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Sample records for antipsychotic-naive first-episode schizophrenia

  1. Sensorimotor gating and habituation in antipsychotic-naive, first-episode schizophrenia patients before and after 6 months' treatment with quetiapine

    DEFF Research Database (Denmark)

    Aggernaes, Bodil; Glenthøj, Birte Yding; Ebdrup, Bjorn H;

    2010-01-01

    of the human startle reflex in a large group of antipsychotic-naive, first-episode schizophrenia patients, and the effect of subsequent treatment with quetiapine. Thirty-four antipsychotic-naive, first-episode schizophrenia patients (24 males, 10 females), and age- and gender-matched healthy controls were......Impaired prepulse inhibition of the startle reflex (PPI) in schizophrenia has been replicated in many studies. However, previous results may have been influenced by course of illness, and antipsychotic medication. Studies on antipsychotic-naive, first-episode schizophrenia patients are lacking...

  2. Effects of Dopamine D2/D3 Blockade on Human Sensory and Sensorimotor Gating in Initially Antipsychotic-Naive, First-Episode Schizophrenia Patients

    DEFF Research Database (Denmark)

    Düring, Signe; Glenthøj, Birte Y; Andersen, Gitte Saltoft;

    2014-01-01

    , habituation, and sensitization. Treatment with amisulpride showed no effects on these measures, either at 2 or 6 weeks of follow-up. This is the first study investigating the effects of monotherapy with a relatively selective dopamine D2/D3 receptor antagonist (amisulpride) on sensory and sensorimotor gating......, the effects of a potent D2/D3 receptor antagonist, amisulpride, were investigated on PPI and P50 gating in a large sample of antipsychotic-naive, first-episode patients with schizophrenia. A total of 52 initially antipsychotic-naive, first-episode schizophrenia patients were assessed for their P50 gating, PPI...... deficits in a longitudinal study of a large group of initially antipsychotic-naive, first-episode patients with schizophrenia. Our finding that amisulpride effectively reduced symptom severity in our patients without reducing their PPI deficits indicates that increased activity of dopamine D2 receptors may...

  3. Hippocampal and caudate volume reductions in antipsychotic-naive first-episode schizophrenia

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    Ebdrup, Bjørn Hylsebeck; Glenthøj, Birte; Rasmussen, Hans;

    2010-01-01

    that hippocampal and caudate volumes were decreased in patients with first-episode schizophrenia. We found no ventricular enlargement, differences in global volume or significant associations between tissue volume and duration of untreated illness or psychopathology. The hippocampal volume reductions appeared...

  4. Structural brain correlates of sensorimotor gating in antipsychotic-naive men with first-episode schizophrenia

    DEFF Research Database (Denmark)

    Hammer, Trine B; Oranje, Bob; Skimminge, Arnold

    2013-01-01

    and structural MRI (1.5 and 3 T) in men with first-episode schizophrenia and age-matched controls. Voxel-based morphometry was used to investigate the association between PPI and grey matter volumes. Results: We included 27 patients and 38 controls in the study. Patients had lower PPI than controls. The brain...... areas in which PPI and grey matter volume correlated did not differ between the groups. Independent of group, PPI was significantly and positively associated with regional grey matter volume in the right superior parietal cortex. Prepulse inhibition and grey matter volume associations were also observed...

  5. Progressive striatal and hippocampal volume loss in initially antipsychotic-naive, first-episode schizophrenia patients treated with quetiapine: relationship to dose and symptoms

    DEFF Research Database (Denmark)

    Ebdrup, Bjørn H; Skimminge, Arnold; Rasmussen, Hans;

    2011-01-01

    -weighted images (3 T) from 22 patients and 28 matched healthy controls were analysed using tensor-based morphometry. Non-parametric voxel-wise group comparisons were performed. Small volume correction was employed for striatum, hippocampus and ventricles. Dose-dependent medication effects and associations...... scarcely been investigated. Here we investigated structural brain changes in antipsychotic-naive, first-episode schizophrenia patients after 6 months treatment with the SGA, quetiapine. We have recently reported on baseline volume reductions in the caudate nucleus and hippocampus. Baseline and follow-up T1...... with psychopathology were assessed. Patients had significant bilateral striatal and hippocampal loss over the 6-month treatment period. When compared to controls the striatal volume loss was most pronounced with low quetiapine doses and less apparent with high doses. Post-hoc analyses revealed that the striatal volume...

  6. Apoptotic markers in cultured fibroblasts correlate with brain metabolites and regional brain volume in antipsychotic-naive first-episode schizophrenia and healthy controls.

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    Batalla, A; Bargalló, N; Gassó, P; Molina, O; Pareto, D; Mas, S; Roca, J M; Bernardo, M; Lafuente, A; Parellada, E

    2015-08-25

    Cultured fibroblasts from first-episode schizophrenia patients (FES) have shown increased susceptibility to apoptosis, which may be related to glutamate dysfunction and progressive neuroanatomical changes. Here we determine whether apoptotic markers obtained from cultured fibroblasts in FES and controls correlate with changes in brain glutamate and N-acetylaspartate (NAA) and regional brain volumes. Eleven antipsychotic-naive FES and seven age- and gender-matched controls underwent 3-Tesla magnetic resonance imaging scanning. Glutamate plus glutamine (Glx) and NAA levels were measured in the anterior cingulate (AC) and the left thalamus (LT). Hallmarks of apoptotic susceptibility (caspase-3-baseline activity, phosphatidylserine externalization and chromatin condensation) were measured in fibroblast cultures obtained from skin biopsies after inducing apoptosis with staurosporine (STS) at doses of 0.25 and 0.5 μM. Apoptotic biomarkers were correlated to brain metabolites and regional brain volume. FES and controls showed a negative correlation in the AC between Glx levels and percentages of cells with condensed chromatin (CC) after both apoptosis inductions (STS 0.5 μM: r = -0.90; P = 0.001; STS 0.25 μM: r = -0.73; P = 0.003), and between NAA and cells with CC (STS 0.5 μM induction r = -0.76; P = 0.002; STS 0.25 μM r = -0.62; P = 0.01). In addition, we found a negative correlation between percentages of cells with CC and regional brain volume in the right supratemporal cortex and post-central region (STS 0.25 and 0.5 μM; P < 0.05 family-wise error corrected (FWEc)). We reveal for the first time that peripheral markers of apoptotic susceptibility may correlate with brain metabolites, Glx and NAA, and regional brain volume in FES and controls, which is consistent with the neuroprogressive theories around the onset of the schizophrenia illness.

  7. Decreased frontal serotonin2A receptor binding in antipsychotic-naive patients with first-episode schizophrenia

    DEFF Research Database (Denmark)

    Rasmussen, Hans; Erritzoe, David; Andersen, Rune;

    2010-01-01

    Postmortem investigations and the receptor affinity profile of atypical antipsychotics have implicated the participation of serotonin(2A) receptors in the pathophysiology of schizophrenia. Most postmortem studies point toward lower cortical serotonin(2A) binding in schizophrenic patients. However...

  8. Apoptotic markers in cultured fibroblasts correlate with brain metabolites and regional brain volume in antipsychotic-naive first-episode schizophrenia and healthy controls

    NARCIS (Netherlands)

    Batalla, A.; Bargallo, N.; Gasso, P.; Molina, O.; Pareto, D.; Mas, S.; Roca, J.M.; Bernardo, M.; Lafuente, A.; Parellada, E.

    2015-01-01

    Cultured fibroblasts from first-episode schizophrenia patients (FES) have shown increased susceptibility to apoptosis, which may be related to glutamate dysfunction and progressive neuroanatomical changes. Here we determine whether apoptotic markers obtained from cultured fibroblasts in FES and cont

  9. Stability of prepulse inhibition and habituation of the startle reflex in schizophrenia: a 6-year follow-up study of initially antipsychotic-naive, first-episode schizophrenia patients

    DEFF Research Database (Denmark)

    Hammer, Trine Bjørg; Oranje, Bob; Fagerlund, Birgitte;

    2011-01-01

    Deficits in information processing appear to be core features in the pathogenesis of schizophrenia. Prepulse inhibition (PPI) and habituation of the startle reflex are operational measures of early information processing. Impaired PPI in schizophrenia has been replicated in many studies and is re......Deficits in information processing appear to be core features in the pathogenesis of schizophrenia. Prepulse inhibition (PPI) and habituation of the startle reflex are operational measures of early information processing. Impaired PPI in schizophrenia has been replicated in many studies...... and is regarded as an endophenotype for schizophrenia. However, reports on the stability of PPI over a longer period of time are lacking, both for patients with schizophrenia and for healthy subjects. The current study examined 25 initially drug-naive, first-episode schizophrenia patients and 23 healthy matched...

  10. [First episode of schizophrenia and nursing care].

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    Giacon, Bianca Cristina Ciccone; Galera, Sueli Aparecida Frari

    2006-06-01

    Schizophrenia is one of the main health problems in current days, requiring considerable investment from the health system. Intervening in the first episode offers a unique opportunity in the treatment of schizophrenia and influences the course of the illness. This article consists of a critical literature review aimed at examining knowledge on first episode schizophrenia and discussing the contribution of nursing care. A research was carried out in bibliographical databases. The data collected made possible the organization of information on the general concept of schizophrenia, its first episode, types of intervention and nursing performance. We found out that in Brazil there are few studies related to first episode schizophrenia in Nursing, few available specialized services, and few social resources. This situation reveals the need for more studies on first episode schizophrenia.

  11. Volume and asymmetry abnormalities of insula in antipsychotic-naive schizophrenia: A 3-Tesla magnetic resonance imaging study

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    Harve Shanmugam Virupaksha

    2012-01-01

    Full Text Available Context: Insula, which is a vital brain region for self-awareness, empathy, and sensory stimuli processing, is critically implicated in schizophrenia pathogenesis. Existing studies on insula volume abnormalities report inconsistent findings potentially due to the evaluation of ′antipsychotic-treated′ schizophrenia patients as well as suboptimal methodology. Aim: To understand the role of insula in schizophrenia. Materials and Methods: In this first-time 3-T magnetic resonance imaging study, we examined antipsychotic-naive schizophrenic patients (N=30 and age-, sex-, handedness- and education-matched healthy controls (N=28. Positive and negative symptoms were scored with good interrater reliability (intraclass correlation coefficient (ICC>0.9 by using the scales for negative and positive symptoms. Gray matter volume of insula and its anterior/posterior subregions were measured by using a three-dimensional, interactive, semiautomated software based on the valid method with good interrater reliability (ICC>0.85. Intracranial volume was automatically measured by using the FreeSurfer software. Results: Patients had significantly deficient gray matter volumes of left (F=33.4; Pleft in male patients in comparison with male controls (left>right (t=2.7; P=0.01. Conclusions: Robust insular volume deficits in antipsychotic-naive schizophrenia support intrinsic role for insula in pathogenesis of this disorder. The first-time demonstration of a relationship between right posterior insular deficit and negative symptoms is in tune with the background neurobiological literature. Another novel observation of sex-specific anterior insular asymmetry reversal in patients supports evolutionary postulates of schizophrenia pathogenesis.

  12. Dyskinesia and Parkinsonism in Antipsychotic-Naive Patients With Schizophrenia, First-Degree Relatives and Healthy Controls : A Meta-analysis

    NARCIS (Netherlands)

    Koning, Jeroen P. F.; Tenback, Diederik E.; van Os, Jim; Aleman, Andre; Kahn, Rene S.; van Harten, Peter N.

    2010-01-01

    Background: Several studies have reported the presence of dyskinesia and parkinsonism in antipsychotic-naive patients with schizophrenia as well as in their first-degree relatives. These movement disorders may therefore form an integral part of the illness and its (genetic) liability. Method: A syst

  13. Orbitofrontal lobe volume deficits in Antipsychotic-Naive schizophrenia: A 3-Tesla MRI study

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    Behere Rishikesh

    2009-01-01

    Full Text Available Background: Prefrontal cortex deficits have been consistently demonstrated in schizophrenia. The orbitofrontal lobe (OFL, a critical component of the prefrontal cortex, subserves social and neuro-cognitive functions. While these functional impairments are established in schizophrenia, the OFL volume deficits have not been well studied, especially in antipsychotic-naοve patients. Aim: To study OFL volume deficits in antipsychotic-naοve schizophrenia patients in comparison with matched healthy controls using high-resolution 3-tesla (3T magnetic resonance imaging (MRI. Materials and Methods: Fourteen antipsychotic-naοve schizophrenia patients (DSM-IV and 14 age-, sex-, handedness- and education-matched healthy controls were scanned using 3T MRI. Psychopathology was assessed in the patient group using the scale for assessment of negative symptoms and the scale for assessment of positive symptoms (SAPS. The OFL volume was measured using Region of Interest (ROI-based manual morphometry technique, with good inter-rater reliability (intra-class correlation coefficient = 0.98. Results: Total OFL volume was significantly smaller in schizophrenia patients (43.3 ± 9.6 mL in comparison with healthy controls (52.1 ± 12.2 mL after controlling for the potential confounding effects of age, sex and intracranial volume (F = 5.3, P = .03. Duration of untreated psychosis did not correlate significantly with OFL volumes. There was a trend towards significant negative correlation between the left and total OFL volumes and SAPS scores (r = -0.49, P = .06. Conclusion: OFL volume deficits might underlie the pathogenesis of schizophrenia symptoms with possible neuro-developmental origins.

  14. Frontal fasciculi and psychotic symptoms in antipsychotic-naive patients with schizophrenia before and after 6 weeks of selective dopamine D2/3 receptor blockade

    DEFF Research Database (Denmark)

    Ebdrup, Bjørn H; Raghava, Jayachandra M; Nielsen, Mette Ødegaard;

    2016-01-01

    of fractional anisotropy (FA) using voxelwise tract-based spatial statistics (TBSS) and anatomic region of interest (ROI)-based analyses. Subsequently, patients underwent 6 weeks of antipsychotic monotherapy with amisulpride. We repeated the examinations after 6 weeks. RESULTS: We included 38 patients...... longitudinal fasciculus (z = -3.31, p= 0.001). At re-examination, all correlations between positive symptoms and frontal fasciculi had resolved. Fractional anisotropy in the ATR increased more in patients than in controls (z = -4.92, pamisulpride dose correlated positively with FA changes...... in the right CT (t= 2.52, p= 0.019). LIMITATIONS: Smoking and a previous diagnosis of substance abuse were potential confounders. Long-term effects of amisulpride on white matter were not evaluated. CONCLUSION: Antipsychotic-naive patients with schizophrenia displayed subtle deficits in white matter...

  15. Neurological soft signs discriminating mood disorders from first episode schizophrenia

    NARCIS (Netherlands)

    Boks, MPM; Liddle, PF; Burgerhof, JGM; Knegtering, R; Bosch, RJ

    2004-01-01

    Objective: To investigate the specificity of neurological soft signs (NSS) for first episode schizophrenia compared with mood disorders. Method: We assessed NSS in a sample of 60 healthy controls, 191 first episode psychosis patients and 81 mood disorder patients. We used a principle component analy

  16. Social cognition and neurocognitive deficits in first-episode schizophrenia

    DEFF Research Database (Denmark)

    Bliksted, Vibeke Fuglsang; Fagerlund, Birgitte; Weed, Ethan;

    2014-01-01

    -episode schizophrenia. Researchers have speculated about social cognitive subgroups since patients with schizophrenia appear to be a very heterogeneous group. METHODS: Patients with a recent diagnosis of first-episode schizophrenia were tested regarding theory of mind, social perception, neurocognition, IQ...... symptoms. CONCLUSIONS: Complex aspects of social cognition explained 24% of the variance in the patient group. The other principal components consisted mainly of aspects of simple perception of theory of mind. Neurocognition and clinical symptoms only explained a minor proportion of the variance......, and clinical symptoms. RESULTS: Data from 36 first-episode schizophrenia patients and 36 one to one matched healthy controls were analysed. Principal component analysis in the patient group was used to examine the variance contributed by different aspects of social cognition, neurocognition, and clinical...

  17. Relationship between Interleukin-6 gene polymorphism and hippocampal volume in antipsychotic-naive schizophrenia: evidence for differential susceptibility?

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    Sunil Vasu Kalmady

    Full Text Available BACKGROUND: Various lines of evidence including epidemiological, genetic and foetal pathogenetic models suggest a compelling role for Interleukin-6 (IL-6 in the pathogenesis of schizophrenia. IL-6 mediated inflammatory response triggered by maternal infection or stress induces disruption of prenatal hippocampal development which might contribute towards psychopathology during adulthood. There is a substantial lack of knowledge on how genetic predisposition to elevated IL-6 expression effects hippocampal structure in schizophrenia patients. In this first-time study, we evaluated the relationship between functional polymorphism rs1800795 of IL-6 and hippocampal gray matter volume in antipsychotic-naïve schizophrenia patients in comparison with healthy controls. METHODOLOGY: We examined antipsychotic-naïve schizophrenia patients [N = 28] in comparison with healthy controls [N = 37] group matched on age, sex and handedness. Using 3 Tesla - MRI, bilateral hippocampi were manually segmented by blinded raters with good inter-rater reliability using a valid method. Additionally, Voxel-based Morphometry (VBM analysis was performed using hippocampal mask. The IL-6 level was measured in blood plasma using ELISA technique. SNP rs1800795 was genotyped using PCR and DNA sequencing. Psychotic symptoms were assessed using Scale for Assessment of Positive Symptoms and Scale for Assessment of Negative Symptoms. RESULTS: Schizophrenia patients had significantly deficient left and right hippocampal volumes after controlling for the potential confounding effects of age, sex and total brain volume. Plasma IL-6 levels were significantly higher in patients than controls. There was a significant diagnosis by rs1800795 genotype interaction involving both right and left hippocampal volumes. Interestingly, this effect was significant only in men but not in women. CONCLUSION: Our first time observations suggest a significant relationship between IL-6 rs1800795 and reduced

  18. Inferior parietal lobule volume and schneiderian first-rank symptoms in Antipsychotic-Naive schizophrenia: A 3-Tesla MRI study

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    Danivas Vijay

    2009-01-01

    Full Text Available Background: As per Frith′s neuro-cognitive model, inferior parietal lobule (IPL is implicated in the pathogenesis of Schneiderian first-rank symptoms (FRS in schizophrenia. The specific role of IPL structural abnormalities in the pathogenesis of FRS is yet to be ascertained. Materials and Methods: Using 3-tesla MRI scanner, this first-time study examined antipsychotic-naοve schizophrenia patients ( n = 28 (patients with FRS [FRS +]: N = 14, M: F = 7:7; and patients without FRS [FRS-]: N = 14, M: F = 7:7 in comparison with sex-, handedness-, education- and socioeconomic status-matched healthy controls ( n = 14, M: F = 7:7. The volume of IPL was measured using a three-dimensional, interactive, semi-automated analysis, with good inter-rater reliability. Results: FRS + patients showed significant volume deficit in right IPL in comparison with healthy controls (F = 4.0; P=.028 after controlling for the potential confounding effects of age, sex and intracranial volume. Conclusions: Right IPL volume deficit in FRS+patients adds further support to the Frith′s model of FRS in schizophrenia.

  19. Luria revisited: complex motor phenomena in first episode schizophrenia and schizophrenia spectrum disorders.

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    Zaytseva, Yuliya; Korsakova, Natalya; Gurovich, Isaac Ya; Heinz, Andreas; Rapp, Michael A

    2014-12-15

    Patients with schizophrenia frequently exhibit motor deficits. However, to date, there are no studies comparing motor performance in first episode patients with schizophrenia and schizophrenia spectrum disorders (SSD; e.g. schizoaffective and brief psychosis). Participants comprised 57 first episode patients with schizophrenia, 32 first episode patients with SSD, and 51 healthy controls who underwent neuropsychological testing based on Luria׳s systematic approach, including the following tests on complex motor sequencing: the Fist-Edge-Palm (FEP) test and the bimanual probe (BP). Schizophrenia patients performed worse than SSD patients in FEP and BP, and both patient groups showed decreased scores compared to healthy controls. Furthermore, we found that a higher proportion of schizophrenia cases failed to correct their motor performance and needed external error correction, while SSD cases exhibited a higher proportion of self-correction in FEP and in BP. Lack of insight and poor executive functioning correlated with motor performance in schizophrenia, while impulse control and difficulties in abstract thinking were related to motor performance in schizophrenia spectrum disorder. Thus, psychomotor impairments appear already in first episode patients with schizophrenia and differ from impairments in SSD. Especially the inability to self-correct errors may be characteristic of schizophrenia, suggesting that impairments in error monitoring are related to psychomotor dysfunction in schizophrenia.

