was

  9. Alternate Level of Care Patients in Public General Hospital Psychiatry.

    ERIC Educational Resources Information Center

    Marcos, Luis R.; Gil, Rosa M.

    1984-01-01

    Analyzes the interaction between psychiatric services in public general hospitals and in other institutional settings. A one-day census of patients in a New York general hospital showed the hospital was providing care to a large number of patients in need of other, less intensive institutional settings. (BH)

  10. 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…

  11. Hospital-based patient education programs and the role of the hospital librarian.

    PubMed Central

    Harris, C L

    1978-01-01

    This paper examines current advances in hospital-based patient education, and delineates the role of the hospital librarian in these programs. Recently, programs of planned patient education have been recognized by health care personnel and the public as being an integral part of health care delivery. Various key elements, including legislative action, the advent of audiovisual technology, and rising health care costs have contributed to the development of patient education programs in hospitals. As responsible members of the hospital organization, hospital librarians should contribute their expertise to patient education programs. They are uniquely trained with skills in providing information on other health education programs; in assembling, cataloging, and managing collections of patient education materials; and in providing documentation of their use. In order to demonstrate the full range of their skills and to contribute to patient care, education, and research, hospital librarians should actively participate in programs of planned patient education. PMID:418835

  12. 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

  13. Tolerance studies with brotizolam in hospitalized patients

    PubMed Central

    von Delbrück, Orla; Goetzke, Edda; Nagel, Cornelia

    1983-01-01

    1 A long-term study of brotizolam (minimum 4 weeks: maximum 26 weeks) was carried out in hospitalized patients (29 to 95 years) who complained of sleep disturbance. 3.0% of the patients used 0.125 mg, 86.4% used 0.25 mg, and 10.0% used 0.5 mg daily. During the trial there was no evidence of tolerance. 2 There were no symptoms of overdosage, physical and psychological dependency or withdrawal, and there were no interactions with the concurrently prescribed drugs. 3 There were no changes in vital functions, haematology, or in the biochemical investigations of blood or urine which could be attributed to the drug. PMID:6362697

  14. Test-retest stability of the oral niacin test and electrodermal activity in patients with schizophrenia.

    PubMed

    Nilsson, B M; Hultman, C M; Ekselius, L

    2009-01-01

    In schizophrenia, well-replicated findings support an attenuated niacin skin-flush response. We have previously reported a delayed skin-flush after niacin ingestion and also an association between niacin non-responding and electrodermal non-responding in schizophrenia. The stability of the niacin and electrodermal tests was now studied in a test-retest design. An additional aim was to assess the association previously found. Twenty-three patients with schizophrenia underwent two sessions 3 months apart during which an oral niacin test was conducted and electrodermal activity was measured. Despite similar values for niacin outcome variables at the group level, there was high intraindividual variation. Test-retest stability for the oral niacin test was thus low, although a trend toward correlation for the dichotomous response criterion was found. Most electrodermal measures correlated between baseline and retest. A significant association between the tests was again found; niacin non-responding implied electrodermal non-responding, providing further support for a common underlying aberration in schizophrenia. PMID:19864122

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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.

  20. 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

  1. [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

  2. [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.

  3. Atypical Antipsychotics and Metabolic Syndrome in Patients with Schizophrenia: Risk Factors, Monitoring, and Healthcare Implications

    PubMed Central

    Riordan, Henry J.; Antonini, Paola; Murphy, Michael F.

    2011-01-01

    Background Metabolic syndrome is a leading cause of morbidity and mortality in patients with schizophrenia, with a prevalence rate double that of nonpsychiatric populations. Given the amount of evidence suggesting a link between atypical antipsychotic medications and metabolic syndrome, several agencies have recommended regular clinical monitoring of weight, symptoms of hyperglycemia, and glucose in chronically medicated patients with schizophrenia. Objectives To summarize the current literature on atypical antipsychotic-induced metabolic syndrome in patients with schizophrenia, outline some of the molecular mechanisms behind this syndrome, identify demographic and disease-related risk factors, and describe cost-effective methods for surveillance. Discussion The differential prevalence of metabolic syndrome associated with various atypical antipsychotic medications has been evidenced across numerous studies, with higher effects seen for certain antipsychotic medications on weight gain, waist circumference, fasting triglyceride level, and glucose levels. Given the association of these symptoms, all atypical antipsychotic medications currently include a warning about the risk of hyperglycemia and diabetes, as well as suggestions for regular monitoring. Despite this, very little data are available to support adherence to these monitoring recommendations. Lack of awareness and resources, diffusion of responsibility, policy implementation, and organizational structure have all been implicated. Conclusion The treatment of schizophrenia involves a balance in terms of risks and benefits. Failing to treat because of risk for complications from metabolic syndrome may place the patient at a higher risk for more serious health outcomes. Supporting programs aimed at increasing monitoring of simple laboratory and clinical measures associated with metabolic syndrome may decrease important risk factors, improve patients' quality of life, and reduce healthcare costs. PMID:25126357

  4. Evidence of abnormalities in mid-latency auditory evoked responses (MLAER) in cognitive subtypes of patients with schizophrenia.