  20. The neurobiology and treatment of first-episode schizophrenia.

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    Kahn, R S; Sommer, I E

    2015-02-01

    It is evident that once psychosis is present in patients with schizophrenia, the underlying biological process of the illness has already been ongoing for many years. At the time of diagnosis, patients with schizophrenia show decreased mean intracranial volume (ICV) as compared with healthy subjects. Since ICV is driven by brain growth, which reaches its maximum size at approximately 13 years of age, this finding suggests that brain development in patients with schizophrenia is stunted before that age. The smaller brain volume is expressed as decrements in both grey and white matter. After diagnosis, it is mainly the grey matter loss that progresses over time whereas white matter deficits are stable or may even improve over the course of the illness. To understand the possible causes of the brain changes in the first phase of schizophrenia, evidence from treatment studies, postmortem and neuroimaging investigations together with animal experiments needs to be incorporated. These data suggest that the pathophysiology of schizophrenia is multifactorial. Increased striatal dopamine synthesis is already evident before the time of diagnosis, starting during the at-risk mental state, and increases during the onset of frank psychosis. Cognitive impairment and negative symptoms may, in turn, result from other abnormalities, such as NMDA receptor hypofunction and low-grade inflammation of the brain. The latter two dysfunctions probably antedate increased dopamine synthesis by many years, reflecting the much earlier presence of cognitive and social dysfunction. Although correction of the hyperdopaminergic state with antipsychotic agents is generally effective in patients with a first-episode psychosis, the effects of treatments to correct NMDA receptor hypofunction or low-grade inflammation are (so far) rather modest at best. Improved efficacy of these interventions can be expected when they are applied at the onset of cognitive and social dysfunction, rather than at the

  1. Increased Blood-Reelin-Levels in First Episode Schizophrenia.

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    Tobias Hornig

    Full Text Available Reelin is an extracellular glycoprotein involved in several functions of brain development, synaptogenesis and dendritic proliferation. Numerous studies found perturbation in the reelin system and altered serum reelin levels in neuropsychiatric patients using the western blot procedure. In the international literature, this is the first study that made use of an enzyme-linked immunosorbent assay to analyze serum reelin protein concentration quantitatively.In order to study possible alterations in reelin blood levels in schizophrenia, we analyzed this signal in schizophrenic patients with a first episode hallucinatory and paranoid syndrome and control subjects in a pilot study design.We found increased blood reelin protein concentration in schizophrenic patients compared to healthy controls.Our findings point to a relevant role of reelin metabolism in the pathogenesis of schizophrenia.Reelin could be a biomarker for the course of disease or psychopharmacological treatment.We conclude that the reelin protein blood concentration might be a relevant signal with respect to the pathophysiology of schizophrenia.

  2. Predictors of poor adherence to medication among patients with first-episode schizophrenia-spectrum disorder

    DEFF Research Database (Denmark)

    Quach, Phuong Le; Mors, Ole; Christensen, Torben Østergaard;

    2009-01-01

    This study sought to identify predictors for poor adherence to medication among patients with first-episode schizophrenia-spectrum disorder.......This study sought to identify predictors for poor adherence to medication among patients with first-episode schizophrenia-spectrum disorder....

  3. Sensorimotor gating and habituation in antipsychotic-naive, first-episode schizophrenia patients before and after 6 months' treatment with quetiapine

    DEFF Research Database (Denmark)

    Aggernaes, Bodil; Glenthøj, Birte Yding; Ebdrup, Bjorn H

    2010-01-01

    . Treatment with quetiapine for 6 months increased male PPI to a level where it was no longer statistically different from the controls. The much smaller group of females did not show PPI deficits at baseline. In addition, compared to controls, patients appeared highly aroused and showed a strong yet non...

  4. Right lateralized white matter abnormalities in first-episode, drug-naive paranoid schizophrenia.

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    Guo, Wenbin; Liu, Feng; Liu, Zhening; Gao, Keming; Xiao, Changqing; Chen, Huafu; Zhao, Jingping

    2012-11-30

    Numerous studies in first-episode schizophrenia suggest the involvement of white matter (WM) abnormalities in multiple regions underlying the pathogenesis of this condition. However, there has never been a neuroimaging study in patients with first-episode, drug-naive paranoid schizophrenia by using tract-based spatial statistics (TBSS) method. Here, we used diffusion tensor imaging (DTI) with TBSS method to investigate the brain WM integrity in patients with first-episode, drug-naive paranoid schizophrenia. Twenty patients with first-episode, drug-naive paranoid schizophrenia and 26 healthy subjects matched with age, gender, and education level were scanned with DTI. An automated TBSS approach was employed to analyze the data. Voxel-wise statistics revealed that patients with paranoid schizophrenia had decreased fractional anisotropy (FA) values in the right superior longitudinal fasciculus (SLF) II, the right fornix, the right internal capsule, and the right external capsule compared to healthy subjects. Patients did not have increased FA values in any brain regions compared to healthy subjects. There was no correlation between the FA values in any brain regions and patient demographics and the severity of illness. Our findings suggest right-sided alterations of WM integrity in the WM tracts of cortical and subcortical regions may play an important role in the pathogenesis of paranoid schizophrenia.

  5. Mismatch Negativity in First-Episode Schizophrenia: A Meta-Analysis.

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    Haigh, Sarah M; Coffman, Brian A; Salisbury, Dean F

    2017-01-01

    Mismatch negativity (MMN) to deviant stimuli is robustly smaller in individuals with chronic schizophrenia compared with healthy controls (Cohen's d > 1.0 or more), leading to the possibility of MMN being used as a biomarker for schizophrenia. However, there is some debate in the literature as to whether MMN is reliably reduced in first-episode schizophrenia patients. For the biomarker to be used as a predictive marker for schizophrenia, it should be reduced in the majority of cases known to have the disease, particularly at disease onset. We conducted a meta-analysis on the fourteen studies that measured MMN to pitch or duration deviants in healthy controls and patients within 12 months of their first episode of schizophrenia. The overall effect size showed no MMN reduction in first-episode patients to pitch-deviants (Cohen's d schizophrenia prediction, while duration-deviant MMN may hold some promise, albeit nearly a third as large an effect as in chronic schizophrenia. Potential causes for discrepancies between studies are discussed.

  6. Cortisol and ACTH levels in drug-naive adolescents with first-episode early onset schizophrenia.

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    Şimşek, Şeref; Gençoğlan, Salih; Yüksel, Tuğba; Aktaş, Hüseyin

    2017-03-01

    The aim of this study was to investigate serum levels of cortisol and adrenocorticotropic hormone in adolescents with first-episode early onset schizophrenia. A total of 23 adolescent patients, who did not receive prior therapy and who were diagnosed with psychosis according to DSM-IV, were included. Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, Positive and Negative Symptom Scale, and Clinical Global Impression Scale were conducted with the participants. No significant differences were found between the patients and the control subjects in serum cortisol and adrenocorticotropic hormone levels (P > .05). Our study's findings do not support the hypothesis of increased hypothalamic-pituitary-adrenal axis activity in first-episode early onset schizophrenia.

  7. IQ subgroups in relation to neurocognitive profiles, psychopathology and brain volume in first-episode schizophrenia

    DEFF Research Database (Denmark)

    Jensen, Maria Høj; Glenthøj, Birte Yding; Rostrup, Egill

    Background and Aim: Approximately half of patients with schizophrenia experience a deterioration in IQ before or around illness onset and recent studies have found apositive association between IQ and brain volume in first episode schizophrenia. The aim of this study was to examine the combined...... impact of estimated IQ trajectory and IQ level at illness onset on psychopathology, neurocognitive profiles and brain volume. Materials and methods: The design is a cross-sectional, case-control study of 60 first-episode antipsychotic-naïve schizophrenia patients and 60 matched healthy controls....... Promorbid IQ was estimated using the Danish Adult Reading Test and current IQ using 4 subtests from Wechsler's Adult Intelligence Scale III. Patients were divided into 4 subgroups based on a combination of both IQ trajectory from premorbid levels (stable vs. deteriorating) and IQ at illness onset (high vs...

  8. The effect of antipsychotic drugs on nonspecific inflammation markers in the first episode of schizophrenia

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    Stefanović Vesna

    2015-01-01

    Full Text Available Background/Aim. Immune system disorder, including inflammation, takes a significant place when considering still unclear etiology of schizophrenia. The aim of this study was to determine the blood levels of nonspecific inflammation markers in the first episode of schizophrenia and their relation to the therapy response. Methods. In this study we determined the blood levels of nonspecific inflammation markers: white blood cells count (WBC, C-reactive protein (CRP, erythrocytes sedimentation rate (ESR and the elements of differential white blood cell counts (or the leukocyte formula: granulocytes (Gra, lymphocytes (Lym and monocytes (Mon, in the first episode of schizofrenia, in 78 patients hospitalized at the Clinic for Psychiatric Disorders “Dr Laza Lazarević” in Belgrade. The levels were measured at admission to the clinic, as well as after 4 weeks of antipsychotic treatment. The Positive and negative syndrome scale for schizophrenia (PANSS was applied to measure the severity of psychopathology and response to the treatment. Results. During the first episode of schizophrenia, before initiation of antipsychotic treatment, the frequency of abnormal values was high (≥ 25% of the patients for the following non-specific inflammation markers: WBC, CRP, ESR and Gra, in the leukocyte formula, but dropped after 4 weeks of antipsychotic treatment at the level of high statistical significance for WBC and Gra (p < 0.001. The ESR remained unchanged in as many as 50% of the patients even after 4-week antipsychotic treatment, at the level of statistical significance in the non-responders compared to the responders (p = 0.045. Conclusion. The obtained results indicate that in the first episode of schizophrenia the blood levels of non-specific inflammation markers (WBS, CRP, ESR and Gra from the leukocyte formula were high in the subpopulation of patients with the tendency towards normalization of inflammation parameters after a 4-week antipsychotic

  9. Relationship between event-related potential P300 and first episode schizophrenia

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    CHEN Xing-shi; LU Ying-zhi; WANG Ji-jun; WANG Hong-xing; ZHANG Ming-dao; LOU Fei-yin; CHEN Chong

    2007-01-01

    @@ Although P300 abnormalities of event-related potentials (ERPs) are consistently reported among schizophrenic patients as being the most compelling indices of their brain dysfunction,1 whether they are trait markers or state markers of schizophrenia remains in controversy.2,3 To shed a light on this point, we made a longitudinal study of P300 among first episode schizophrenic patients, from no medication until the patients had been medicated for 12 weeks.

  10. Association between unmet needs and clinical status in patients with first episode of schizophrenia in Chile

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    Natalia eJorquera

    2015-04-01

    Full Text Available Background: Schizophrenia is a severe mental disorder involving needs in several matters that are often not covered. A need is defined as a gap between the ideal state and the current state of a patient about a specific topic. Aim: To describe needs in patients with first episode of schizophrenia at the start of treatment, and to describe associated clinical factors. Methods: Observational descriptive cross-sectional design. Patients were over fifteen years old, with first episode schizophrenia, and admitted to treatment in the public health system from six district in two cities of Chile, between 2005 and 2006. Sociodemographic data, clinical evaluations of current psychosis based on the PANSS, and the time of untreated psychosis were obtained. A clinical interview, was carried out followed by the Camberwell Assessment of Need. Results: 29 patients were evaluated, 79.3% male, mean age 21.9 years old. The areas with more needs reported were; psychotic symptoms with 65.5% of sample, 21.1% of which reported it unmet; and daytime activities, where 44.8% of patients reported a need, 61.54% of them as unmet. The percentage of unmet needs correlated with PANSS score (r= 0.55; p=0.003, and with time of positive symptoms prior to diagnosis (r= 0.416; p=0.03. Discussion: Needs assessment in schizophrenia is necessary. It may affect its clinical course, be relevant in its management and help monitor recovery. Defining the main needs in people with first episode schizophrenia and associated factors allows for a better design of treatment strategies in order to obtain better therapeutic results and recovery.

  11. Reduced anterior cingulate gyrus volume correlates with executive dysfunction in men with first-episode schizophrenia.

    Science.gov (United States)

    Szeszko, P R; Bilder, R M; Lencz, T; Ashtari, M; Goldman, R S; Reiter, G; Wu, H; Lieberman, J A

    2000-06-16

    Although frontal lobe structural and functional abnormalities have been identified in schizophrenia, their relationship remains elusive. Because the frontal lobes are both structurally and functionally heterogeneous, it is possible that some measures of frontal lobe structure may not have accurately identified relevant frontal lobe subregions. The authors hypothesized that the volumes of two dorsal, 'archicortical' subregions (i.e. superior frontal gyrus and anterior cingulate gyrus), but not a ventral, 'paleocortical' subregion (i.e. orbital frontal region) would be significantly and selectively correlated with executive and motor dysfunction in patients with schizophrenia as previously reported for the anterior hippocampal region. Volumes of these frontal lobe subregions were measured from magnetic resonance images based on sulcal anatomy in 20 men and 15 women with first-episode schizophrenia. All patients completed a comprehensive neuropsychological test battery while clinically stabilized that encompassed six domains of functioning: attention, executive, motor, visuospatial, memory and language. Findings indicated that reduced anterior cingulate gyrus volume was significantly correlated with worse executive functioning in men; among women, there were no significant correlations. Among men, anterior cingulate gyrus volume was significantly more strongly correlated with executive functioning than with attention, visuospatial, memory, language and general intellectual functioning. Neither executive nor motor functioning was significantly more strongly correlated with the dorsal 'archicortical' volumes than with orbital frontal volume. These findings suggest a link between executive deficits and dysfunction of the dorsal 'archicortical' system and implicate sex differences in their relationship in first-episode schizophrenia.

  12. Gender Differences in Schizophrenia and First-Episode Psychosis: A Comprehensive Literature Review

    Directory of Open Access Journals (Sweden)

    Susana Ochoa

    2012-01-01

    Full Text Available Recent studies have begun to look at gender differences in schizophrenia and first-episode psychosis in an attempt to explain the heterogeneity of the illness. However, a number of uncertainties remain. This paper tries to summarize the most important findings in gender differences in schizophrenia and first-psychosis episodes. Several studies indicate that the incidence of schizophrenia is higher in men. Most of the studies found the age of onset to be earlier in men than in women. Findings on symptoms are less conclusive, with some authors suggesting that men suffer more negative symptoms while women have more affective symptoms. Premorbid functioning and social functioning seem to be better in females than males. However, cognitive functioning remains an issue, with lack of consensus on differences in neuropsychological profile between women and men. Substance abuse is more common in men than women with schizophrenia and first-episode psychosis. In terms of the disease course, women have better remission and lower relapse rates. Lastly, there is no evidence of specific gender differences in familial risk and obstetric complications. Overall, gender differences have been found in a number of variables, and further study in this area could help provide useful information with a view to improving our care of these patients.

  13. Predictors of remission and recovery in a first-episode schizophrenia spectrum disorder sample: 2-year follow-up of the OPUS trial

    DEFF Research Database (Denmark)

    Petersen, Lone; Thorup, Anne; Øqhlenschlaeger, Johan;

    2008-01-01

    To examine the frequency and predictors of good outcome for patients with first-episode schizophrenia spectrum disorder (SSD).......To examine the frequency and predictors of good outcome for patients with first-episode schizophrenia spectrum disorder (SSD)....

  14. The association between anomalous self-experiences, self-esteem and depression in first episode schizophrenia

    Directory of Open Access Journals (Sweden)

    Elisabeth Haug

    2016-11-01

    Full Text Available Background: Anomalous self-experiences (ASEs aggregate in schizophrenia spectrum disorders, but the relationship between ASEs, and depression has been studied to a limited extent. Lower self-esteem has been shown to be associated with depression in early psychosis. Our hypothesis is that ASEs in early phases of schizophrenia are linked to lower levels of self-esteem, which in turn is associated with depression. Aim: The aim is to examine the relationship between ASEs, self-esteem and depression in first-episode schizophrenia spectrum disorders.Method: ASEs were assessed in 55 patients with first-episode schizophrenia by means of the Examination of anomalous Self-Experience (EASE instrument. Assessment of depression was based on the Calgary Depression Scale for Schizophrenia (CDSS. Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES. Symptom severity was assessed using the Structured Clinical Interview for the Positive and Negative Syndrome Scale (SCI-PANSS. Substance misuse was measured with the Drug Use Disorder Identification Test (DUDIT, and alcohol use was measured with the Alcohol Use Disorder Identification Test (AUDIT. Data on childhood adjustment were collected using the Premorbid Adjustment Scale (PAS. Data on childhood trauma were collected using the Norwegian version of the Childhood Trauma Questionnaire, short form (CTQ-SF. Results: Analyses detected a significant association between current depression and ASEs as measured by the EASE in women, but not in men. The effect of ASEs on depression appeared to be mediated by self-esteem. No other characteristics associated with depression influenced the relationship between depression, self-esteem and ASEs. Conclusion: Evaluating ASEs can assist clinicians in understanding patients’ experience of self-esteem and depressive symptoms. The complex interaction between ASEs, self-esteem, depression and suicidality could be a clinical target for the prevention of suicidality

  15. Detection of Borna Disease Virus (BDV) in Patients with First Episode of Schizophrenia.

    Science.gov (United States)

    Soltani, Hasan; Mohammadzadeh, Serwa; Makvandi, Manoochehr; Pakseresht, Siroos; Samarbaf-Zadeh, Alireza

    2016-10-01

    Objective: Schizophrenia is a complex widespread neuropsychiatric disorder. This illness encompasses a complex debilitating mental disorder causing illusion, delusion, disturbed relationship, low motivation and decline of emotion. Viral infection of the brain including Borna Disease Virus (BDV) may play a role in transient or permanent neurological and behavioral abnormalities. This role of Borna virus has not been resolved outright yet, and based on published papers investigation examining the role of this virus in schizophrenia is in progress worldwide. Method: In this study, Nested Reverse Transcription-Polymerase Chain Reaction (Nested RT-PCR) was used for detection of BDV Ribonucleic Acid (RNA) in Peripheral Blood Mononuclear Cells (PBMCs) of a group of patients experiencing the first episode of schizophrenia. The results were compared with a normal group. Results: In our study, no BDV-positive was found in PBMCs of the case group. Out of 40 participants of control group one was positive for P24 gene of BDV. This result are similar to several published papers about this topic. Conclusion: An etiological relationship between Bornavirus and schizophrenia was not found in this study. More investigations are warranted to illustrate the probable relationship between bornavirus infection and schizophrenia.

  16. Detection of Borna Disease Virus (BDV in Patients with First Episode of Schizophrenia

    Directory of Open Access Journals (Sweden)

    Hasan Soltani

    2016-12-01

    Full Text Available Objective: Schizophrenia is a complex widespread neuropsychiatric disorder. This illness encompasses a complex debilitating mental disorder causing illusion, delusion, disturbed relationship, low motivation and decline of emotion. Viral infection of the brain including Borna Disease Virus (BDV may play a role in transient or permanent neurological and behavioral abnormalities. This role of Borna virus has not been resolved outright yet, and based on published papers investigation examining the role of this virus in schizophrenia is in progress worldwide.Method: In this study, Nested Reverse Transcription–Polymerase Chain Reaction (Nested RT-PCR was used for detection of BDV Ribonucleic Acid (RNA in Peripheral Blood Mononuclear Cells (PBMCs of a group of patients experiencing the first episode of schizophrenia. The results were compared with a normal group.Results: In our study, no BDV-positive was found in PBMCs of the case group. Out of 40 participants of control group one was positive for P24 gene of BDV. This result are similar to several published papers about this topic.Conclusion: An etiological relationship between Bornavirus and schizophrenia was not found in this study. More investigations are warranted to illustrate the probable relationship between bornavirus infection and schizophrenia.

  17. Plasma metabonomics study of first-Episode schizophrenia treated with olanzapine in female patients.

    Science.gov (United States)

    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.

  18. FOLLOW-UP STUDY ON AUDITORY EVOKED POTENTIAL P50 IN FIRST-EPISODE SCHIZOPHRENIA

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To investigate the variation of auditory evoked potential P50 in first-episode schizo-phrenia. Methods P50 was recorded from 66 schizophrenics and 92 normal controls with American Brova instrument, and assessing their psychotic symptoms with PANSS. Results Compared with NC, schizophrenics showed sensory gating deficit, reflecting by increased S2/S1 ratio ( NC: 42 ± 21%, Sch :81 ± 40%, P < 0. 01 ). No significant correlation was found between PANSS score and the three markers for assessing the sensory gating, such as the S2/S1 ratio, S2-S1, and 100 (1-S2/S1) ( P >0. 05). Schizophrenics showed no differences with P50 markers between the 5 weeks and 12 weeks of treatment. Conclusion P50 might be biological trait marker of schizophrenia.

  19. Altered depth of the olfactory sulcus in first-episode schizophrenia.

    Science.gov (United States)

    Takahashi, Tsutomu; Nakamura, Yumiko; Nakamura, Kazue; Ikeda, Eiji; Furuichi, Atsushi; Kido, Mikio; Kawasaki, Yasuhiro; Noguchi, Kyo; Seto, Hikaru; Suzuki, Michio

    2013-01-10

    A shallow olfactory sulcus has been reported in chronic schizophrenia, possibly reflecting abnormal forebrain development during early gestation. However, it remains unclear whether this abnormality exists at the early illness stage and/or develops progressively over the course of the illness. This magnetic resonance imaging (MRI) study investigated the length and depth of the olfactory sulcus in 64 first-episode schizophrenia patients and 64 controls, of whom longitudinal MRI data (mean inter-scan interval=2.6 years) were available for 20 patients and 21 controls. In the cross-sectional comparison at the baseline, the schizophrenia patients had a significantly shallower olfactory sulcus compared with the controls bilaterally, but there was no group difference in its anterior-posterior length. A longitudinal comparison demonstrated that the sulcus length and depth did not change over time in either group. The olfactory sulcus measures of the patients did not significantly correlate with clinical variables such as onset age, medication or symptom severity. These findings suggest that the olfactory sulcus depth, but not length, may be a static vulnerability marker of schizophrenia that reflects early neurodevelopmental abnormality.

  20. Skin ceramide alterations in first-episode schizophrenia indicate abnormal sphingolipid metabolism.

    Science.gov (United States)

    Smesny, Stefan; Schmelzer, Christian E H; Hinder, Anke; Köhler, Alexandra; Schneider, Christiane; Rudzok, Maria; Schmidt, Ulrike; Milleit, Berko; Milleit, Christine; Nenadic, Igor; Sauer, Heinrich; Neubert, Reinhard H H; Fluhr, Joachim W

    2013-07-01

    There is considerable evidence for specific pathology of lipid metabolism in schizophrenia, affecting polyunsaturated fatty acids and in particular sphingolipids. These deficits are assumed to interfere with neuronal membrane functioning and the development and maintenance of myelin sheaths. Recent studies suggest that some of these lipid pathologies might also be detected in peripheral skin tests. In this study, we examined different skin lipids and their relation to schizophrenia. We assessed epidermal lipid profiles in 22 first-episode antipsychotic-naïve schizophrenia patients and 22 healthy controls matched for age and gender using a hexan/ethanol extraction technique and combined high-performance thin-layer chromatography/gas-chromatography. We found highly significant increase of ceramide AH and NH/AS classes in patients and decrease of EOS and NP ceramide classes. This is the first demonstration of specific peripheral sphingolipid alterations in schizophrenia. The results support recent models of systemic lipid pathology and in particular of specific sphingolipids, which are crucial in neuronal membrane integrity. Given recent findings showing amelioration of psychopathology using fatty acid supplementation, our findings also bear relevance for sphingolipids as potential biomarkers of the disease.

  1. The association between psychopathology of first-episode psychosis patients within the schizophrenia spectrum and previous offending

    DEFF Research Database (Denmark)

    Munkner, Runa; Haastrup, Soeren; Joergensen, Torben

    2009-01-01

    Patients with schizophrenia have been shown to have an increased risk of criminality. The aim was to describe possible psychopathological differences between schizophrenia spectrum patients with and without a criminal career before first-episode psychosis. In a multi-centre study, 16 psychiatric ...

  2. Dorsal striatal volumes in never-treated patients with first-episode schizophrenia before and during acute treatment

    NARCIS (Netherlands)

    Emsley, Robin; Asmal, Laila; du Plessis, Stéfan; Chiliza, Bonginkosi; Kidd, Martin; Carr, Jonathan; Vink, Matthijs

    2015-01-01

    BACKGROUND: Studies of pre-and post-treatment striatal volume in schizophrenia have reported conflicting results. MATERIALS AND METHODS: We assessed dorsal striatal (caudate and putamen) volumes bilaterally in 22 never-treated, non-substance-abusing patients with first-episode schizophrenia or schiz

  3. Duration of Untreated Psychosis Is Associated with More Negative Schizophrenia Symptoms after Acute Treatment for First-Episode Psychosis

    Science.gov (United States)

    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.…

  4. New developments in diagnosis and treatment update: Schizophrenia/first episode psychosis in children and adolescents.

    Science.gov (United States)

    Lachman, Anusha

    2014-01-01

    Childhood onset schizophrenia (COS) is diagnosed before the age of 13 years, and early onset schizophrenia (EOS) is diagnosed before the age of 18 years. EOS is considered extremely rare and its prevalence in comparison to the worldwide prevalence of schizophrenia (1%) has not adequately been studied. Patients who experience the first episode of psychosis need to be treated early and optimally to lessen the morbidity and improve the outcome of the illness. Treatment needs to be a combination of both pharmacological and non-pharmacological modalities. Pharmacological intervention is necessary for remission, improvement of positive symptoms and to aid with the efficacy of psychosocial interventions. There is a lack of efficacy and safety data of the use of antipsychotic medication in children, with most of the information available being extrapolations of adult data. An increased use of atypical antipsychotic drugs in the treatment of EOS has been accompanied by growing concern about the appropriate use and associated side effects in children and adolescents. This update highlights new developments, concepts and treatment trends in EOS.

  5. Relationship of Cognition to Clinical Response in First-Episode Schizophrenia Spectrum Disorders.

    Science.gov (United States)

    Trampush, Joey W; Lencz, Todd; DeRosse, Pamela; John, Majnu; Gallego, Juan A; Petrides, Georgios; Hassoun, Youssef; Zhang, Jian-Ping; Addington, Jean; Kellner, Charles H; Tohen, Mauricio; Burdick, Katherine E; Goldberg, Terry E; Kane, John M; Robinson, Delbert G; Malhotra, Anil K

    2015-11-01

    First-episode schizophrenia (FES) spectrum disorders are associated with pronounced cognitive dysfunction across all domains. However, less is known about the course of cognitive functioning, following the first presentation of psychosis, and the relationship of cognition to clinical course during initial treatment. The present longitudinal study examined the magnitude of neurocognitive impairment, using the MATRICS Consensus Cognitive Battery, in patients experiencing their first episode of psychosis at baseline and after 12 weeks of randomized antipsychotic treatment with either aripiprazole or risperidone. At baseline, FES patients evidenced marked impairments in cognitive functioning. Notably, performance on the mazes task of planning and reasoning significantly predicted the likelihood of meeting stringent criteria for positive symptom remission during the first 12 weeks of the trial. Performance on indices of general cognitive function, working memory, and verbal learning improved over time, but these improvements were mediated by improvements in both positive and negative symptoms. We did not detect any differential effects of antipsychotic medication assignment (aripiprazole vs risperidone) on cognitive functioning. Our results suggest that a brief paper-and-pencil measure reflecting planning/reasoning abilities may index responsivity to antipsychotic medication. However, improvements in cognitive functioning over time were related to clinical symptom improvement, reflecting "pseudospecificity."

  6. The effect of positive symptoms on social cognition in first-episode schizophrenia is modified by the presence of negative symptoms

    DEFF Research Database (Denmark)

    Bliksted, Vibeke Fuglsang; Videbech, Poul B; Fagerlund, Birgitte

    2017-01-01

    Objective: There is considerable evidence that patients with schizophrenia have neurocognitive and social-cognitive deficits. It is unclear how such deficits in first-episode schizophrenia relate to current clinical symptoms. Method: Fifty-nine patients with first-episode schizophrenia (FES) were...

  7. Disrupted brain anatomical connectivity in medication-naïve patients with first-episode schizophrenia.

    Science.gov (United States)

    Zhang, Ruibin; Wei, Qinling; Kang, Zhuang; Zalesky, Andrew; Li, Meng; Xu, Yong; Li, Leijun; Wang, Junjing; Zheng, Liangrong; Wang, Bin; Zhao, Jingping; Zhang, Jinbei; Huang, Ruiwang

    2015-03-01

    Previous studies suggested that the topological properties of brain anatomical networks may be aberrant in schizophrenia (SCZ), and most of them focused on the chronic and antipsychotic-medicated SCZ patients which may introduce various confounding factors due to antipsychotic medication and duration of illness. To avoid those potential confounders, a desirable approach is to select medication-naïve, first-episode schizophrenia (FE-SCZ) patients. In this study, we acquired diffusion tensor imaging datasets from 30 FE-SCZ patients and 34 age- and gender-matched healthy controls. Taking a distinct gray matter region as a node, inter-regional connectivity as edge and the corresponding streamline counts as edge weight, we constructed whole-brain anatomical networks for both groups, calculated their topological parameters using graph theory, and compared their between-group differences using nonparametric permutation tests. In addition, network-based statistic method was utilized to identify inter-regional connections which were impaired in the FE-SCZ patients. We detected only significantly decreased inter-regional connections in the FE-SCZ patients compared to the controls. These connections were primarily located in the frontal, parietal, occipital, and subcortical regions. Although small-worldness was conserved in the FE-SCZ patients, we found that the network strength and global efficiency as well as the degree were significantly decreased, and shortest path length was significantly increased in the FE-SCZ patients compared to the controls. Most of the regions that showed significantly decreased nodal parameters belonged to the top-down control, sensorimotor, basal ganglia, and limbic-visual system systems. Correlation analysis indicated that the nodal efficiency in the sensorimotor system was negatively correlated with the severity of psychosis symptoms in the FE-SCZ patients. Our results suggest that the network organization is changed in the early stages of the

  8. Neuron-specific Enclose and Myelin Basic Protein in Cerebrospinal Fluid of Patients with First Episode Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    LI Shuying; WU Hanrong; GUO Huirong; ZHAO Zheng

    2006-01-01

    In order to study whether patients with schizophrenia have cerebral injury, neuron-specific enolase (NSE) and myelin basic protein (MBP)in cerebrospinal fluid (CSF) of 33 patients with first episode schizophrenia and 9 from the control group were determined by double antibody sandwich enzyme immunoassay method. The results showed that there was significant difference in the NSE contents between the experimental group and control group (P<0.01). The NSE contents in CSF in the experimental group were positively correlated with MBP in schizophrenia patients (P<0.05). These findings suggested that patients with schizophrenia had cerebral injury.

  9. Anti-NMDA receptor antibodies in patients with a first episode of schizophrenia

    Directory of Open Access Journals (Sweden)

    Masopust J

    2015-03-01

    Full Text Available Jirí Masopust,1,2 Ctirad Andrýs,3 Jan Bažant,1 Oldrich Vyšata,4 Kamil Kuca,5 Martin Vališ4 1Department of Psychiatry, Faculty of Medicine in Hradec Kralové, Charles University in Prague, University Hospital Hradec Králové, Hradec Králové, Czech Republic; 2National Institute of Mental Health, Klecany, Czech Republic; 3Institute of Clinical Immunology and Allergology, Charles University in Prague, Faculty of Medicine in Hradec Králové, and University Hospital Hradec Králové, Hradec Králové, Czech Republic; 4Department of Neurology, Charles University in Prague, Faculty of Medicine in Hradec Králové, and University Hospital Hradec Králové, Hradec Králové, Czech Republic; 5Biomedical Research Centrum, University Hospital Hradec Králové, Hradec Králové, Czech Republic Background: Encephalitis with antibodies against N-methyl-D-aspartate receptor (NMDA-R is classified as an autoimmune disorder with psychotic symptoms, which are frequently dominant. However, it remains unclear how frequently NMDA-R antibodies lead to a condition that mimics psychosis and first-episode schizophrenia. In our work, we investigated the presence of antibodies against NMDA-R in patients with first-episode psychosis (FEP in comparison with healthy volunteers.Methods: This study included 50 antipsychotic-naïve patients with FEP (including 21 women and 50 healthy volunteers (including 21 women. The mean age of the patients was 27.4 (±7.4 years and that of the healthy controls was 27.0 (±7.3 years. Antibodies against NMDA-R in the serum were detected by immunofluorescence.Results: None of the investigated patients with an FEP and none of the healthy controls showed positive antibodies against NMDA-Rs.Conclusion: According to results of studies, a small proportion of patients with an FEP possess antibodies against NMDA-R. However, the extent to which this finding contributes to the etiopathogenesis of the response to antipsychotic medication and

  10. Course and predictors of suicidality over the first two years of treatment in first-episode schizophrenia spectrum psychosis

    DEFF Research Database (Denmark)

    Melle, Ingrid; Johannessen, Jan Olav; Friis, Svein;

    2010-01-01

    The objective of this study was to investigate the course of suicidal behavior over the first 2 years of comprehensive, integrated treatment in two groups of patients with DSM-IV first episode schizophrenia spectrum psychosis, where one group was recruited through an early detection program. We...

  11. Prevalence and Profile of Cognitive Deficits in a Cohort of First-Episode Antipsychotic-Naïve Schizophrenia Patients

    DEFF Research Database (Denmark)

    Jensen, Maria Høj; Glenthøj, Birte Yding; Nielsen, Mette Ødegaard;

    2014-01-01

    -control study with assessment at baseline and follow-ups after 6 weeks, 6 months, 1 and 2 years. Sixty first-episode antipsychotic-naïve schizophrenia patients and 60 matched healthy controls have been examined at baseline. The study uses several instruments, including BACS (Brief Assessment of Cognition...

  12. Gamma oscillatory power is impaired during cognitive control independent of medication status in first-episode schizophrenia.

    Science.gov (United States)

    Minzenberg, Michael J; Firl, Alana J; Yoon, Jong H; Gomes, Glenn C; Reinking, Celeste; Carter, Cameron S

    2010-12-01

    Schizophrenia is characterized by impaired cognitive control associated with prefrontal cortex dysfunction, but the underlying pathophysiological mechanisms remain unknown. Higher cognitive processes are associated with cortical oscillations in the gamma range, which are also impaired in chronic schizophrenia. We tested whether cognitive control-related gamma deficits are observed in first-episode patients, and whether they are associated with antipsychotic medication exposure. Fifty-three first-episode schizophrenia patients (21 without antipsychotic medication treatment) and 29 healthy control subjects underwent electroencephalography (EEG) during performance of a preparatory cognitive control task (preparing to overcome prepotency or POP task). The first-episode schizophrenia patient group was impaired (relative to the control group) on task performance and on delay-period gamma power at each of the three subgroups of frontal electrodes. The unmedicated patient subgroup was similarly impaired compared with controls, and was not different on these measures compared with the medicated patient subgroup. In contrast, delay-period theta power was not impaired in the full patient group nor in the unmedicated patient subgroup. Impaired cognitive control-related gamma cortical oscillatory activity is present at the first psychotic episode in schizophrenia, and is independent of medication status. This suggests that altered local circuit function supporting high-frequency oscillatory activity in prefrontal cortex ensembles may serve as the pathophysiological substrate of cognitive control deficits in schizophrenia.

  13. Follow-up of N400 in the Rehabilitation of First-episode Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    Xiang-Dong Du; Guang-Ya Zhang; Yong Yang; Zhe Li; Wen Pan; Guang-Zhong Yin; Ri-Xia Dong

    2015-01-01

    Background:The N400 component of event-related potentials (ERP) has recently drawn widespread attention at home and abroad.This study was to explore the relationship between N400 changes and risperidone treatment and rehabilitation in first-episode schizophrenia (FES).Methods:ERP component N400 was recorded by Guangzhou Runjie W J-l ERP instruments,in 58 FES before and 6 months,15 months after risperidone treatment,and in 62 normal controls.The patients' syndromes were assessed by Positive and Negative Syndrome Scale (PANSS).And the stimuli are Chinese sentences with matching (congruent) or mismatching (incongruent) ending words.Results:N400 latencies were prolonged,and amplitudes were decreased in Cz,Pz,Fz,C3,C4,in FES compared with in NC,before treatment.The prolonged N400 latencies and decreased amplitudes were negatively correlated with the patients' positive scale and total scale of PANSS.There are significant differences of N400 amplitudes and latencies in 6 months and 15 months follow-up after treatment.Before treatment,6 months and 15 months after treatment,N400 latencies are 446 ± 35 ms,440 ± 37 ms,414 ± 31 ms (F =9.72,P < 0.01) in incongruent situation;N400 amplitudes are 5.2 ± 4.6 μtⅤ,5.7 ± 4.8 μⅤ,7.3 ± 5.0 μⅤ (F =2.06,P > 0.05) in congruent situation,and 8.5 ± 5.9 μⅤ,10.1 ± 5.0 μⅤ,11.9 ± 7.0 μⅤ (F =3.697,P < 0.05) in incongruent situation.Conclusions:N400 could be used to predict the effects of treatment of schizophrenia to some degree.The linguistic and cognitive impairment in schizophrenia can be improved by antipsychotic drugs.

  14. Differential effects of antipsychotic drugs on insight in first episode schizophrenia : Data from the European First-Episode Schizophrenia Trial (EUFEST)

    NARCIS (Netherlands)

    Pijnenborg, G. H. M.; Timmerman, Marieke; Derks, E.M.; Fleischhacker, W. W.; Kahn, R. S.; Aleman, A.

    2015-01-01

    Although antipsychotics are widely prescribed, their effect of on improving poor illness insight in schizophrenia has seldom been investigated and therefore remains uncertain. This paper examines the effects of low dose haloperidol, amisulpride, olanzapine, quetiapine, and ziprasidone on insight in

  15. Rorschach Inkblot Method data at baseline and after 2 years treatment of consecutively admitted patients with first-episode schizophrenia

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Andersen, Palle Bent; Knudsen, Per Bjerregaard;

    2012-01-01

    Background: The Rorschach Inkblot Method is regarded as an important clinical instrument for detailed diagnostic description of the integrative capacities of individuals in psychotic states and as an instrument for measuring progression in the course of treatment. Aims: To describe relevant...... Rorschach variables at baseline in a group of consecutively admitted patients with first-episode schizophrenia. Furthermore, to describe the changes in these variables from baseline to year 2 for the group of patients given psychiatric standard treatment, and to compare these changes with changes in other......'s Rorschach Comprehensive System at inclusion and after 2 years. Results: Core variables of the Rorschach, assumed to show changes (e.g. reality testing, perceptual and thought disorders) in patients with a first episode of schizophrenia, all improved but revealed no significant changes after 2 years...

  16. Treatment of patients with first-episode psychosis: two-year outcome data from the Danish National Schizophrenia Project

    OpenAIRE

    2006-01-01

    First episode psychosis interventions have been in focus in the last two decades in an attempt to improve the course and outcome of schizophrenic disorders. The Danish National Schizophrenia Project began in 1997 its intake of patients, aged 16-35, with a first psychotic episode of a schizophrenic spectrum disorder, diagnosed by ICD-10 (F20-29). The study was carried out as a prospective, longitudinal, multicentre investigation, encompassing 16 centres, spread all over the c...

  17. The association between psychopathology of first-episode psychosis patients within the schizophrenia spectrum and previous offending.

    Science.gov (United States)

    Munkner, Runa; Haastrup, Soeren; Joergensen, Torben; Kramp, Peter

    2009-01-01

    Patients with schizophrenia have been shown to have an increased risk of criminality. The aim was to describe possible psychopathological differences between schizophrenia spectrum patients with and without a criminal career before first-episode psychosis. In a multi-centre study, 16 psychiatric treatment centres included and rated 477 patients with first-episode psychosis over a 2-year period on socio-demography, the Positive and Negative Syndrome Scale, OPerational CRITeria checklist, Global Assessment of Functioning, Premorbid Adjustment Scale and Self-report Insight Scale for psychosis. Data were linked with data concerning criminal and psychiatric history. No key characteristics were found to assist the early detection of criminal persons before first psychiatric hospital contact for a psychotic incident. However, when adjusted for sex, age, abuse, living conditions, marital status, employment status and education, a primarily positive symptomatology was associated with a prior criminal career. The premorbid level of functioning and several function parameters were also significantly associated with criminal history. There are significant differences in psychopathology between schizophrenia spectrum patients with and without a criminal career before first-episode psychosis, and a better screening procedure in the judicial system could detect these individuals earlier and make adequate treatment possible.

  18. Prevalence and profile of cognitive deficits in a cohort of first-episode antipsychotic-naïve schizophrenia patients

    DEFF Research Database (Denmark)

    Jensen, Maria Høj; Glenthøj, Birte Yding; Nielsen, Mette Ødegaard;

    medication, which can affect the results on specific domains such as processing speed. As part of the PECANS project (Pan European Collaboration on Antipsychotic Naïve Schizophrenia) the aim of the present study is to establish the prevalence and profile of cognitive deficits in a cohort of first......Background and Aims: Cognitive deficits are considered a core feature of schizophrenia with prevalence estimates ranging from ca. 75-85 %. These deficits are present in the early phase of the illness; however in most first-episode schizophrenia studies the patients are receiving antipsychotic......-episode antipsychotic-naïve schizophrenia patients, without the potential confounding effects associated with medication and chronicity. Methods: The overall design of the PECANS project is a 2-year longitudinal case-control study with assessment at baseline and follow-ups after 6 weeks, 6 months, 1 and 2 years. Sixty...

  19. Impaired prepulse inhibition of acoustic startle in Chinese patients with first-episode, medication-na(i)ve schizophrenia

    Institute of Scientific and Technical Information of China (English)

    WANG Zhi-ren; TAN Yun-long; YANG Fu-de; ZHANG Wu-fang; ZOU Yi-zhuang; TAN Shu-ping; SONG Chong-sheng

    2013-01-01

    Background Patients with schizophrenia have prominent abnormality in information processing that can be observed by measures of prepulse inhibition (PPI) of acoustic startle reflex and PPI deficits have been considered as a candidate endophenotypic marker of schizophrenia.However,there has been little information on PPI and related measures in Chinese patients with schizophrenia.The research was to explore the deficits of acoustic startle reflex that might exist in Chinese patients with schizophrenia.Methods Startle response to acoustic stimuli,habituation,and PPI were examined in 31 Chinese patients with first-episode,medication-naǐve schizophrenia and 30 age-and sex-matched healthy Chinese controls.At the same day of startle testing,psychopathological symptoms of the patients were assessed with the Positive and Negative Syndrome Scale (PANSS).Results Compared with healthy controls,patients exhibited the significant reduction in startle response and PPI deficits at 60 milliseconds (ms) intervals (PPI60,P <0.05) but not at 30 or 120 ms intervals.Furthermore,there was a relatively strong correlation between PPI60 (P <0.05) and scores of positive scale of PANSS in patients with schizophrenia.Conclusion Our findings confirmed impaired PPI in Chinese patients with schizophrenia and suggested that a relationship between sensorimotor gating deficits and clinical symptoms of patients with schizophrenia might exist.