    PubMed

    Mazhari, Shahrzad; Price, Greg; Waters, Flavie; Dragović, Milan; Jablensky, Assen

    2011-05-30

    Abnormalities in measures of mid-latency auditory evoked responses (MLAER) have frequently been reported in schizophrenia, while few studies have examined whether these measures could distinguish cognitive subtypes of schizophrenia. The aim of this study was to investigate whether patterns of performance on MLAER measures could differentiate a cognitive subtype of patients characterized by pervasive cognitive deficits (CD) from patients with only mild cognitive deficits (CS) and controls. An auditory paired-click conditioning test was administered to 55 schizophrenia patients (26 CD, 29 CS) and 49 healthy controls. Amplitudes, latencies and sensory gating indices of the P50, N100, and P200 MLAER were analysed. The results showed that CD patients exhibited smaller S1 amplitudes of N100 and P200 than controls, while CS patients were comparable to controls. Binary logistic regression identified the P200 S1 amplitude as a significant predictor of patients' membership in the CD subtype. However, none of the other MLAER measures could differentiate the two subtypes of schizophrenia. These findings suggest that the abnormal pathophysiologic mechanisms underlying the electrophysiological brain responses to auditory stimulation are associated with the pervasive cognitive deficits, which characterize the CD subtype of schizophrenia. This finding might provide additional electrophysiological endophenotypes for future genetic research of schizophrenia.

  5. Modafinil for Clozapine-Treated Schizophrenia Patients: A Double-Blind, Placebo-Controlled Pilot Trial

    PubMed Central

    Freudenreich, Oliver; Henderson, David C.; Macklin, Eric A.; Evins, A. Eden; Fan, Xiaoduo; Cather, Cori; Walsh, Jared P.; Goff, Donald C.

    2016-01-01

    Background Patients with schizophrenia often suffer from cognitive deficits and negative symptoms that are poorly responsive to antipsychotics including clozapine. Clozapine-induced sedation can worsen cognition and impair social and occupational functioning. Objectives To evaluate the efficacy, tolerability, and safety of modafinil for negative symptoms, cognition, and wakefulness/fatigue in DSM-IV–diagnosed schizophrenia patients treated with clozapine. Method A double-blind, placebo-controlled, flexible-dosed 8-week pilot trial was conducted between September 2003 and September 2007, adding modafinil up to 300 mg/d to stabilized schizophrenia outpatients receiving clozapine. Psychopathology, cognition, and wakefulness/fatigue were assessed with standard rating scales. Results Thirty-five patients were randomly assigned to treatment with study drug and included in the analysis. Modafinil did not reduce negative symptoms or wakefulness/fatigue or improve cognition compared to placebo. Modafinil was well tolerated and did not worsen psychosis. Conclusions Results of this pilot trial do not support routine use of modafinil to treat negative symptoms, cognitive deficits, or wakefulness/fatigue in patients on clozapine. However, given our limited power to detect a treatment effect and the clear possibility of a type II error, larger trials are needed to resolve or refute a potential therapeutic effect of uncertain magnitude. Trial Registration clinicaltrials.gov Identifier: NCT00573417 PMID:19689921

  6. Effects of discontinuation of long-term anticholinergic treatment in elderly schizophrenia patients.

    PubMed

    Drimer, T; Shahal, B; Barak, Y

    2004-01-01

    Anticholinergic medication (ACM) is frequently used in psychiatry to treat the side-effects of D2 blocking agents. However, ACM is not without adverse effects and, in the elderly, cognitive and memory impairments have been emphasized. The aim of this study was to evaluate the effects of discontinuation of ACM on cognitive functions in a group of elderly chronic schizophrenia patients. Twenty-seven elderly patients (age 60 years or older), who were diagnosed as suffering from schizophrenia (DSM-IV) and receiving ACM in addition to antipsychotic treatment, were enrolled. Before and after ACM was discontinued, the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) subscale was administered. Twenty-one patients completed the study. All were receiving Akineton (biperiden), 2-6 mg daily before the study. Significant improvement in the ADAS-Cog total score was demonstrated (P < 0.03), as well as in the ideational praxia and orientation subscales. Improvement was correlated with the previous dose of biperidin. No adverse events or emergent extrapyramidal symptoms were noted. Discontinuation of ACM may be warranted in chronic schizophrenia patients since it may improve cognitive functioning with no adverse effects.

  7. 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

  8. 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.

  9. [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

  10. 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

  11. 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

  12. 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

  13. 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…

  14. 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.…

  15. 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

  16. 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

  17. Pharmacotherapy for Hyperglyc