  20. Cognitive control deficit in patients with first-episode schizophrenia is associated with complex deviations of early brain development

    Science.gov (United States)

    Gay, Olivier; Plaze, Marion; Oppenheim, Catherine; Gaillard, Raphael; Olié, Jean-Pierre; Krebs, Marie-Odile; Cachia, Arnaud

    2017-01-01

    Background Several clinical and radiological markers of early neurodevelopmental deviations have been independently associated with cognitive impairment in patients with schizophrenia. The aim of our study was to test the cumulative and/or interactive effects of these early neurodevelopmental factors on cognitive control (CC) deficit, a core feature of schizophrenia. Methods We recruited patients with first-episode schizophrenia-spectrum disorders, who underwent structural MRI. We evaluated CC efficiency using the Trail Making Test (TMT). Several markers of early brain development were measured: neurological soft signs (NSS), handedness, sulcal pattern of the anterior cingulate cortex (ACC) and ventricle enlargement. Results We included 41 patients with schizophrenia in our analysis, which revealed a main effect of ACC morphology (p = 0.041) as well as interactions between NSS and ACC morphology (p = 0.005), between NSS and handedness (p = 0.044) and between ACC morphology and cerebrospinal fluid (CSF) volume (p = 0.005) on CC measured using the TMT-B score – the TMT-A score. Limitations No 3- or 4-way interactions were detected between the 4 neurodevelopmental factors. The sample size was clearly adapted to detect main effects and 2-way interactions, but may have limited the statistical power to investigate higher-order interactions. The effects of treatment and illness duration were limited as the study design involved only patients with first-episode psychosis. Conclusion To our knowledge, our study provides the first evidence of cumulative and interactive effects of different neurodevelopmental markers on CC efficiency in patients with schizophrenia. Such findings, in line with the neurodevelopmental model of schizophrenia, support the notion that CC impairments in patients with schizophrenia may be the final common pathway of several early neurodevelopmental mechanisms. PMID:28245174

  1. Decrease in temporal gyrus gray matter volume in first-episode, early onset schizophrenia: an MRI study.

    Directory of Open Access Journals (Sweden)

    Jinsong Tang

    Full Text Available BACKGROUND: Loss of gray matter has been previously found in early-onset schizophrenic patients. However, there are no consistent findings between studies due to different methods used to measure grey matter volume/density and influences of confounding factors. METHODS: The volume of gray matter (GM was measured in 29 first episode early-onset schizophrenia (EOS and 34 well-matched healthy controls by using voxel-based morphometry (VBM. Psychotic symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS. The correlations between the GM volume and PANSS scores, age of psychosis onset, duration of psychosis, and chlorpromazine (CPZ equivalent value were investigated. RESULTS: Relative to healthy subjects, the patients with first episode EOS showed significantly lower GM volume in the left middle and superior temporal gyrus. The loss of GM volume negatively correlated with PANSS-positive symptoms (p = 0.002, but not with PANSS-negative symptoms, PANSS-general psychopathology, and PANSS-total score. No significant correlation was found between GM volume and age of psychosis onset, duration of psychosis, and CPZ equivalent value. CONCLUSION: Patients with first episode EOS have evidence of reduced GM in the left middle and superior temporal gyrus. Structural abnormalities in the left middle and superior temporal gyrus may contribute to the pathophysiology of schizophrenia.

  2. Cognitive Behavioral Therapy across the Stages of Psychosis: Prodromal, First Episode, and Chronic Schizophrenia

    Science.gov (United States)

    Valmaggia, Lucia R.; Tabraham, Paul; Morris, Eric; Bouman, Theo K.

    2008-01-01

    Since the early 1990s, cognitive behavioral therapy (CBT) has been increasingly used as an adjunctive treatment for psychotic disorders. This paper describes the CBT of three cases, each at a different stage of psychotic disorder: at-risk mental state, first-episode psychosis, and chronic psychotic disorder. For the at-risk mental state, treatment…

  3. The association between psychopathology of first-episode psychosis patients within the schizophrenia spectrum and previous offending

    DEFF Research Database (Denmark)

    Munkner, Runa; Haastrup, Soeren; Joergensen, Torben

    2008-01-01

    treatment centres included and rated 477 patients with first-episode psychosis over a 2-year period on socio-demography, the Positive and Negative Syndrome Scale, OPerational CRITeria checklist, Global Assessment of Functioning, Premorbid Adjustment Scale and Self-report Insight Scale for psychosis. Data......, employment status and education, a primarily positive symptomatology was associated with a prior criminal career. The premorbid level of functioning and several function parameters were also significantly associated with criminal history. There are significant differences in psychopathology between...... schizophrenia spectrum patients with and without a criminal career before first-episode psychosis, and a better screening procedure in the judicial system could detect these individuals earlier and make adequate treatment possible....

  4. Gender differences in young adults with first-episode schizophrenia spectrum disorders at baseline in the Danish OPUS study

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia

    2007-01-01

    , and duration of untreated psychosis were similar for men and women. Men had more severe negative symptoms, poorer premorbid functioning, and poorer social networks, whereas women had more severe hallucinations. More men than women were substance abusers, were unemployed, and lived alone. Women had poorer self......-esteem than men, in spite of better scores in functioning. Premorbid social adjustment was significantly related to the level of negative symptoms and number of friends. Conclusion is that men and women with first-episode psychosis showed different psychopathological characteristics and different social......Gender differences in age at first onset, duration of untreated psychosis, psychopathology, social functioning, and self-esteem were investigated in a group of 578 young adults with a first-episode schizophrenia spectrum disorder. The mean age at first-onset of symptoms, age at first contact...

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

    Science.gov (United States)

    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.

  6. Social cognition in schizophrenia, Part 2: 12-month stability and prediction of functional outcome in first-episode patients.

    Science.gov (United States)

    Horan, William P; Green, Michael F; DeGroot, Michael; Fiske, Alan; Hellemann, Gerhard; Kee, Kimmy; Kern, Robert S; Lee, Junghee; Sergi, Mark J; Subotnik, Kenneth L; Sugar, Catherine A; Ventura, Joseph; Nuechterlein, Keith H

    2012-06-01

    This study evaluated the longitudinal stability and functional correlates of social cognition during the early course of schizophrenia. Fifty-five first-episode schizophrenia patients completed baseline and 12-month follow-up assessments of 3 key domains of social cognition (emotional processing, theory of mind, and social/relationship perception), as well as clinical ratings of real-world functioning and symptoms. Scores on all 3 social cognitive tests demonstrated good longitudinal stability with test-retest correlations exceeding .70. Higher baseline and 12-month social cognition scores were both robustly associated with significantly better work functioning, independent living, and social functioning at the 12-month follow-up assessment. Furthermore, cross-lagged panel analyses were consistent with a causal model in which baseline social cognition drove later functional outcome in the domain of work, above and beyond the contribution of symptoms. Social cognitive impairments are relatively stable, functionally relevant features of early schizophrenia. These results extend findings from a companion study, which showed stable impairments across patients in prodromal, first-episode, and chronic phases of illness on the same measures. Social cognitive impairments may serve as useful vulnerability indicators and early clinical intervention targets.

  7. Treatment of patients with first-episode psychosis: two-year outcome data from the Danish National Schizophrenia Project

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Valbak, Kristian; Harder, Susanne

    2006-01-01

    First episode psychosis interventions have been in focus in the last two decades in an attempt to improve the course and outcome of schizophrenic disorders. The Danish National Schizophrenia Project began in 1997 its intake of patients, aged 16-35, with a first psychotic episode of a schizophrenic...... patients in the treatment-as-usual group. Improvement in the intervention groups continued into the second year. Patients receiving integrated assertive treatment faired better than those being treated with the less intensive method of supportive psychodynamic psychotherapy, and the latter group improved...

  8. Metabolic syndrome and aerobic fitness in patients with first-episode schizophrenia, including a 1-year follow-up

    DEFF Research Database (Denmark)

    Nyboe, L.; Vestergaard, C. H.; Moeller, M. K.

    2015-01-01

    OBJECTIVE: To compare the prevalence of metabolic syndrome (MetS) and metabolic abnormalities in patients with first-episode schizophrenia (FES) with sex- and age-matched healthy controls; to investigate changes in MetS during 1year of treatment; and to investigate predictors of MetS. METHODS......: Patients with FES (N=99) and healthy controls (N=50) were included in the study. MetS was defined according to IDF based on waist circumference (WC), blood pressure (BP), triglycerides (TG), high-density lipoprotein (HDL), and fasting-glucose. Data on physical activity, aerobic fitness, smoking...

  9. Assessment of empathy in first-episode psychosis and meta-analytic comparison with previous studies in schizophrenia.

    Science.gov (United States)

    Achim, Amelie M; Ouellet, Rosalie; Roy, Marc-André; Jackson, Philip L

    2011-11-30

    Empathy is a multidimensional construct that relies on affective and cognitive component processes. A few studies have reported impairments of both cognitive and affective empathy components in patients with schizophrenia. It is, however, not known whether these difficulties are already present at psychosis onset. The affective and cognitive components of empathy were thus assessed in 31 patients with first-episode psychosis (FEP) and 31 matched healthy controls using the Interpersonal Reactivity Index (IRI). Our results were then compared to previous studies of empathy in patients with more chronic schizophrenia via a meta-analysis. In addition, we also assessed the relationship between empathy ratings, Mentalizing performance and clinical symptoms. Contrary to what has been reported in people with more chronic schizophrenia, the IRI ratings did not significantly differ between FEP and controls in our study, though a trend was observed for the Personal distress scale. For the Perspective taking scale, our meta-analysis revealed a significantly lower effect size in this study with FEP patients relative to previous schizophrenia studies. In the FEP group, the IRI ratings were not related to positive, negative or general psychopathology symptoms, but a significant relationship emerged between the Liebowitz Social Anxiety Scale and Perspective taking (negative correlation). In addition, a significant positive correlation was observed between the Empathic concern subscale and our theory of mind task. This study supports the idea that the cognitive component of empathy is less affected in patients with first-episode psychosis relative to patients with more chronic schizophrenia, and the impairments reported in previous reports with more chronic populations should be interpreted in light of a possible deterioration of this cognitive skill. The findings also provide some insight into the relationship between empathy and clinical symptoms such as social anxiety.

  10. The Association between Anomalous Self-experiences, Self-esteem and Depressive Symptoms in First Episode Schizophrenia.

    Science.gov (United States)

    Haug, Elisabeth; Øie, Merete G; Andreassen, Ole A; Bratlien, Unni; Romm, Kristin L; Møller, Paul; Melle, Ingrid

    2016-01-01

    Background: Anomalous self-experiences (ASEs) aggregate in schizophrenia spectrum disorders, but the relationship between ASEs, and depression has been studied to a limited extent. Lower self-esteem has been shown to be associated with depression in early psychosis. Our hypothesis is that ASEs in early phases of schizophrenia are linked to lower levels of self-esteem, which in turn is associated with depression. Aim: The aim is to examine the relationship between ASEs, self-esteem and depression in first-episode schizophrenia spectrum disorders. Method: ASEs were assessed in 55 patients with first-episode schizophrenia by means of the Examination of anomalous Self-Experience (EASE) instrument. Assessment of depression was based on the Calgary Depression Scale for Schizophrenia (CDSS). Self-esteem was measured using the Rosenberg Self-Esteem Scale (RSES). Symptom severity was assessed using the Structured Clinical Interview for the Positive and Negative Syndrome Scale (SCI-PANSS). Substance misuse was measured with the Drug Use Disorder Identification Test (DUDIT), and alcohol use was measured with the Alcohol Use Disorder Identification Test (AUDIT). Data on childhood adjustment were collected using the Premorbid Adjustment Scale (PAS). Data on childhood trauma were collected using the Norwegian version of the Childhood Trauma Questionnaire, short form (CTQ-SF). Results: Analyses detected a significant association between current depression and ASEs as measured by the EASE in women, but not in men. The effect of ASEs on depression appeared to be mediated by self-esteem. No other characteristics associated with depression influenced the relationship between depression, self-esteem and ASEs. Conclusion: Evaluating ASEs can assist clinicians in understanding patients' experience of self-esteem and depressive symptoms. The complex interaction between ASEs, self-esteem, depression and suicidality could be a clinical target for the prevention of suicidality in this

  11. Compensatory cognitive training for people with first-episode schizophrenia: results from a pilot randomized controlled trial.

    Science.gov (United States)

    Mendella, Paul D; Burton, Cynthia Z; Tasca, Giorgio A; Roy, Paul; St Louis, Lea; Twamley, Elizabeth W

    2015-03-01

    Cognitive training or remediation now has multiple studies and meta-analyses supporting its efficacy in improving cognition and functioning in people with schizophrenia. However, relatively little is known about cognitive training outcomes in early psychosis. We conducted a pilot randomized controlled trial of Compensatory Cognitive Training (CCT) compared to Treatment as Usual (TAU) in 27 participants with first-episode psychosis who had received treatment for psychosis for less than six months. Assessments of cognition (MATRICS Consensus Cognitive Battery; MCCB) and functional capacity (UCSD Performance-Based Skills Assessment-Brief; UPSA-B) were administered at baseline and following the 12-week treatment. The CCT condition, compared to TAU, was associated with significant improvements on the MCCB composite score, as well as MCCB subtests measuring processing speed (Trail Making) and social cognition (Mayer-Salovey-Caruso Emotional Intelligence Test), with large effects on these three outcome measures. There were no significant CCT-associated effects on the UPSA-B or on positive, negative, or depressive symptoms. CCT treatment of cognitive impairments in first-episode schizophrenia is feasible and can result in large effect size improvements in global cognition, processing speed, and social cognition.

  12. Effects of antipsychotics on insight in schizophrenia: results from independent samples of first-episode and acutely relapsed patients.

    Science.gov (United States)

    Misiak, Błażej; Frydecka, Dorota; Beszłej, Jan A; Moustafa, Ahmed A; Tybura, Piotr; Kucharska-Mazur, Jolanta; Samochowiec, Agnieszka; Bieńkowski, Przemysław; Samochowiec, Jerzy

    2016-07-01

    We aimed to investigate whether antipsychotics differentially impact insight and whether these effects appear because of improvement in psychopathological manifestation in 132 first-episode schizophrenia patients and 201 acutely relapsed schizophrenic patients, who were followed up for 12 weeks. Olanzapine and risperidone were administered to first-episode schizophrenia patients, whereas acutely relapsed schizophrenic patients were treated with olanzapine, perazine and ziprasidone. The Positive And Negative Syndrome Scale (PANSS) was used to assess psychopathology. Insight was assessed using the G12 item of PANSS. Unadjusted mixed-model regression analysis indicated a significant improvement in the PANSS G12 item score in both groups. There were no significant differences between distinct treatment subgroups of patients in terms of improvement in the PANSS G12 item score. After adjustment for the trajectories of changes in symptom dimensions, a decrease in the PANSS G12 item score was because of an improvement in positive, negative and excitement symptoms. A decrease in the PANSS G12 item score was also related to an increase in the severity of depressive symptomatology. Our results indicate that antipsychotics exert similar effects on insight in acute psychosis. These effects are likely because of an improvement in psychopathological manifestation. The improvement in insight might be related to the development of depressive symptoms.

  13. Structural brain abnormalities in first episode schizophrenia. Is it just illness?

    NARCIS (Netherlands)

    Rais, M.

    2011-01-01

    Although neuroimaging studies consistently demonstrated brain volume alterations in patients with schizophrenia, confounding factors like age, IQ, duration of the illness, use of antipsychotic medication and drug (ab-)use might partly explain these results. Therefore, the relation between confoundin

  14. Magnetic resonance imaging and the prediction of outcome in first-episode schizophrenia

    DEFF Research Database (Denmark)

    Dazzan, Paola; Arango, Celso; Fleischacker, Wolfgang

    2015-01-01

    UNLABELLED: Magnetic Resonance Imaging (MRI) measures are promising outcome markers for schizophrenia, since regional frontal and temporal grey matter volumes reductions, and enlargement of the ventricles, have been associated with outcome in this disorder. However, a number of methodological...

  15. Estimation of the cool executive function using frontal electroencephalogram signals in first-episode schizophrenia patients

    OpenAIRE

    Yu, Yi; Zhao, Yun; Si, Yajing; Ren, Qiongqiong; Ren, Wu; JING, CHANGQIN; Zhang, Hongxing

    2016-01-01

    Background In schizophrenia, executive dysfunction is the most critical cognitive impairment, and is associated with abnormal neural activities, especially in the frontal lobes. Complexity estimation using electroencephalogram (EEG) recording based on nonlinear dynamics and task performance tests have been widely used to estimate executive dysfunction in schizophrenia. Methods The present study estimated the cool executive function based on fractal dimension (FD) values of EEG data recorded f...

  16. Long-term diagnostic stability and outcome in recent first-episode cohort studies of schizophrenia.

    Science.gov (United States)

    Bromet, Evelyn J; Naz, Bushra; Fochtmann, Laura J; Carlson, Gabrielle A; Tanenberg-Karant, Marsha

    2005-07-01

    Knowing the long-term outcomes of schizophrenia and stability of a schizophrenia diagnosis are important from a clinical standpoint as well as essential to future research on diagnostic classifications and outcome. As in prior research on schizophrenia, prospectively designed long-term studies over the past 30 years find that the predominant course of illness includes chronically poor functioning, with little evidence of long-term improvement. Mortality due to suicide is significant at about 10% over 10-year periods of follow-up. Within studies, outcome domains are interrelated, and the relatively consistent predictors of poorer outcome include family history of schizophrenia, insidious onset, poor premorbid functioning, severity of negative symptoms, and severity and duration of untreated psychosis. Residing in a developed rather than a developing country is also associated with a poorer long-term course. The diagnostic stability of schizophrenia is less well studied. The positive predictive value exceeds 90%, and preliminary findings from the 10-year follow-up of the Suffolk County Mental Health Project cohort have found that the agreement across time increased from k = .52 (baseline to 10 years) to k = .76 (6 or 24 months to 10 years). After discussing several limitations of the existing body of research, we suggest that future studies incorporate more "modifiable" risk factors into the assessment battery that could potentially be used as building blocks in experimental intervention designs.

  17. Family-based case-control study of homotopic connectivity in first-episode, drug-naive schizophrenia at rest

    Science.gov (United States)

    Guo, Wenbin; Liu, Feng; Chen, Jindong; Wu, Renrong; Li, Lehua; Zhang, Zhikun; Zhao, Jingping

    2017-01-01

    Family-based case-control design is rarely used but powerful to reduce the confounding effects of environmental factors on schizophrenia. Twenty-eight first-episode, drug-naive patients with schizophrenia, 28 family-based controls (FBC), and 40 healthy controls (HC) underwent resting-state functional MRI. Voxel-mirrored homotopic connectivity (VMHC), receiver operating characteristic curve (ROC), and support vector machine (SVM) were used to process the data. Compared with the FBC, the patients showed lower VMHC in the precuneus, fusiform gyrus/cerebellum lobule VI, and lingual gyrus/cerebellum lobule VI. The patients exhibited lower VMHC in the precuneus relative to the HC. ROC analysis exhibited that the VMHC values in these brain regions might not be ideal biomarkers to distinguish the patients from the FBC/HC. However, SVM analysis indicated that a combination of VMHC values in the precuneus and lingual gyrus/cerebellum lobule VI might be used as a potential biomarker to distinguish the patients from the FBC with a sensitivity of 96.43%, a specificity of 89.29%, and an accuracy of 92.86%. Results suggested that patients with schizophrenia have decreased homotopic connectivity in the motor and low level sensory processing regions. Neuroimaging studies can adopt family-based case-control design as a viable option to reduce the confounding effects of environmental factors on schizophrenia. PMID:28256527

  18. Early detection of the first episode of schizophrenia and suicidal behavior

    DEFF Research Database (Denmark)

    Melle, Ingrid; Johannesen, Jan Olav; Friis, Svein;

    2006-01-01

    The suicide rate in schizophrenia is high, with the risk being highest early in the course. The rate of suicide attempts before treatment onset is also high and is often the event leading up to first treatment contact. A previous report showed that the duration of untreated psychosis can be reduced...

  19. Sex-Specific Patterns of Aberrant Brain Function in First-Episode Treatment-Naive Patients with Schizophrenia

    Directory of Open Access Journals (Sweden)

    Wei Lei

    2015-07-01

    Full Text Available Male and female patients with schizophrenia show significant differences in a number of important clinical features, yet the neural substrates of these differences are still poorly understood. Here we explored the sex differences in the brain functional aberrations in 124 treatment-naïve patients with first-episode schizophrenia (61 males, compared with 102 age-matched healthy controls (50 males. Maps of degree centrality (DC and amplitude of low-frequency fluctuations (ALFF were constructed using resting-state functional magnetic resonance imaging data and compared between groups. We found that: (1 Selective DC reduction was observed in the right putamen (Put_R in male patients and the left middle frontal gyrus (MFG in female patients; (2 Functional connectivity analysis (using Put_R and MFG as seeds found that male and female patients have disturbed functional integration in two separate networks, i.e., the sensorimotor network and the default mode network; (3 Significant ALFF alterations were also observed in these two networks in both genders; (4 Sex specific brain functional alterations were associated with various symptoms in patients. These results suggested that sex-specific patterns of functional aberration existed in schizophrenia, and these patterns were associated with the clinical features both in male and female patients.

  20. Basic symptoms and psychotic symptoms: their relationships in the at risk mental states, first episode and multi-episode schizophrenia.

    Science.gov (United States)

    Comparelli, Anna; De Carolis, Antonella; Emili, Emanuele; Rigucci, Silvia; Falcone, Ilaria; Corigliano, Valentina; Curto, Martina; Trovini, Giada; Dehning, Julia; Kotzalidis, Giorgio D; Girardi, Paolo

    2014-05-01

    In the field of the early psychosis two main approaches attempt to develop rating tools, one investigating the basic symptoms domain, and the other the attenuated psychotic symptoms. To explore the relationship between basic symptoms (BSs) and other symptom domains in different phases of the psychotic illness 32 at ultra-high risk (UHR), 49 first episode schizophrenia (FES), 42 multiple episode schizophrenia (MES), and 28 generalized anxiety disorder (GAD) patients were enrolled. Participants were assessed using the SIPS/SOPS and the FCQ scales. Analyses of covariance taking into account socio-demographic and clinical variables significantly different between groups were applied to compare FCQ and SOPS scores. Finally FCQ and SOPS principal component analysis was carried out in the schizophrenia spectrum group. SOPS scores were higher in the UHR, FES and MES groups compared to the GAD control group. Concordantly, FES and MES groups had a higher number of basic symptoms in comparison with the GAD group, whereas UHR did not differ from the control group. The largest number of correlations between BSs and psychotic symptoms was found in the GAD group. According to the principal component analysis (PCA) five factors were extracted, with the BSs loading on a unique factor. Our findings imply that the boundary between psychotic and non-psychotic conditions cannot be outlined on the basis of the presence/absence of basic and psychotic symptoms.

  1. Gender differences in young adults with first-episode schizophrenia spectrum disorders at baseline in the Danish OPUS study.

    Science.gov (United States)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia; Ohlenschlaeger, Johan; Christensen, Torben; Krarup, Gertrud; Jorgensen, Per; Nordentoft, Merete

    2007-05-01

    Gender differences in age at first onset, duration of untreated psychosis, psychopathology, social functioning, and self-esteem were investigated in a group of 578 young adults with a first-episode schizophrenia spectrum disorder. The mean age at first-onset of symptoms, age at first contact, and duration of untreated psychosis were similar for men and women. Men had more severe negative symptoms, poorer premorbid functioning, and poorer social networks, whereas women had more severe hallucinations. More men than women were substance abusers, were unemployed, and lived alone. Women had poorer self-esteem than men, in spite of better scores in functioning. Premorbid social adjustment was significantly related to the level of negative symptoms and number of friends. Conclusion is that men and women with first-episode psychosis showed different psychopathological characteristics and different social functioning, which cannot be explained by older age of onset for women. Women make more suicide attempts and experience lower self-esteem in spite of better social functioning.

  2. Treatment of patients with first-episode psychosis: two-year outcome data from the Danish National Schizophrenia Project

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Valbak, Kristian; Harder, Susanne;

    2006-01-01

    First episode psychosis interventions have been in focus in the last two decades in an attempt to improve the course and outcome of schizophrenic disorders. The Danish National Schizophrenia Project began in 1997 its intake of patients, aged 16-35, with a first psychotic episode of a schizophrenic...... psychodynamic psychotherapy as a supplement to treatment as usual", "integrated, assertive, psychosocial and educational treatment programme", or "treatment as usual". Data on symptoms and social function and sociodemographic data were obtained at inclusion, and at year 1 and 2. The three sub-cohorts did...... patients in the treatment-as-usual group. Improvement in the intervention groups continued into the second year. Patients receiving integrated assertive treatment faired better than those being treated with the less intensive method of supportive psychodynamic psychotherapy, and the latter group improved...

  3. Gender differences in young adults with first-episode schizophrenia spectrum disorders at baseline in the Danish OPUS study

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia

    2007-01-01

    Gender differences in age at first onset, duration of untreated psychosis, psychopathology, social functioning, and self-esteem were investigated in a group of 578 young adults with a first-episode schizophrenia spectrum disorder. The mean age at first-onset of symptoms, age at first contact......, and duration of untreated psychosis were similar for men and women. Men had more severe negative symptoms, poorer premorbid functioning, and poorer social networks, whereas women had more severe hallucinations. More men than women were substance abusers, were unemployed, and lived alone. Women had poorer self-esteem...... functioning, which cannot be explained by older age of onset for women. Women make more suicide attempts and experience lower self-esteem in spite of better social functioning....

  4. Cerebellar grey-matter deficits, cannabis use and first-episode schizophrenia in adolescents and young adults.

    Science.gov (United States)

    Cohen, Martin; Rasser, Paul E; Peck, Greg; Carr, Vaughan J; Ward, Philip B; Thompson, Paul M; Johnston, Patrick; Baker, Amanda; Schall, Ulrich

    2012-04-01

    Epidemiological data link adolescent cannabis use to psychosis and schizophrenia, but its contribution to schizophrenia neuropathology remains controversial. First-episode schizophrenia (FES) patients show regional cerebral grey- and white-matter changes as well as a distinct pattern of regional grey-matter loss in the vermis of the cerebellum. The cerebellum possesses a high density of cannabinoid type 1 receptors involved in the neuronal diversification of the developing brain. Cannabis abuse may interfere with this process during adolescent brain maturation leading to 'schizophrenia-like' cerebellar pathology. Magnetic resonance imaging and cortical pattern matching techniques were used to investigate cerebellar grey and white matter in FES patients with and without a history of cannabis use and non-psychiatric cannabis users. In the latter group we found lifetime dose-dependent regional reduction of grey matter in the right cerebellar lobules and a tendency for more profound grey-matter reduction in lobule III with younger age at onset of cannabis use. The overall regional grey-matter differences in cannabis users were within the normal variability of grey-matter distribution. By contrast, FES subjects had lower total cerebellar grey-matter:total cerebellar volume ratio and marked grey-matter loss in the vermis, pedunculi, flocculi and lobules compared to pair-wise matched healthy control subjects. This pattern and degree of grey-matter loss did not differ from age-matched FES subjects with comorbid cannabis use. Our findings indicate small dose-dependent effects of juvenile cannabis use on cerebellar neuropathology but no evidence of an additional effect of cannabis use on FES cerebellar grey-matter pathology.

  5. Impact of avolition and cognitive impairment on functional outcome in first-episode schizophrenia-spectrum disorder: a prospective one-year follow-up study.

    Science.gov (United States)

    Chang, Wing Chung; Hui, Christy Lai Ming; Chan, Sherry Kit Wa; Lee, Edwin Ho Ming; Chen, Eric Yu Hai

    2016-02-01

    Previous research investigating the relationships between avolition, cognition and functioning in schizophrenia mostly focused on chronic samples and were cross-sectional in design. Impacts of avolition and cognition on longitudinal functional outcome in first-episode patients are under-studied. We assessed 114 Chinese aged 18-55 years presenting with first-episode schizophrenia-spectrum disorder aiming to identify baseline predictors of 1-year functional outcome. Results showed that both avolition and global cognition independently predicted functioning, with avolition being the strongest predictor above and beyond cognition and other symptom dimensions. Our findings indicate the central role of in determining longitudinal functional status in the early illness stage.

  6. Frequency and predictive values of first rank symptoms at baseline among 362 young adult patients with first-episode schizophrenia Results from the Danish OPUS study

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia;

    2007-01-01

    To investigate the frequency of the Schneiderian First Rank Symptoms (FRSs) in a representative group of patients with first-episode schizophrenia and to analyse the predictive value of these symptoms in relation to psychopathology, work situation, depression, dependency and admission after 2 yea...

  7. Frequency and predictive values of first rank symptoms at baseline among 362 young adult patients with first-episode schizophrenia Results from the Danish OPUS study

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia;

    2007-01-01

    To investigate the frequency of the Schneiderian First Rank Symptoms (FRSs) in a representative group of patients with first-episode schizophrenia and to analyse the predictive value of these symptoms in relation to psychopathology, work situation, depression, dependency and admission after 2 years...

  8. Lack of progressive reduction in P3 amplitude after the first-episode of schizophrenia: A 6-year follow-up study.

    Science.gov (United States)

    Devrim-Üçok, Müge; Keskin-Ergen, Yasemin; Üçok, Alp

    2016-09-30

    P3 event-related potential may track the course of neurophysiological pathology in schizophrenia. Reduction in the amplitude of the auditory P3 is a widely replicated finding, already present at the first psychotic episode, in schizophrenia. Whether a progressive deficit is present in auditory P3 in schizophrenia over the course of illness is yet to be clarified. Previous longitudinal studies did not report any change in P3 over time in schizophrenia. However, these studies have been inconclusive, because of their relatively short follow-up periods, lack of follow-up data on controls, and assessment of patients already at the chronic stages of schizophrenia. Auditory P3 potentials, elicited by an oddball paradigm, were assessed in 14 patients with first-episode schizophrenia and 22 healthy controls at baseline and at the 6-year follow-up. P3 amplitudes were smaller in patients with first-episode schizophrenia than in controls. Importantly, over the 6-year interval, the P3 amplitudes were reduced in controls, but they did not change in patients. The lack of P3 reduction over time in patients with schizophrenia might be explained by the maximal reduction in P3 already at baseline or by the alleviation of P3 reduction over time.

  9. Patterns of regional gray matter loss at different stages of schizophrenia: A multisite, cross-sectional VBM study in first-episode and chronic illness

    Directory of Open Access Journals (Sweden)

    Ulysses S. Torres

    2016-01-01

    Conclusion: The above data indicate that brain changes associated with the diagnosis of schizophrenia are more widespread in chronic schizophrenia compared to first-episode patients. Our findings also suggest that relative GM volume deficits may be greater in (presumably more severe cases with earlier age of onset, as well as varying as a function of illness duration in specific frontal brain regions. Finally, our results highlight the potentially complex effects of the continued use of antipsychotic drugs on structural brain abnormalities in schizophrenia, as we found that cumulative doses of antipsychotics affected brain volumes globally rather than selectively on frontal-temporal regions.

  10. Longitudinal changes in prospective memory and their clinical correlates at 1-year follow-up in first-episode schizophrenia

    Science.gov (United States)

    Ungvari, Gabor S.; Ng, Chee H.; Zhou, Yan; Zhang, Liang; Zhou, Jingjing; Shum, David H. K.; Man, David; Liu, Deng-Tang; Li, Jun; Xiang, Yu-Tao

    2017-01-01

    This study aimed to investigate prospective memory (PM) and the association with clinical factors at 1-year follow-up in first-episode schizophrenia (FES). Thirty-two FES patients recruited from a university-affiliated psychiatric hospital in Beijing and 17 healthy community controls (HCs) were included. Time- and event-based PM (TBPM and EBPM) performances were measured with the Chinese version of the Cambridge Prospective Memory Test (C-CAMPROMPT) at baseline and at one-year follow-up. A number of other neurocognitive tests were also administered. Remission was determined at the endpoint according to the PANSS score ≤ 3 for selected items. Repeated measures analysis of variance revealed a significant interaction between time (baseline vs. endpoint) and group (FES vs. HCs) for EBPM (F(1, 44) = 8.8, p = 0.005) and for all neurocognitive components. Paired samples t-tests showed significant improvement in EBPM in FES (13.1±3.7 vs. 10.3±4.8; t = 3.065, p = 0.004), compared to HCs (15.7±3.6 vs. 16.5±2.3; t = -1.248, p = 0.230). A remission rate of 59.4% was found in the FES group. Analysis of covariance revealed that remitters performed significantly better on EBPM (14.9±2.6 vs. 10.4±3.6; F(1, 25) = 12.2, p = 0.002) than non-remitters at study endpoint. The association between EBPM and 12-month clinical improvement in FES suggests that EBPM may be a potential neurocognitive marker for the effectiveness of standard pharmacotherapy. Furthermore, the findings also imply that PM may not be strictly a trait-related endophenotype as indicated in previous studies. PMID:28245266

  11. Resting-state cerebellar-cerebral networks are differently affected in first-episode, drug-naive schizophrenia patients and unaffected siblings.

    Science.gov (United States)

    Guo, Wenbin; Liu, Feng; Chen, Jindong; Wu, Renrong; Zhang, Zhikun; Yu, Miaoyu; Xiao, Changqing; Zhao, Jingping

    2015-11-26

    Dysconnectivity hypothesis posits that schizophrenia is a disorder with dysconnectivity of the cortico-cerebellar-thalamic-cortical circuit (CCTCC). However, it remains unclear to the changes of the cerebral connectivity with the cerebellum in schizophrenia patients and unaffected siblings. Forty-nine patients with first-episode, drug-naive schizophrenia patients, 46 unaffected siblings of schizophrenia patients and 46 healthy controls participated in the study. Seed-based resting-state functional connectivity approach was employed to analyze the data. Compared with the controls, the patients and the siblings share increased default-mode network (DMN) seed - right Crus II connectivity. The patients have decreased right dorsal attention network (DAN) seed - bilateral cerebellum 4,5 connectivity relative to the controls. By contrast, the siblings exhibit increased FC between the right DAN seed and the right cerebellum 6 and right cerebellum 4,5 compared to the controls. No other abnormal connectivities (executive control network and salience network) are observed in the patients/siblings relative to the controls. There are no correlations between abnormal cerebellar-cerebral connectivities and clinical variables. Cerebellar-cerebral connectivity of brain networks within the cerebellum are differently affected in first-episode, drug-naive schizophrenia patients and unaffected siblings. Increased DMN connectivity with the cerebellum may serve as potential endophenotype for schizophrenia.

  12. Cognitive impairments in first-episode drug-naive and chronic medicated schizophrenia: MATRICS consensus cognitive battery in a Chinese Han population.

    Science.gov (United States)

    Wu, Jing Qin; Chen, Da Chun; Tan, Yun Long; Xiu, Mei Hong; Yang, Fu De; Soares, Jair C; Zhang, Xiang Yang

    2016-04-30

    Cognitive deficits are a core feature of schizophrenia and we examined the cognitive profile of first-episode and chronic schizophrenia in a Chinese Han population using the MATRICS Consensus Cognitive Battery (MCCB). We recruited 79 first-episode drug-naïve (FEDN) schizophrenia, 132 chronic medicated schizophrenia inpatients and 124 healthy controls. We assessed patient psychopathology using the Positive and Negative Syndrome Scale (PANSS). MCCB total score (pMSCEIT) were significantly higher in FEDN than in chronic patients (all p<0.05). FEDN exhibited relative weakness in continuous performance, whereas chronic patients exhibited relative weakness in mazes. Multiple regression analysis confirmed that in FEDN and chronic patients, total score and negative symptom of PANSS were independent contributors to MCCB total score, respectively. Our results not only demonstrate the applicability of the MCCB as a sensitive measure of cognitive impairment for schizophrenia patients in a Chinese Han population, but also suggest that the compromised cognition is present in the early stage of schizophrenia, some of which could be more severe in the chronic stage of illness.

  13. Social network among young adults with first-episode schizophrenia spectrum disorders: results from the Danish OPUS trial

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia;

    2006-01-01

    Social network has considerable impact on physical and mental health. Patients experiencing first-episode psychosis early in adult life may experience severe problems concerning development and maintenance of their social network....

  14. Social network among young adults with first-episode schizophrenia spectrum disorders: results from the Danish OPUS trial

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia;

    2006-01-01

    Social network has considerable impact on physical and mental health. Patients experiencing first-episode psychosis early in adult life may experience severe problems concerning development and maintenance of their social network.......Social network has considerable impact on physical and mental health. Patients experiencing first-episode psychosis early in adult life may experience severe problems concerning development and maintenance of their social network....

  15. Effects of Blocking D2/D3 Receptors on Mismatch Negativity and P3a Amplitude of Initially Antipsychotic Naïve, First Episode Schizophrenia Patients

    DEFF Research Database (Denmark)

    Düring, Signe; Glenthøj, Birte Yding; Oranje, Bob

    2016-01-01

    BACKGROUND: Reduced mismatch negativity and P3a amplitude have been suggested to be among the core deficits in schizophrenia since the late 1970s. Blockade of dopamine D2 receptors play an important role in the treatment of schizophrenia. In addition, there is some evidence indicating that deficits...... in mismatch negativity and P3a amplitude are related to increased dopaminergic activity. This is the first study investigating the effect of amisulpride, a potent D2-antagonist, on mismatch negativity and P3a amplitude in a large group of antipsychotic-naïve, first-episode schizophrenia patients. METHODS...... reduced P3a amplitude compared with healthy controls, but no differences in mismatch negativity. Although the treatment with amisulpride significantly improved the patients' psychopathological (PANSS) and functional (GAF) scores, it did not influence their mismatch negativity amplitude, while also...

  16. Role of Long-Acting Injectable Second-Generation Antipsychotics in the Treatment of First-Episode Schizophrenia: A Clinical Perspective

    Directory of Open Access Journals (Sweden)

    Radovan Přikryl

    2012-01-01

    Full Text Available Approximately 80% of patients with the first-episode schizophrenia reach symptomatic remission after antipsychotic therapy. However, within two years most of them relapse, mainly due to low levels of insight into the illness and nonadherence to their oral medication. Therefore, although the formal data available is limited, many experts recommend prescribing long-acting injectable second-generation antipsychotics (mostly risperidone or alternatively paliperidone in the early stages of schizophrenia, particularly in patients who have benefited from the original oral molecule in the past and agree to receive long-term injectable treatment. Early application of long-acting injectable second-generation antipsychotics can significantly reduce the risk of relapse in the future and thus improve not only the social and working potential of patients with schizophrenia but also their quality of life.

  17. Re-visiting the nature and relationships between neurological signs and neurocognitive functions in first-episode schizophrenia: An invariance model across time.

    Science.gov (United States)

    Chan, Raymond C K; Dai, Shan; Lui, Simon S Y; Ho, Karen K Y; Hung, Karen S Y; Wang, Ya; Geng, Fu-lei; Li, Zhi; Cheung, Eric F C

    2015-07-02

    The present study examined different types of neurological signs in patients with first-episode schizophrenia and their relationships with neurocognitive functions. Both cross-sectional and longitudinal designs were adopted with the use of the abridged Cambridge Neurological Inventory which comprises items capturing motor coordination, sensory integration and disinhibition. A total of 157 patients with first-episode schizophrenia were assessed at baseline and 101 of them were re-assessed at six-month interval. A structural equation model (SEM) with invariance model across time was used for data analysis. The model fitted well with the data at baseline assessment, X^2(21) = 21.78, p = 0.413, NFI = 0.95, NNFI = 1.00, CFI = 1.00, IFI = 1.00, RMSEA = 0.015. Subsequent SEM analysis with invariance model at six-month interval also demonstrated the same stable pattern across time and showed strong measurement invariance and structure invariance across time. Our findings suggest that neurological signs capture more or less the same construct captured by conventional neurocognitive tests in patients with schizophrenia. The measurement and structure of these relationships appear to be stable over time.

  18. Imaging Microglial Activation in Untreated First-Episode Psychosis: A PET Study With [18F]FEPPA

    Science.gov (United States)

    Hafizi, Sina; Tseng, Huai-Hsuan; Rao, Naren; Selvanathan, Thiviya; Kenk, Miran; Bazinet, Richard P.; Suridjan, Ivonne; Wilson, Alan A.; Meyer, Jeffrey H.; Remington, Gary; Houle, Sylvain; Rusjan, Pablo M.; Mizrahi, Romina

    2017-01-01

    Objective Neuroinflammation and abnormal immune responses are increasingly implicated in the pathophysiology of schizophrenia. Previous positron emission tomography (PET) studies targeting the translocator protein 18 kDa (TSPO) have been limited by high nonspecific binding of the first-generation radioligand, low-resolution scanners, small sample sizes, and psychotic patients being on antipsychotics or not being in the first episode of their illness. The present study uses the novel second-generation TSPO PET radioligand [18F]FEPPA to evaluate whether microglial activation is elevated in the dorsolateral prefrontal cortex and hippocampus of untreated patients with first-episode psychosis. Method Nineteen untreated patients with first-episode psychosis (14 of them antipsychotic naive) and 20 healthy volunteers underwent a high-resolution [18F]FEPPA PET scan and MRI. Dynamic PET data were analyzed using the validated two-tissue compartment model with arterial plasma input function with total volume of distribution (VT) as outcome measure. All analyses were corrected for TSPO rs6971 polymorphism (which is implicated in differential binding affinity). Results No significant differences were observed between patients and healthy volunteers in microglial activation, as indexed by [18F]FEPPA VT, in either the dorsolateral prefrontal cortex or the hippocampus. There were no significant correlations between [18F]FEPPA VT and duration of illness, clinical presentation, or neuropsychological measures after adjusting for multiple testing. Conclusions The lack of significant differences in [18F]FEPPA VT between groups suggests that microglial activation is not present in first-episode psychosis. PMID:27609240

  19. MMPI in first-episode paranoid schizophrenia%MMPI对首发偏执型精神分裂症的价值探讨

    Institute of Scientific and Technical Information of China (English)

    张辉; 王晓英

    2011-01-01

    Objective To study the characteristics and diagnosis value of MMPI (Minnesota Multiphasic Personality Inventory) in first-episode paranoid schizophrenia. Methods Before the treatment, MMPI was administrated to the patient with first-episode paranoid schizophrenia. Analyzed the efficiency of the survey results and compared the results with that of controls of the same number. Results ignificant differences were found between the patients with first-episode paranoid schizophrenia and healthy controls in two validity scales and T-scores of seven clinical sub-scale. For the T-scorcs of the MMPI two point codes types for Pa (paranoid) and Sc (schizophrenia), there was a significant difference between the study and control group. For first-episode paranoid schizophrenia, the MMPI results cannot resolve the contradictions between sensitivity and specificity, the false positive and negative results should be noticed. Conclusion MMPI results were more specific and sensitive compared with the normal controls. However, it cannot replace clinical psychiatric examination for diagnosis of the first-episode paranoid schizophrenia. MMPI could be chosen as an accessory method for clinical psychiatry.%目的 探讨MMPI(明尼苏达多项人格测查表)在首发偏执型精神分裂症中的特征及诊断价值.方法 对首发偏执型精神分裂症患者,在未治疗前行MMPI测试,分析其有效测评结果,并与之按1∶1匹配正常组对照分析.结果 首发偏执型精神分裂症患者组有2个效度量表及7个临床子量表的T分均与正常对照组差异有统计学意义;临床子量表两点测图Pa(偏执)、Sc(精神分裂)模式的T分,患者组与正常对照组差异有统计学意义;MMPI的测试结果无法解决敏感性与特异性间矛盾,存在假阳性与假阴性结果.结论 MMPI对首发偏执型精神分裂症的敏感性与特异性高于正常人群的随机水平,将其作为精神科临床辅助检查工具有一定的实用价

  20. Striatal D2/3 Binding Potential Values in Drug-Naïve First-Episode Schizophrenia Patients Correlate With Treatment Outcome

    DEFF Research Database (Denmark)

    Wulff, Sanne; Pinborg, Lars Hageman; Svarer, Claus;

    2015-01-01

    One of best validated findings in schizophrenia research is the association between blockade of dopamine D2 receptors and the effects of antipsychotics on positive psychotic symptoms. The aim of the present study was to examine correlations between baseline striatal D2/3 receptor binding potential...... (BPp) values and treatment outcome in a cohort of antipsychotic-naïve first-episode schizophrenia patients. Additionally, we wished to investigate associations between striatal dopamine D2/3 receptor blockade and alterations of negative symptoms as well as functioning and subjective well-being. Twenty...... antagonist amisulpride. There was a significant negative correlation between striatal D2/3 receptor BPp at baseline and improvement of positive symptoms in the total group of patients. Comparing patients responding to treatment to nonresponders further showed significantly lower baseline BPp...

  1. A randomized controlled study of the efficacy of six-month supplementation with concentrated fish oil rich in omega-3 polyunsaturated fatty acids in first episode schizophrenia.

    Science.gov (United States)

    Pawełczyk, Tomasz; Grancow-Grabka, Marta; Kotlicka-Antczak, Magdalena; Trafalska, Elżbieta; Pawełczyk, Agnieszka

    2016-02-01

    Short-term clinical trials of omega-3 polyunsaturated fatty acids (n-3 PUFA) as add-on therapy in patients with schizophrenia revealed mixed results. The majority of these studies used an 8- to 12-week intervention based on ethyl-eicosapentaenoic acid. A randomized placebo-controlled trial was designed to compare the efficacy of 26-week intervention, composed of either 2.2 g/day of n-3 PUFA, or olive oil placebo, with regard to symptom severity in first-episode schizophrenia patients. Seventy-one patients (aged 16-35) were enrolled in the study and randomly assigned to the study arms. The primary outcome measure of the clinical evaluation was schizophrenia symptom severity change measured by the Positive and Negative Syndrome Scale (PANSS). Mixed models repeated measures analysis revealed significant differences between the study arms regarding total PANSS score change favouring n-3 PUFA (p = 0.016; effect size (ES) = 0.29). A fifty-percent improvement in symptom severity was achieved significantly more frequently in the n-3 PUFA group than in the placebo group (69.4 vs 40.0%; p = 0.017). N-3 PUFA intervention was also associated with an improvement in general psychopathology, measured by means of PANSS (p = 0.009; ES = 0.32), depressive symptoms (p = 0.006; ES = 0.34), the level of functioning (p = 0.01; ES = 0.31) and clinical global impression (p = 0.046; ES = 0.29). The findings suggest that 6-month intervention with n-3 PUFA may be a valuable add-on therapy able to decrease the intensity of symptoms and improve the level of functioning in first-episode schizophrenia patients.

  2. The research of cognitive style of patients with first episode schizophrenia%首发精神分裂症患者认知风格的研究

    Institute of Scientific and Technical Information of China (English)

    张敏桥; 戴天刚; 易鹏程

    2014-01-01

    Objective To explore the different cognitive styles between patients with first-episode schizophrenia and normal people. Methods We tested 42 patients with first-episode schizophrenia and 43 normal adults with Stick Frame Instrument Test(SFIT) and Embedded Figure Test(EFT). Then we compared the sum of errors of SFIT and the scores of EFT. Results①There was significant difference of scores of error between the two groups in the SFIT when the stick and the frame are in small angle(P0.05). ②There was no significant difference either between nor in the two groups of the scores of EFT (P>0.05).③The sum of errors of SFIT and the scroes of EFT showed a weak negative correlation (r=-0.255,P0.05);③用图形镶嵌实验得分与棒框仪误差总和具有较弱相关性(r=-0.255,P<0.05)。结论首发精神分裂症患者与健康志愿者之间的认知风格存在差异,但采用不同的实验工具可能会得到不同的结论。

  3. Neurocognitive functioning in subjects at risk for a first episode of psychosis compared with first- and multiple-episode schizophrenia.

    NARCIS (Netherlands)

    Pukrop, R.; Schultze-Lutter, F.; Ruhrmann, S.; Brockhaus-Dumke, A.; Tendolkar, I.; Bechdolf, A.; Matuschek, E.; Klosterkotter, J.

    2006-01-01

    Evidence from neurobiological studies suggests that schizophrenia arises from an early abnormality in brain development and possibly further progressive developmental mechanisms. Despite a delay between the acquisition of neuropathology and the triggering of psychosis, neurobiological susceptibility

  4. A Virtual Reality Task Based on Animal Research - Spatial Learning and Memory in Patients after the First Episode of Schizophrenia

    Directory of Open Access Journals (Sweden)

    Iveta eFajnerova

    2014-05-01

    Full Text Available Objective: Cognitive deficit is considered to be a characteristic feature of schizophrenia disorder. A similar cognitive dysfunction was demonstrated in animal models of schizophrenia. However, the poor comparability of methods used to assess cognition in animals and humans could be responsible for low predictive validity of current animal models. In order to assess spatial abilities in schizophrenia and compare our results with the data obtained in animal models we designed a virtual analogue of the Morris water maze (MWM, the virtual Four Goals Navigation (vFGN task.Method: Twenty-nine patients after the first psychotic episode with schizophrenia symptoms and a matched group of healthy volunteers performed the vFGN task. They were required to find and remember four hidden goal positions in an enclosed virtual arena. The task consisted of two parts. The Reference memory (RM session with a stable goal position was designed to test spatial learning. The Delayed-matching-to-place (DMP session presented a modified working memory protocol designed to test the ability to remember a sequence of three hidden goal positions.Results: Data obtained in the RM session show impaired spatial learning in schizophrenia patients compared to healthy controls in pointing and navigation accuracy. The DMP session showed impaired spatial memory in schizophrenia during the recall of spatial sequence and similar deficit in spatial bias in probe trials. The pointing accuracy and the quadrant preference showed higher sensitivity toward the cognitive deficit than the navigation accuracy. Direct navigation to the goal was affected by sex and age of the tested subjects. Age affected spatial performance only in healthy controls. Conclusions: Despite some limitations of the study, our results correspond well to previous studies in animal models of schizophrenia and support the decline of spatial cognition in schizophrenia, indicating the usefulness of the vFGN task in

  5. Neurological signs and involuntary movements in schizophrenia: intrinsic to and informative on systems pathobiology.

    LENUS (Irish Health Repository)

    Whitty, Peter F

    2012-02-01

    While it has long been considered whether the pathobiology of schizophrenia extends beyond its defining symptoms to involve diverse domains of abnormality, in the manner of a systemic disease, studies of neuromotor dysfunction have been confounded by treatment with antipsychotic drugs. This challenge has been illuminated by a new generation of studies on first-episode schizophrenia before initiation of antipsychotic treatment and by opportunities in developing countries to study chronically ill patients who have remained antipsychotic naive due to limitations in provision of psychiatric care. Building from studies in antipsychotic-naive patients, this article reviews 2 domains of neuromotor dysfunction in schizophrenia: neurological signs and involuntary movements. The presence and characteristics of neurological signs in untreated vis-a-vis treated psychosis indicate a vulnerability marker for schizophrenia and implicate disruption to neuronal circuits linking the basal ganglia, cerebral cortex, and cerebellum. The presence and characteristics of involuntary movements in untreated vis-a-vis treated psychosis indicate an intrinsic feature of the disease process and implicate dysfunction in cortical-basal ganglia-cortical circuitry. These neuromotor disorders of schizophrenia join other markers of subtle but pervasive cerebral and extracerebral, systemic dysfunction, and complement current concepts of schizophrenia as a disorder of developmentally determined cortical-basal ganglia-thalamo-cortical\\/cerebellar network disconnectivity.

  6. Abnormal auditory sensory gating-out in first-episode and never-medicated paranoid schizophrenia patients: an fMRI study.

    Science.gov (United States)

    Ji, Bin; Mei, Wei; Zhang, John X; Jing, Juzhen; Wu, Qiulin; Zhuo, Yongning; Xiao, Zhuangwei

    2013-08-01

    Numerous electrophysiological studies have showed auditory sensory gating-out abnormalities in chronic schizophrenia with antipsychotic medication. Previous research has used functional magnetic resonance imaging (fMRI) with excellent spatial resolution to identify the neural substrates of sensory gating-out deficits revealing increased hemodynamic response in the hippocampus, thalamus and prefrontal cortex. However, such results obtained from medicated patients may be confounded by antipsychotic medication. The present study scanned 15 first-episode schizophrenia patients not yet receiving any medical treatment and 15 healthy controls matched in gender, age and education when they performed a sensory gating-out task adapted for fMRI. The symptoms of the patients were assessed with the positive and negative syndrome scale. Different from previous findings, the schizophrenia patients showed decreased activation in hippocampus and thalamus during sensory gating-out, compared with the normal controls. The results support the theory attributing abnormal sensory gating-out in schizophrenia patients to the dysfunction of hippocampus and thalamus.

  7. Dysconnectivity within the default mode in first-episode schizophrenia: a stochastic dynamic causal modeling study with functional magnetic resonance imaging.

    Science.gov (United States)

    Bastos-Leite, António J; Ridgway, Gerard R; Silveira, Celeste; Norton, Andreia; Reis, Salomé; Friston, Karl J

    2015-01-01

    We report the first stochastic dynamic causal modeling (sDCM) study of effective connectivity within the default mode network (DMN) in schizophrenia. Thirty-three patients (9 women, mean age = 25.0 years, SD = 5) with a first episode of psychosis and diagnosis of schizophrenia--according to the Diagnostic and Statistic Manual of Mental Disorders, 4th edition, revised criteria--were studied. Fifteen healthy control subjects (4 women, mean age = 24.6 years, SD = 4) were included for comparison. All subjects underwent resting state functional magnetic resonance imaging (fMRI) interspersed with 2 periods of continuous picture viewing. The anterior frontal (AF), posterior cingulate (PC), and the left and right parietal nodes of the DMN were localized in an unbiased fashion using data from 16 independent healthy volunteers (using an identical fMRI protocol). We used sDCM to estimate directed connections between and within nodes of the DMN, which were subsequently compared with t tests at the between subject level. The excitatory effect of the PC node on the AF node and the inhibitory self-connection of the AF node were significantly weaker in patients (mean values = 0.013 and -0.048 Hz, SD = 0.09 and 0.05, respectively) relative to healthy subjects (mean values = 0.084 and -0.088 Hz, SD = 0.15 and 0.77, respectively; P < .05). In summary, sDCM revealed reduced effective connectivity to the AF node of the DMN--reflecting a reduced postsynaptic efficacy of prefrontal afferents--in patients with first-episode schizophrenia.

  8. The N1 auditory evoked potential component as an endophenotype for schizophrenia: high-density electrical mapping in clinically unaffected first-degree relatives, first-episode, and chronic schizophrenia patients.

    Science.gov (United States)

    Foxe, John J; Yeap, Sherlyn; Snyder, Adam C; Kelly, Simon P; Thakore, Jogin H; Molholm, Sophie

    2011-08-01

    The N1 component of the auditory evoked potential (AEP) is a robust and easily recorded metric of auditory sensory-perceptual processing. In patients with schizophrenia, a diminution in the amplitude of this component is a near-ubiquitous finding. A pair of recent studies has also shown this N1 deficit in first-degree relatives of schizophrenia probands, suggesting that the deficit may be linked to the underlying genetic risk of the disease rather than to the disease state itself. However, in both these studies, a significant proportion of the relatives had other psychiatric conditions. As such, although the N1 deficit represents an intriguing candidate endophenotype for schizophrenia, it remains to be shown whether it is present in a group of clinically unaffected first-degree relatives. In addition to testing first-degree relatives, we also sought to replicate the N1 deficit in a group of first-episode patients and in a group of chronic schizophrenia probands. Subject groups consisted of 35 patients with schizophrenia, 30 unaffected first-degree relatives, 13 first-episode patients, and 22 healthy controls. Subjects sat in a dimly lit room and listened to a series of simple 1,000-Hz tones, indicating with a button press whenever they heard a deviant tone (1,500 Hz; 17% probability), while the AEP was recorded from 72 scalp electrodes. Both chronic and first-episode patients showed clear N1 amplitude decrements relative to healthy control subjects. Crucially, unaffected first-degree relatives also showed a clear N1 deficit. This study provides further support for the proposal that the auditory N1 deficit in schizophrenia is linked to the underlying genetic risk of developing this disorder. In light of recent studies, these results point to the N1 deficit as an endophenotypic marker for schizophrenia. The potential future utility of this metric as one element of a multivariate endophenotype is discussed.

  9. Anterior cingulate cortex-related connectivity in first-episode schizophrenia: a spectral dynamic causal modeling study with functional magnetic resonance imaging

    Directory of Open Access Journals (Sweden)

    Long-Biao eCui

    2015-11-01

    Full Text Available Understanding the neural basis of schizophrenia (SZ is important for shedding light on the neurobiological mechanisms underlying this mental disorder. Structural and functional alterations in the anterior cingulate cortex (ACC, dorsolateral prefrontal cortex (DLPFC, hippocampus, and medial prefrontal cortex (MPFC have been implicated in the neurobiology of SZ. However, the effective connectivity among them in SZ remains unclear. The current study investigated how neuronal pathways involving these regions were affected in first-episode SZ using functional magnetic resonance imaging (fMRI. Forty-nine patients with a first-episode of psychosis and diagnosis of SZ—according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision—were studied. Fifty healthy controls (HCs were included for comparison. All subjects underwent resting state fMRI. We used spectral dynamic causal modeling (DCM to estimate directed connections among the bilateral ACC, DLPFC, hippocampus, and MPFC. We characterized the differences using Bayesian parameter averaging (BPA in addition to classical inference (t-test. In addition to common effective connectivity in these two groups, HCs displayed widespread significant connections predominantly involved in ACC not detected in SZ patients, but SZ showed few connections. Based on BPA results, SZ patients exhibited anterior cingulate cortico-prefrontal-hippocampal hyperconnectivity, as well as ACC-related and hippocampal-dorsolateral prefrontal-medial prefrontal hypoconnectivity. In summary, sDCM revealed the pattern of effective connectivity involving ACC in patients with first-episode SZ. This study provides a potential link between SZ and dysfunction of ACC, creating an ideal situation to associate mechanisms behind SZ with aberrant connectivity among these cognition and emotion-related regions.

  10. Impaired temporoparietal deactivation with working memory load in antipsychotic-naïve patients with first-episode schizophrenia

    DEFF Research Database (Denmark)

    Nejad, Ayna B; Ebdrup, Bjørn H; Siebner, Hartwig R;

    2011-01-01

    Abstract Objectives. Neuroimaging studies have shown abnormal task-related deactivations during working memory (WM) in schizophrenia patients with recent emphasis on brain regions within the default mode network. Using fMRI, we tested whether antipsychotic-naïve schizophrenia patients were impaired...... load) conditions. Results. Contrasting the 2-back and 0-back conditions revealed that patients deactivated default mode network regions to a similar degree as controls. However, patients were impaired in deactivating large bilateral clusters centred on the superior temporal gyrus with increasing WM...... load. These regions activated with the no WM load condition (0-back) in both groups. Conclusions. Because 0-back activation reflects verbal attention processes, patients' persistent activation in the 1-back and 2-back conditions may reflect an inability to shift cognitive strategy with onset of WM...

  11. An fMRI study of visual attention and sensorimotor function before and after antipsychotic treatment in first-episode schizophrenia.

    Science.gov (United States)

    Keedy, Sarah K; Rosen, Cherise; Khine, Tin; Rajarethinam, Rajaprabhakaran; Janicak, Philip G; Sweeney, John A

    2009-04-30

    While much is known about receptor affinity profiles of antipsychotic medications, less is known about their impact on functional brain systems in patients with schizophrenia. We conducted functional magnetic resonance imaging (fMRI) studies with first-episode schizophrenia patients as they made saccades to unpredictable visual targets before and after 4-6 weeks of antipsychotic treatment. Matched healthy individuals were scanned at similar time intervals. Pretreatment, patients had less activation in frontal and parietal eye fields and cerebellum. After treatment these disturbances were not present, suggesting improved function in attentional and sensorimotor systems. Other pretreatment abnormalities were noted in sensory and ventromedial prefrontal cortex, but after treatment these abnormalities were absent or less prominent, in line with improved function in attentional systems. In addition, although not abnormal at baseline, there was reduced activity after treatment in dorsal prefrontal cortex, dorsal striatum, and dorsomedial thalamus, suggesting a potential adverse effect of treatment on frontostriatal systems, perhaps related to dopamine blockade in the caudate. These findings provide evidence for a complex impact of antipsychotic medication on functional brain systems in schizophrenia and illustrate the potential of neuroimaging biomarkers for both adverse and beneficial drug effects on functional brain systems.

  12. Similarities and differences of functional connectivity in drug-naïve, first-episode adolescent and young adult with major depressive disorder and schizophrenia

    Science.gov (United States)

    Wei, Shengnan; Womer, Fay; Geng, Haiyang; Jiang, Xiaowei; Zhou, Qian; Chang, Miao; Zhou, Yifang; Tang, Yanqing; Wang, Fei

    2017-01-01

    Major depressive disorder (MDD) and schizophrenia (SZ) are considered two distinct psychiatric disorders. Yet, they have considerable overlap in symptomatology and clinical features, particularly in the initial phases of illness. The amygdala and prefrontal cortex (PFC) appear to have critical roles in these disorders; however, abnormalities appear to manifest differently. In our study forty-nine drug-naïve, first-episode MDD, 45 drug-naïve, first-episode SZ, and 50 healthy control (HC) participants from 13 to 30 years old underwent resting-state functional magnetic resonance imaging. Functional connectivity (FC) between the amygdala and PFC was compared among the three groups. Significant differences in FC were observed between the amygdala and ventral PFC (VPFC), dorsolateral PFC (DLPFC), and dorsal anterior cingulated cortex (dACC) among the three groups. Further analyses demonstrated that MDD showed decreased amygdala-VPFC FC and SZ had reductions in amygdala-dACC FC. Both the diagnostic groups had significantly decreased amygdala-DLPFC FC. These indicate abnormalities in amygdala-PFC FC and further support the importance of the interaction between the amygdala and PFC in adolescents and young adults with these disorders. Additionally, the alterations in amygdala-PFC FC may underlie the initial similarities observed between MDD and SZ and suggest potential markers of differentiation between the disorders at first onset. PMID:28287187

  13. Improvement of cognitive flexibility and cingulate blood flow correlates after atypical antipsychotic treatment in drug-naive patients with first-episode schizophrenia.

    Science.gov (United States)

    Pardo, Bernardo M; Garolera, Maite; Ariza, Mar; Pareto, Deborah; Salamero, Manel; Valles, Vicenç; Delgado, Luis; Alberni, Joan

    2011-12-30

    The aim of this study was to examine the changes in cognitive flexibility and associated cerebral blood flow in the anterior cingulate lobe of drug-naive patients with first-episode schizophrenia who were treated with atypical antipsychotics for 6 weeks. Single photon emission computed tomography (SPECT) images were obtained from 8 healthy subjects both at rest and while performing the flexibility subtest of the TAP (Test for Attentional Performance). SPECT images were obtained in parallel from 8 first-episode drug-naive schizophrenic patients while they were performing the same task both before and after 6 weeks of neuroleptic treatment. In the control group, an increase in the perfusion indices of the dorsal section of the anterior cingulate gyrus was observed in the activation condition. Task performance was altered and the level of perfusion of the brain region related to the task execution was significantly decreased in the patients at baseline. After treatment, there was a significant improvement in both task performance and the level of perfusion of the dorsal section of the anterior cingulate. We conclude that treatment with second-generation neuroleptics improves cognitive flexibility, and there was a relationship between such improvements and normalization of perfusion indices of the involved brain areas.

  14. Altered Patterns of Reward Activation in a Large Cohort of Antipsychotic Naïve First Episode Schizophrenia Patients

    DEFF Research Database (Denmark)

    Nielsen, Mette Ødegaard; Rostrup, Egill; Wulff, Sanne;

    2014-01-01

    the multivariate approach called partial least squares (PLS). This method was used in order to find functionally connected patterns in a whole brain context. PLS have the benefit that it does not analyze specific contrasts or compare groups. Instead the PLS analysis identifies new variables (latent variables....... Further it demonstrated several changes during outcome evaluation, particularly in relation to unexpected outcome. This is very much in line with the idea of an altered prediction error response. Finally our analyses suggest that the schizophrenia patients might even have a different evaluation...

  15. Detection and significance of serum interleukin-6, tumor necrosis factor-α and interleukin-1β in first-episode schizophrenia patients

    Institute of Scientific and Technical Information of China (English)

    Tao Yan; Chao Cheng; Hui-Xia Wang; Yuan-Yuan Li; Shuai-Bin Zhang

    2015-01-01

    Objective:To detect changes of serum interleukin-6, tumor necrosis factor-α and interleukin-1β in first-episode and different subtypes, and to analyze the correlation between pathological and immune mechanism.Methods:90 first-episode schizophrenia patients admitted to our hospital were enrolled as observation group, and were subdivided into four groups including negative and positive , family type and distributing types. During the same period, 35 physical healthy volunteers were enrolled as control group. Serum interleukin-6, tumor necrosis factor-αand interleukin-1β in both observation group and control group were detected with enzyme-linked immunosorbent (ELISA), correlation between these factors and mental symptoms were analyzed with pearson correlation analysis.Results:The levels of serum IL-6, TNF-αα, IL-1β of the observation group before and after the treatment were significantly higher than those of control group, the level of IL-1β in observation group after treatment was significantly lower than that before the treatment (P<0.05). Before treatment, the level of IL-6 in family type was significantly higher than that in distributing type, the level of TNF-αα in negative type was significantly higher than that in positive type. After treatment the level of TNF-αα was significantly reduced in family type and negative type, the IL-1β was significantly reduced in four subtypes. Pearson correlation analysis showed that TNF-αα lever was positively correlated with symptoms of negative subtype. IL-1β level and PANSS scores, symptoms of both positive and negative types were positively correlated.Conclusion:The levels of IL-6, TNF-αα, IL-1β levels are significantly increases in patients with first-episode schizophrenia, immune activation may be activated and IL-6 level is closely related to the family type of the disease which is genetic influenced, TNF-αα is associated with symptoms of negative type. IL-1β level may be a certain extent

  16. Localized gray matter volume reductions in the pars triangularis of the inferior frontal gyrus in individuals at clinical high-risk for psychosis and first episode for schizophrenia.

    Science.gov (United States)

    Iwashiro, Norichika; Suga, Motomu; Takano, Yosuke; Inoue, Hideyuki; Natsubori, Tatsunobu; Satomura, Yoshihiro; Koike, Shinsuke; Yahata, Noriaki; Murakami, Mizuho; Katsura, Masaki; Gonoi, Wataru; Sasaki, Hiroki; Takao, Hidemasa; Abe, Osamu; Kasai, Kiyoto; Yamasue, Hidenori

    2012-05-01

    Recent studies have suggested an important role for Broca's region and its right hemisphere counterpart in the pathophysiology of schizophrenia, owing to its roles in language and interpersonal information processing. Broca's region consists of the pars opercularis (PO) and the pars triangularis (PT). Neuroimaging studies have suggested that they have differential functional roles in healthy individuals and contribute differentially to the pathogenesis of schizophrenic symptoms. However, volume changes in these regions in subjects with ultra-high risk for psychosis (UHR) or first-episode schizophrenia (FES) have not been clarified. In the present 3 Tesla magnetic resonance imaging study, we separately measured the gray matter volumes of the PO and PT using a reliable manual-tracing volumetry in 80 participants (20 with UHR, 20 with FES, and 40 matched controls). The controls constituted two groups: the first group was matched for age, sex, parental socioeconomic background, and intelligence quotient to UHR (n=20); the second was matched for those to FES (n=20). Compared with matched controls, the volume of the bilateral PT, but not that of the PO, was significantly reduced in the subjects with UHR and FES. The reduced right PT volume, which showed the largest effect size among regions-of-interest in the both UHR and FES groups, correlated with the severity of the positive symptoms also in the both groups. These results suggest that localized gray matter volume reductions of the bilateral PT represent a vulnerability to schizophrenia in contrast to the PO volume, which was previously found to be reduced in patients with chronic schizophrenia. The right PT might preferentially contribute to the pathogenesis of psychotic symptoms.

  17. MiRNA-365 and miRNA-520c-3p respond to risperidone treatment in first-episode schizophrenia after a 1 year remission

    Institute of Scientific and Technical Information of China (English)

    LIU Sha; YUAN Yan-bo; GUAN Li-li; WEI Hui; CHENG Zhang; HAN Xue; YANG Lei

    2013-01-01

    Background MicroRNAs (miRNAs) control gene expression by destabilizing target transcripts and inhibiting their translation.Aberrant expression of miRNAs has been described in many human diseases,including schizophrenia.However,the effects on miRNA expression in response to antipsychotic treatment in peripheral circulation have not been thoroughly examined.Methods Using quantitative real-time PCR (qRT-PCR),We quantified the expression of seven candidate miRNAs in plasma samples of 40 first-episode schizophrenics before and after antipsychotic treatment.The patients were all treated with risperidone and achieved remission in 1 year.Results Compared with the baseline,the expression levels of miR-365 and miR-520c-3p were significantly downregulated after 1 year of risperidone treatment (P <0.001).There were no significant correlations between the clinical symptoms and the expression levels of these two miRNAs (P >0.05).Conclusions This study analyzed possible circulating miRNAs in response to antipsychotic monotherapy for schizophrenia,the further mechanism need to be confirmed.

  18. The effects of community intervention on first-episode schizophrenia%社区干预对首发精神分裂症的作用

    Institute of Scientific and Technical Information of China (English)

    刘敏东; 陆强; 李子欢; 张玲; 谢焱; 唐全胜; 张进祥; 蒋春雷; 杨丽; 许祖年; 潘剑秋

    2011-01-01

    Objective :To explore the effect of community interventions on first-episode schizophrenia.Method:Patients with first-episode schizophrenia were brought into a community management and randomly divided into intervention group for 27 cases and control group for 29 cases, followed up for one year. The convalescent effects were assessed using brief psychiatric rating scale ( BPRS ), social disability scrcening schedule (SDSS) and insight treatment attitude questionnaire (ITAQ) , those were performed at the admission time of before the treatment,intervented for haft a year and one year. Results: The score of BPRS, SDSS and IRAQ,adherence of medicine, decrease rate of recurrence and rehospitalization and the number of troublemaking after one year of intervention group were significantly better than those of control group( P < O.01 or P < O.05 ).Conclusion:Through community intervention,it is an effective way to strengthen the patients with fwst-episode schizophrenia in community adherence of medicine, improve their social function recovery, decrease the rate of recurrence and rehospitalization, reduce the behavior of troublemaking.%目的:探讨社区干预和训练对首发精神分裂症康复效果.方法:对首发精神分裂症患者纳入社区管理,随机分为干预组27例和对照组29例,进行为期1年的追踪随访,采用简明精神病评定量表(BPRS)、社会功能缺陷筛选量表(SDSS)和自知力与治疗态度问卷(ITAQ ),在人组、干预半年和1年时进行康复效果评估.结果:干预组在随访1年后的BPRS、SDSS、ITAQ评分、服药依从性、复发率和再住院率、肇事肇祸的次数均显著优于对照组(P<0.01或P<0.05).结论:开展社区干预和训练,可提高社区首发精神分裂症患者的服药依从性、恢复社会功能,降低复发率和再住院率,减少肇事肇祸行为,效果良好.

  19. First Episode Psychosis

    Science.gov (United States)

    ... About Psychosis Treatment Share Fact Sheet: First Episode Psychosis Download PDF Download ePub Order a free hardcopy En Español Facts About Psychosis The word psychosis is used to describe conditions ...

  20. The effect of betahistine, a histamine H1 receptor agonist/H3 antagonist, on olanzapine-induced weight gain in first-episode schizophrenia patients.

    Science.gov (United States)

    Poyurovsky, Michael; Pashinian, Artashes; Levi, Aya; Weizman, Ronit; Weizman, Abraham

    2005-03-01

    Histamine antagonism has been implicated in antipsychotic drug-induced weight gain. Betahistine, a histamine enhancer with H1 agonistic/H3 antagonistic properties (48 mg t.i.d.), was coadministered with olanzapine (10 mg/day) in three first-episode schizophrenia patients for 6 weeks. Body weight was measured at baseline and weekly thereafter. Clinical rating scales were completed at baseline and at week 6. All participants gained weight (mean weight gain 3.1+/-0.9 kg) and a similar pattern of weight gain was observed: an increase during the first 2 weeks and no additional weight gain (two patients) or minor weight loss (one patient) from weeks 3 to 6. None gained 7% of baseline weight, which is the cut-off for clinically significant weight gain. Betahistine was safe and well tolerated and did not interfere with the antipsychotic effect of olanzapine. Our findings justify a placebo-controlled evaluation of the putative weight-attenuating effect of betahistine in olanzapine-induced weight gain.

  1. First-episode psychosis

    DEFF Research Database (Denmark)

    Simonsen, Erik

    2011-01-01

    . Patients with first-episode psychosis had significantly high NEO-PI-R scores for neuroticism and agreeableness, and lower scores for conscientiousness and extroversion. The median time for remission in the total sample was three months. Female gender and better premorbid functioning were predictive of less...

  2. Comparative study on sex differences and marital status of the patients with first episode schizophrenia%首发精神分裂症患者性别差异与婚姻状况对照研究

    Institute of Scientific and Technical Information of China (English)

    张延赤; 赵富帅; 赵丽丽; 郑博文

    2015-01-01

    Objective:To compare the difference of sex and marriage status of male and female inpatients with first episode schizophrenia.Methods:124 inpatients with first episode schizophrenia were selected.The clinical data were compared and analyzed.Results:The marital status of male was obviously inferior to female.The married rate was lower than that of female.The divorce rate was higher than that of female.Conclusion:The marriage status of male and female patients with first episode schizophrenia have significant difference.It should be focused on one respect in formulating rehabilitation treatment programme.%目的:比较男性与女性首发精神分裂症住院患者性别、婚姻状况的差异.方法:收集首发精神分裂症住院患者124例,对临床资料进行比较分析.结果:男性的婚姻状况明显不如女性,已婚率低于女性,离婚率高于女性.结论:男性及女性首发精神分裂症患者婚姻状况存在显著差异,在制定康复治疗方案时,应有所侧重.

  3. Voxel-Based Morphometry in Individuals at Genetic High Risk for Schizophrenia and Patients with Schizophrenia during Their First Episode of Psychosis

    Science.gov (United States)

    Bai, Chuan; Zhou, Qian; Wei, Shengnan; Jiang, Xiaowei; Geng, Haiyang; Zhou, Yifang; Tang, Yanqing; Wang, Fei

    2016-01-01

    Background Understanding morphologic changes in vulnerable and early disease state of schizophrenia (SZ) may provide further insight into the development of psychosis. Method Whole brain voxel-based morphometry was performed to identify gray matter (GM) regional differences in 60 individuals with SZ during their first psychotic episode (FE-SZ), 31 individuals at genetic high risk for SZ (GHR-SZ) individuals, and 71 healthy controls. Results Significant differences were found in several regions including the prefrontal cortex, parietal lobe, temporal lobe, hippocampus, occipital lobe, and cerebellum among the three groups (p<0.05, corrected). Compared to the HC group, the FE-SZ group had significantly decreased GM volumes in several regions including the cerebellum, hippocampus, fusiform gyrus, lingual gyrus, supramarginal gyrus, and superior, middle, and inferior temporal gyri and significantly increased GM volumes in the middle frontal gyrus and inferior operculum frontal gyrus (p<0.05). The GHR-SZ group had significant decreases in GM volumes in the supramaginal gyrus, precentral gyrus, and rolandic operculum and significant increases in GM volumes in the cerebellum, fusiform gyrus, middle frontal gyrus, inferior operculum frontal gyrus, and superior, middle, and inferior temporal gyri when compared to the HC group (p<0.05). Compared to the GHR-SZ group, the FE-SZ group had significant decreases in GM volumes in several regions including the cerebellum, fusiform gyrus, supramarginal gyrus, and superior, middle, and inferior temporal gyri (p<0.05). Conclusions The findings herein implicate the involvement of multisensory integration in SZ development and pathophysiology. Additionally, the patterns of observed differences suggest possible indicators of disease, vulnerability, and resiliency in SZ. PMID:27723806

  4. 首发精神分裂症儿童少年的共患病%Comorbidity in children and adolescents with first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    刘芳; 刘靖; 姚旭东

    2011-01-01

    Objective: To investigate the occurrence of comorbidity in children and adolescents with first-episode schizophrenia and explore the clinical features of schizophrenia with comorbidity and risk factors of comorbidity. Methods: Fifty-two children and adolescents meeting criteria for schizophrenia of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-Ⅳ) were included in this cross-sectional study. They were assessed with the self-made general condition questionnaire, Positive and Negative Syndrome Scale (PANSS), KiddieSade-Present and Lifetime Version (K-SADS-PL), Chinese version of Mini International Neuropsychiatric Interview for Children and Adolescents ( MINI Kid) ( Parent Version), Global Assessment Scale (C-GAS) and the Social Disability Screening Schedule (SDSS). Results: There were 57.7% (30/52) of children and adolescents with firstepisode schizophrenia having comorbidities. There were 14 (26. 9% ) with current comorbidities, 10 ( 19. 2% ) with previous comorbidities, 6 (11.5% ) with current and previous comorbidities. There were 24 (46.2%) having 1 comorbidity, 4 (7. 7% ) having 2 comorbidities, 2 (3.8%) having 3 comorbidities. The comorbidities included 19 with depression disorder (4 with suicide behavior), 5 with generalized anxiety disorder, 1 with panic disorder, 2 with obsessive-compulsive disorder, 2 with social phobia, 5 with attention deficit hyperactivity disorder (ADHD), 7 with tic disorder (5 with transient tic disorder and 2 with de la Tourette's syndrome), 2 with pervasive developmental disorder (both were Asperger's syndromes). The previous comorbidities included 5 with depression disorder, 1 with panic disorder, 2 with obsessive-compulsive disorder, 1 with social phobia, 2 with ADHD, 7 with tic disorder. The current comorbidities included 14 with depression disorder, 5 with generalized anxiety disorder, 2 with obsessive-compulsive disorder, 1 with social phobia, 3 with ADHD, 2 with pervasive

  5. Comparison of Neuropsychological Function of First-episode Schizophrenia Patients and Their Healthy Siblings%首发精神分裂症及其健康同胞神经心理功能的比较

    Institute of Scientific and Technical Information of China (English)

    胡茂荣; 王娟; 李乐华; 陈晋东; 吴仁容; 赵靖平

    2011-01-01

    目的:探讨首发精神分裂症患者及其健康同胞神经心理功能差异.方法:采用范畴流利测验、连线测验(TMT)、数字符号编码测验和Stoop测验对在92例首发精神分裂症患者、56例健康同胞及62例健康对照者进行测评.结果:首发精神分裂症患者及其健康同胞所有神经心理测验成绩均差于健康对照组(P<0.05).与健康同胞组比较.首发精神分裂症患者组除范畴流利测验外,其他神经心理测验成绩差异均有统计学意义(P<0.05).结论:首发精神分裂症患者及其健康同胞存在认知损害,语义流畅性功能可能是精神分裂症的潜在内表型.%Objective: To explore difference of neuropsychological function among first-episode schizophrenia patients,their healthy siblings and healthy controls.Methods: 92 first-episode schizophrenia patients, 56 their healthy siblings and 62 healthy controls were assessed with Category Fluency Test, Trail Making Test (TMT), Symbol Coding Test, and Stroop Test.Results: Compared with controls, first-episode schizophrenia patients and their healthy siblings showed poorer performance on all measures of neuropsychological tests.Patients performed worse than siblings in other any measures except for Category Fluency Test.Conclusion: First-episode schizophrenia patients and their healthy siblings have neuropsychological deficits.Semantic verbal fluency may be tests for the potential endophenotype of schizophrenia.

  6. 氨磺必利与利培酮治疗首发精神分裂症的疗效对照研究%Amisulpride and Risperidone Treatment First-episode Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    李婕

    2014-01-01

    Objective To analysis efficacy of amisulpride and risperidone treatment first -episode schizophrenia.Methods 74 patients with first -episode schizo-phrenia were given Amisulpride and risperidone therapy,BPRS score,adverse reaction were compared.Result BPRS rating scale values were significantly reduced,be-tween groups was no significant difference;observation group adverse reactions(18.92%) was obviously lower than the control group.Conclusion Amisulpride and risper-idone can be effective in the treatment of first-episode schizophrenia,Amisulpride low adverse reaction,good safety.%目的:分析氨磺必利与利培酮治疗首发精神分裂症的疗效差异。方法选择74例首发精神分裂症患者为研究对象,分别给予氨磺必利及利培酮治疗,比较BPRS量表评分、不良反应发生率。结果观察组与对照组BPRS量表评分值均明显降低,组间比较无明显差异(P>0.05);观察组不良反应发生率(18.92%)明显低于对照组(P<0.05)。结论氨磺必利与利培酮均可有效治疗首发精神分裂症,氨磺必利不良反应较少,具有优良的治疗安全性。

  7. Epidemiological and clinical characterization following a first psychotic episode in major depressive disorder: Comparisons with Schizophrenia and Bipolar I Disorder in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS).

    LENUS (Irish Health Repository)

    Owoeye, Olabisi

    2013-05-28

    While recent research on psychotic illness has focussed on the nosological, clinical, and biological relationships between schizophrenia and bipolar disorder, little attention has been directed to the most common other psychotic diagnosis, major depressive disorder with psychotic features (MDDP). As this diagnostic category captures the confluence between dimensions of psychotic and affective psychopathology, it is of unappreciated heuristic potential to inform on the nature of psychotic illness. Therefore, the epidemiology and clinical characteristics of MDDP were compared with those of schizophrenia and bipolar disorder within the Cavan-Monaghan First Episode Psychosis Study (n = 370). Epidemiologically, the first psychotic episode of MDDP (n = 77) was uniformly distributed across the adult life span, while schizophrenia (n = 73) and bipolar disorder (n = 73) were primarily disorders of young adulthood; the incidence of MDDP, like bipolar disorder, did not differ between the sexes, while the incidence of schizophrenia was more common in males than in females. Clinically, MDDP was characterized by negative symptoms, executive dysfunction, neurological soft signs (NSS), premorbid intellectual function, premorbid adjustment, and quality of life similar to those for schizophrenia, while bipolar disorder was characterized by less prominent negative symptoms, executive dysfunction and NSS, and better quality of life. These findings suggest that what we currently categorize as MDDP may be more closely aligned with other psychotic diagnoses than has been considered previously. They indicate that differences in how psychosis is manifested vis-à-vis depression and mania may be quantitative rather than qualitative and occur within a dimensional space, rather than validating categorical distinctions.

  8. Primeiro episódio da esquizofrenia e assistência de enfermagem Primer episodio de la esquizofrenia y asistencia de enfermería First episode of schizophrenia and nursing care

    Directory of Open Access Journals (Sweden)

    Bianca Cristina Ciccone Giacon

    2006-06-01

    disponibles y pocos recursos sociales. Tal condición muestra la necesidad de estudios relacionados al primer episodio.Schizophrenia is one of the main health problems in current days, requiring considerable investment from the health system. Intervening in the first episode offers a unique opportunity in the treatment of schizophrenia and influences the course of the illness. This article consists of a critical literature review aimed at examining knowledge on first episode schizophrenia and discussing the contribution of nursing care. A research was carried out in bibliographical databases. The data collected made possible the organization of information on the general concept of schizophrenia, its first episode, types of intervention and nursing performance. We found out that in Brazil there are few studies related to first episode schizophrenia in Nursing, few available specialized services, and few social resources. This situation reveals the need for more studies on first episode schizophrenia.

  9. Association study of polymorphisms in the alpha 7 nicotinic acetylcholine receptor subunit and catechol-o-methyl transferase genes with sensory gating in first-episode schizophrenia.

    Science.gov (United States)

    Liu, Xia; Hong, Xiaohong; Chan, Raymond C K; Kong, Fanzhi; Peng, Zhizhen; Wan, Xiaona; Wang, Changqing; Cheng, Lu

    2013-10-30

    The purpose of the current study was to explore the association of auditory P50 sensory gating (P50) and prepulse inhibition (PPI) of schizophrenia with polymorphisms in the CHRNA7 and COMT genes. One hundred and fourty patients with schizophrenia participated in this study. They were administered the tests P50 and PPI. Moreover, three single nucleotide polymorphisms (SNPs) (rs2337980, rs1909884 and rs883473) in CHRNA7 and three SNPs (rs4680, rs737865 and rs165599) in COMT were selected to be genotyped by polyacrylamide gel microarray techniques. P50 index showed significant reduction in S2 amplitude between wild-type and mutation groups in the COMT rs4680. S1 amplitude of mutation group in the COMT rs737865 was also lower compared to wild-type group. PPI index revealed a shorter pulse latency of mutation group in the rs4680. The suppression ratio of mutation group was lower in COMT rs165599. Negative findings were shown between comparisons in all the CHRNA7 SNPs. We find that P50 and PPI may be influenced by COMT rs4680 polymorphisms in schizophrenia; more excitingly, we find that P50 might be influenced by COMT rs737865 polymorphisms and PPI may be influenced by COMT rs165599 polymorphisms in schizophrenia, and their mutations are associated with the reduction of the risk of P50 or PPI defects in schizophrenia. Futher studies with a larger number of subjects are needed to verify the present findings.

  10. Cognitive Effects of Antipsychotic Drugs in First-Episode Schizophrenia and Schizophreniform Disorder: A Randomized, Open-Label Clinical Trial (EUFEST)

    NARCIS (Netherlands)

    M. Davidson; S. Galderisi; M. Weiser; N. Werbeloff; W.W. Fleischhacker; R.S. Keefe; H. Boter; I.P.M. Keet; D. Prelipceanu; J.K. Rybakowski; J. Libiger; M. Hummer; S. Dollfus; J.J. López-Ibor; L.G. Hranov; W. Gaebel; J. Peuskens; N. Lindefors; A. Riecher-Roessler; R.S. Kahn

    2009-01-01

    Objective: Cognitive impairment, manifested as mild to moderate deviations from psychometric norms, is present in many but not all schizophrenia patients. The purpose of the present study was to compare the effect of haloperidol with that of second-generation antipsychotic drugs on the cognitive per

  11. Clinical analysis on duration of untreated psychosis and early symptoms of first-episode schizophrenia%首发精神分裂症未治疗时间与早期症状临床分析

    Institute of Scientific and Technical Information of China (English)

    陈刚伟

    2011-01-01

    Objective: To investigate the clinical analysis on duration of untreated psychosis (DUP) and early symptoms of first-episode schizophrenia. Methods: Psychotic symptoms rating scale (SOS) was used to evaluate the early symptoms and DUP of 100 patients eligible for the first-episode schizophrenia in CCMD-Ⅲ.Results: Early symptoms with the incidence rate of over 40% and lasting more than 6 months were sleep disturbance, role dysfunction, suspicion, bizarre behaviors, emotional disorders, ideas of reference, abnormal perception, paranoia, abulomania and so on. The median DUP was 26 months and the long DUP was relevant to negative symptoms. Conclusion: The early identification of early symptoms, strengthening publicity of mental health knowledge and shortening DUP are very important.%目的:探讨首发精神分裂症未治疗时间(DUP)及患者早期症状临床分析.方法:对100例符合(CCMD-Ⅲ)中精神分裂症首次发作的患者应用首发精神分裂症精神症状评定量表(SOS)评定早期症状及患者的DUP.结果:发生率>40%、持续时间超过6个月的早期症状依次有睡眠障碍、角色功能障碍、疑心、怪异行为、情绪障碍、牵连观念、知觉异常、妄想、意志缺乏等.DUP中位数为26个月且长DUP与阴性症状相关.结论:尽早识别早期症状,加强精神卫生的知识宣传,缩短DUP非常重要.

  12. Effect of outpatient follow-up on the rehabilitation of patients with first-episode schizophrenia%门诊随访对首发精神分裂症患者康复疗效的影响

    Institute of Scientific and Technical Information of China (English)

    张雪英; 王树珍; 余莉; 石璐

    2013-01-01

    Objective To explore the adjunctive effect of outpatient follow-up on the rehabilitation of patients with first-episode schizophrenia.Methods Methods included establishing outpatient follow-up teams,developing the records of patients,providing follow-up services through telephone,mailing letters,consultation hot line,home-visiting and so on.The two groups of patients with psychiatric symptoms,social function,quality of life and medication compliance were evaluated.Results Outpatient follow-up relieved the psychiatric symptoms and improved social functions,increased the medication compliance and improved the patients'quality of life (P <0.01).Conclusion Outpatient follow-up can significantly improve the rehabilitation of the patients with first-episode schizophrenia,and enhance their quality of life and social functions.%目的 探讨门诊随访对首发精神分裂症患者的辅助治疗作用.方法 成立门诊随访小组,建立患者档案资料,采用电话随访、邮递信函、咨询热线及上门随访等形式进行门诊随访干预,并对两组患者的精神病症状、社会功能、生活质量和服药依从性进行评价.结果 门诊随访干预12个月后,改善了患者精神症状和社会功能,提高了服药依从性和生活质量(P<0.01).结论 门诊随访可明显提高首发精神分裂症患者的康复疗效,提高其生活质量及社会功能.

  13. Association studies of COMT gene polymorphisms with risperidone treatment in first-episode schizophrenia%首发精神分裂症患者利培酮疗效与COMT基因多态性关联研究

    Institute of Scientific and Technical Information of China (English)

    李波; 黎雪松; 龚道元; 谢国军; 陈家强; 彭艳; 王晓娟

    2013-01-01

    目的:探讨首发精神分裂症患者COMT基因多态性与利培酮疗效的关系.方法:100例首发精神分裂症患者使用利培酮治疗8周,以PANSS量表评定疗效;SNaPshot SNP检测COMT基因rs4680和rs4818多态性.结果:利培酮有效组与无效组相比,精神分裂症患者rs4680基因型G/G与A/G、A/A的分布差异具有显著性(x2=5.334,P<0.05),rs4680 G/G基因型与利培酮疗效之间存在明显关联(OR=1.78,P<0.05).结论:rs4680多态性与利培酮治疗首发精神分裂症的临床疗效相关.%Objective To investigate the association of catechol-O-methyltransferase (COMT) gene polymorphisms with response of risperidone treatment in first-episode schizophrenia. Methods One hundred cases of schizophrenic patients were chosen to treat with risperidone for 8 weeks. The efficacy of antipsychotic medication was evaluated by PANSS scale. Allelic typing of COMT was detected by SNaPshot SNP technique. Results The distribution of rs4680 genotype G/G, A/G and A/A had significant difference between risperidone responder group and nonresponder group (X2 = 5.334,P < 0.05) and rs4680 G/G genotype was correlated with the efficacy of risperidone (OR = 1.78,P< 0.05). Conclusion The polymorphisms of rs4680 related with effects of risperidone on first-episode schizophrenia.

  14. Auditory change detection in schizophrenia: sources of activity, related neuropsychological function and symptoms in patients with a first episode in adolescence, and patients 14 years after an adolescent illness-onset

    Directory of Open Access Journals (Sweden)

    Sachsse Jan

    2006-02-01

    Full Text Available Abstract Background The event-related brain response mismatch negativity (MMN registers changes in auditory stimulation with temporal lobe sources reflecting short-term echoic memory and frontal sources a deviance-induced switch in processing. Impairment, controversially present at the onset of schizophrenia, develops rapidly and can remain independent of clinical improvement. We examined the characteristics of the scalp-recorded MMN and related these to tests of short-term memory and set-shifting. We assessed whether the equivalent dipole sources are affected already at illness-onset in adolescence and how these features differ after a 14-year course following an adolescent onset. The strength, latency, orientation and location of frontal and temporal lobe sources of MMN activity early and late in the course of adolescent-onset schizophrenia are analysed and illustrated. Methods MMN, a measure of auditory change-detection, was elicited by short deviant tones in a 3-tone oddball-presentation and recorded from 32 scalp electrodes. Four dipole sources were placed following hypothesis-led calculations using brain electrical source analysis on brain atlas and MR-images. A short neuropsychological test battery was administered. We compared 28 adolescent patients with a first episode of schizophrenia and 18 patients 14 years after diagnosis in adolescence with two age-matched control groups from the community (n = 22 and 18, respectively. Results MMN peaked earlier in the younger than the older subjects. The amplitude was reduced in patients, especially the younger group, and was here associated with negative symptoms and slow set-shifting. In first-episode patients the temporal lobe sources were more ventral than in controls, while the left cingular and right inferior-mid frontal sources were more caudal. In the older patients the left temporal locus remained ventral (developmental stasis, the right temporal locus extended more antero

  15. 精神病未治疗期长短对首发精神分裂症脑灰质的影响%Effect of duration of untreated psychosis on gray matter in untreated first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    魏钦令; 李雷俊; 骆众星; 康庄; 韩自力; 张晋碚

    2011-01-01

    Objective To investigate the association of duration of untreated psychosis(DUP) and the gray matter volumes in patients with first-episode schizophrenia.Methods 39 patients with first-episode schizophrenia were divided into two groups according to DUP:long-DUP group and short-DUP group.All the subjects underwent T1 weighted magnetic resonance imaging.After transformed with MRIcro software,all the images underwent standardization,segmentation,modulation and smoothing with Statistical Parametric Mapping 5 (SPM5) software.The gray matter volumes of the two groups underwent two-sample t-test with a Voxel-based morphometry (VBM)using SPM5 software.Results Long-DUP schizophrenic patients presented significantly reduced GM volume in the left thalamus(MNI:-6,-16,2;cluster=141 voxels)and the left temporal lobe(MNI:-46,-58,-6;cluster=69 Voxels),compared with short-DUP schizophrenic patients.Conclusion Delayed DUP may increase the loss of gray matter in schizophrenia.%目的 分析精神病未治疗期(duration of untreated psychosis,DUP)对精神分裂症患者局部脑灰质结构的影响.方法 39例首发未服药精神分裂症患者根据DUP分为长DUP组和短DUP组.所有受试者接受T1加权成像扫描.所得图像经MRIcro软件转化为统计参数图(Statistical Parametric Mapping-V,SPM5)软件町以处理的图像.然后以SPM5软件进行}冬{像的标准化、分割、调整和平滑等步骤.对两组的平滑后灰质图像以VBM方法进行两样本t检验.结果 ①长DUP患者左侧丘脑区(MNI:-6,-16,2;cluster=141voxels)、左侧颞叶区(MNI:-46,-58,-6;cluster=69 voxels)灰质体积较短DUP患者下降.②未发现长DUP患者有脑区灰质体积较短DUP患者增高.结论 发病后未治疗时间的延长会加重精神分裂症患者的脑灰质结构障碍.

  16. 初发精神分裂症患者神经认知功能早期受损状况调查%The survey of impaired neurocognitive function in patients with first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    刘磊峰; 贺定翠; 邓小鹏; 凃哲明; 刘波

    2014-01-01

    目的:通过分析初发精神分裂症患者与健康人群认知功能的差异,探讨初发精神分裂症患者早期神经认知功能缺陷的程度与特点。方法选取住院的初发精神分裂症患者120例为患者组,健康人群120例为对照组,采用阳性与阴性症状量表、成套神经认知功能测验全面评定患者的精神症状与认知功能。结果(1)阳性症状、阴性症状、一般精神病理以及PANSS总分无性别差异(P>0.05)。(2)在11项神经认知功能测验中,患者组与对照组之间差异显著(P<0.05),患者组学习和记忆、精细动作、信息处理速度以及执行功能的成绩显著低于对照组( P<0.001)。(3)男患者的颜色连线2测验( P<0.05)、Stroop色词测验(单词总数 P<0.05,颜色总数 P<0.05,色/词总数 P<0.01)、WMS-Ⅲ空间广度总分(P<0.01)的成绩显著低于女患者。结论初发精神分裂症患者的认知功能全面损害,且男性患者执行功能与视觉空间记忆的缺陷更严重。%Objective To investigate the neurocognitive function of patients with first-episode schizophrenia by comparing the difference between schizophrenia group and health group.Methods One hundred and twenty patients with first-episode schizophrenia were considered as the patient group ,and 120 normal people were considered as the control group. The psychiat-ric symptoms and cognitive function of two groups were evaluated by a positive and negative syndrome scale and a set of neuro-psychological test battery. Results The neuropsychological function ,learning and memory ,fine movement ,information pro-cessing speed and executive function of patients group were lower than these of control group ;the color trail making test 2 , stroop color word test and WMS-Ⅲ spatial span of male patients were lower than female patients. Conclusion The neuropsy-chological function ,executive function and visual space

  17. Clinical Features and Treatment of First - Episode Schizophrenia in School Students%首发精神分裂症在校患儿的临床特征及治疗

    Institute of Scientific and Technical Information of China (English)

    庞礼娟; 宋学勤; 李幼辉; 李雪; 高金松

    2011-01-01

    Objective To explore the clinical features and efficacy after treatment with risperidone for students with first - episode schizophrenia. Methods One hundred and six patients with first - episode schizophrenia in school were studied retrospectively with self - compiled questionnaire in order to get the general data of them, then treated with risperidone orally disintegrating tablets, and the efficacy was e-valuated with positive and negative syndrome scale, and the safety was evaluated with the treatment emergent symptom scale and the laboratory testing. Consequently, the effect of several factors to efficacy will be analyzed. Results There were no differences between male and female schizophrenic patients in the age of first onset, course, degree and family history( Pa >0.05) , but there was a significant difference between male and female in the age of going to hospital for the first time (P 0.05). Most female schizophrenic patients display positive clinical symptoms,but male patients show negative clinical symptoms. The total efficacious rate of risperidone was 58. 5% and the secondary reaction of it was less. There were significant differences in gender and degree in effectiveness of risperidone (Pa 0.05). Conclusions There are gender differences in the positive and negative clinical symptoms of schizophrenia in school students,and risperidone is an effective and safe antipsychotic in the treatment of first - episode schizophrenia, and there are gender and culture differences in efficacy.%目的 探讨在校学生首发精神分裂症患儿的临床特征及应用利培酮治疗后的疗效.方法 采用自编调查表,对106例在校学生首发精神分裂症患儿进行一般资料采集.入组后单一应用利培酮口腔崩解片治疗,采用阳性与阴性症状量表评定临床症状及疗效,以不良反应量表和实验室监测等进行安全性评定,并分析各因素对其治疗效果的影响.结果 患儿起病年龄、病程、受教育情

  18. Relationship between serum level of GFAP and cognitive function in patients with first episode schizophrenia.%首发精神分裂症患者血清GFAP与认知功能的研究

    Institute of Scientific and Technical Information of China (English)

    李国华; 李继荣; 吴秋霞; 熊鹏; 曾勇; 徐飞; 卢瑾; 姜林伶

    2013-01-01

    目的 研究首发精神分裂症患者血清中胶质纤维酸性蛋白(Glial Fibrillary Acidic Protein,GFAP)水平的变化与认知功能障碍之间的关系.方法 用酶联免疫吸附技术(Enzyme-linked Immunoadsordent Assay,ELISA)测定48例精神分裂症患者(患者组)和42例正常对照者(对照组)血清GFAP的浓度,并用威斯康星卡片分类测验(Wisconsin Cord Sorting Test,WCST)检测首发精神分裂症患者和正常人的认知功能.比较两组血清GFAP浓度,同时探讨GFAP浓度的变化与认知功能的关系.结果 (1)患者组血清浓度高于对照组(P<0.01);(2)患者组WCST成绩低于对照组(P<0.01),表明首发精神分裂症患者认知功能及执行能力比正常人差;(3)相关分析表明WCST中错误应答数、持续性错误数与患者血清GFAP浓度呈正相关,完成分类个数与患者血清GFAP浓度呈负相关(P<0.05).结论 首发精神分裂症患者存在认知功能障碍和神经胶质细胞损害,且代表神经胶质细胞损害的血清GFAP浓度与认知功能障碍程度呈正相关.%Objective To study the relevance between serum level of glial fibrillary acidic protein (GFAP) and cognitive dysfunction in patients with first episode schizophrenia. Methods Serum GFAP level was measured with Enzyme-linked Immunosorbent method and the cognitive function was assessed with Wisconsin cord sorting test in 48 patients with first episode schizophrenia ( study group) and 42 normal controls ( control group) . Serum GFAP level was compared between the two groups and the relationship between GFAP level and cognitive dysfunction was analyzed. Results (1) Serum GFAP level in study group was significantly higher than that in control group ( P <0. 01). (2) Score of WCST in study group was significantly lower than that in control group (P<0.01). (3)Serum GFAP level in study group was positively correlated with number of wrong answers and number of continued errors, and was negatively correlated

  19. Application of Maslows hierarchy of needs in rehabilitation of first-episode schizophrenia%马斯洛需要层次论在首发精神分裂症患者康复中的应用

    Institute of Scientific and Technical Information of China (English)

    蒲金玉; 蒲冬玉; 张笑梅; 孙梦月; 刘情情

    2013-01-01

    目的:探讨马斯洛需要层次论在首发精神分裂症患者康复护理中的应用效果.方法:首发精神分裂症患者80例,随机分为2组各40例.观察组用马斯洛需要层次论作为指导,针对患者不同阶段的不同需要采取护理措施,满足其躯体和心理各层次的需要;对照组按精神科常规护理.分别在入院时、治疗6周后及出院时,采用阳性和阴性症状评定量表(PANSS)、护士用住院患者观察量表(NOSIE-30)及社会功能缺陷筛选量表(SDSS)进行评定.结果:治疗6周后和出院时2组PANSS总分、阳性症状、阴性症状、一般精神病理评分及SDSS评分均低于入院时(P<0.05,0.01),均呈持续下降趋势,且观察组更低于对照组(P<0.05);治疗6周后和出院时2组NOSIE-30评分均高于入院时(P<0.05,0.01),均呈持续上升趋势,且观察组更高于对照组(P<0.05).结论:在首发精神分裂症患者康复过程中,应用马斯洛需要层次论指导临床护理,能提高治疗依从性及生活自理能力,改善患者生活质量,促进社会功能的康复.%Objective: To explore the application of Maslows hierarchy of needs in rehabilitation of first-episode schizophrenia. Methods: Eighty cases of first-episode schizophrenia were randomly divided into two groups.40 cases in each group. The patients in observation group were guided by Maslows hierarchy of needs according to different needs of different stages, and nursing intervention was given to meet patients' physical and psychological needs patients in control group were given routine psychiatric nursing. The scores of PANSS. NOSIE-30 and SDSS on admission.6 weeks after admission.and at discharge were assessed. Results: Six weeks after admission and at discharge, the scores of PANSS. negative symptoms, positive symptoms and general psychopathology subscale in both groups were lower than pretreatment( P<0. 05 .0. 01 ) .exhibiting a persistent downward trend.and more significantly in

  20. Effect of cognitive behavioral therapy on recovery of first episode schizophrenia%认知行为治疗对首发精神分裂症患者康复的影响

    Institute of Scientific and Technical Information of China (English)

    曹九英; 邓文英; 许律琴; 傅深省; 蒋娅玲

    2010-01-01

    目的 探讨认知行为治疗对首发精神分裂症患者康复的影响.方法 将80例精神科住院的首发精神分裂症患者分为两组,对照组40例,采用常规药物治疗和护理,研究组40例,在患者住院2周后增加认知行为治疗.干预前后采用阳性和阴性症状量表(PANSS)、住院患者护士观察量表(NOSIE)、住院精神患者社会功能评定量表(SSPI)、症状评定量表(SCL-90)进行评定,并与对照组进行比较.结果 干预后两组患者NOSIE各因子分、总积极分、总消极分和SSPI量表、PANSS量表评分比较,经统计学分析,差异有统计学意义(P<0.01).研究组患者SCL-90量表因子中人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性因子分明显减少(P<0.05).结论 认知行为治疗干预可明显加快首发精神分裂症患者的社会功能的恢复,提高患者生活质量,促进患者的康复.%Objective To evaluate the intervention effects of cognitive behavior therapy (CBT) on the patients with first episode schizophrenia. Methods A total of 80 patients with first episode schizophrenia were randomly divided into study group (n =40) and control group (n =40). The study group was treated by routine drugs and psychiatric nursing after two weeks combining with CBT while the control group was treated only by routine drugs and psychiatric nursing. Both groups were assessed with Positive and Negative Syndrome Scale (PANSS), Nurses Observation Scale for Inpatient Evaluation (NOSIE) , Scale of Social-skill for Psychiatric Inpatients (SSPI) , and Symptom Check List-90 (SCL-90) before and after CBT intervention. The scores of those scales were compared between two groups. Results There were significant differences after CBT intervention in all factors, total negative factors and total positive factors of NOSIE, total score of SSPI and PANSS (P<0.01) between two groups. Factors score of interpersonal sensitivity, depression, anxiety, panic, paranoid ideation

  1. 奥氮平治疗首发精神分裂症的随访对照研究%A compartive Study of Olanzapine in the treatment of first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    谭余龙

    2011-01-01

    Objective To investigate the olanzapine and risperidone in treatm ent of first-episode schizophrenia curative effect and the security.M ethods 148 patients w ith first-episode schizophrenia patients w ere random ly divided into study group (olanzapine group) in 75 cases and the control group (73 cases,risperidone group) respectively taking olanzapine,risperidone treatm ent.T o evaluate clinicalefficacy,positive and negative sym ptom s scale (P A N SS) form s have been used before the treatm ent and afte the treatm ent at the the end of the second,the forth,the eighth and tw elveth m onth,asw ell as using the social dysfunction screening scale (SD SS ) form to assess the social function.R esults the olanzapine and risperidone groups in cure rate,significant efficiency,P A N SS score and SD SS score difference does not have statistical significance (P>0.05),the olanzapine group in extrapyram idal reactions,endocrine disorders,less than risperidone group,the increase in the body w eight than risperidone group,the difference w as statistically significant (P<0.05).C onclusion B oth O lanzapine and risperidone in the treatm ent of first-episode schizophrenia curative effect are good;but olanzapine less adverse reaction,high safety,high com pliance.%目的 探讨奥氮平与利培酮治疗首发精神分裂症的疗效及安全性.方法 将148例首发精神分裂症患者随机分为研究组(奥氮平组)75例和对照组(利培酮组)73例,分别服用奥氮平、利培酮治疗.于治疗前及治疗第2月、4月、8月及12个月末采用阳性症状与阴性症状量表(PANsS)评定临床疗效,同时以社会功能缺陷筛选表(SDSS)评定社会功能;以副反应量表(TESS)评定不良反应.结果 奥氮平组与利培酮组在痊愈率、显效率、PANSS评分与SDSS评分差异无统计学意义(P>0.05),奥氮平组在锥体外系反应、内分泌失调等方面少于利培酮组,在体质量增加方面多于利培酮组,差异具有统计学意

  2. Diffusion tensor imaging in patients with first episodic schizophrenia%精神分裂症首次发病患者的脑扩散张量成像研究

    Institute of Scientific and Technical Information of China (English)

    王颖; 贾艳滨; 凌雪英; 黄力

    2008-01-01

    Objective To study the abnormality of white matter tracts in patients with first-episodic schizophrenia by using diffusion tensor imaging(DTI).Methods DTI was performed in 26 patients with first episodic schizophrenia and 20 normal comparison subjects,and the fractional anisotropy(FA)values were subsequently measured in multiple brain regions.Results There was a remarkable left-greater-thanright asymmetry anisotropy in the anterior cingulum bundles in controls(P<0.05),while reduced FA was seen in both sides of the anterior cingulum in patients(P<0.05).Lower FA in splenium of corpus callosum was in patients than in controls(P<0.05).Conclusions The patients with first-episodic schizophrenia may have a lack of normal left-greater.than-right asymmetry and aberrant callosal connectivity.%目的 利用磁共振扩散张量成像(DTI)技术研究未经药物治疗的精神分裂症首次发病(以下简称首发)患者主要脑区白质纤维束的异常.方法 选取26例首发精神分裂症患者(患者组)和20名健康志愿者(对照组)行脑DTI扫描(两组均为右利手),测量胼胝体膝部、压部、双侧额叶白质、扣带束前部及海马头的部分各向异性(FA)值.结果 (1)对照组左侧扣带束FA值(0.428±0.067)大于右侧(0.375±0.079;P<0.05).(2)患者组两侧相对应感兴趣区FA值差异均无统计学意义(P>0.05).(3)患者组左右侧胼胝体压部FA值(均为0.734±0.085)、左右侧扣带束前部FA值(0.300±0.068和0.306 4±0.062)均低于对照组(0.785±0.045,0.428±0.067,0.375±0.079;均P<0.05).结论 首发精神分裂症患者存在双侧扣带束、胼胝体压部白质纤维束的受损,支持脑内连接异常假说.

  3. Study on metabolic risk of first-episode acute schizophrenia patients treated with aripiprazole%阿立哌唑对首发急性精神分裂症患者代谢风险的探讨

    Institute of Scientific and Technical Information of China (English)

    吴小立; 文飞; 钟智勇; 韩自力

    2011-01-01

    目的:探讨阿立哌唑对首发急性期精神分裂症患者的代谢影响.方法:31例首发急性期精神分裂症患者入选病例组接受阿立哌唑治疗,治疗前后各测量一次体重、腰围、腰臀比、血清TC、TG、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A1(Apo-A1)、载脂蛋白B(Apo B100)、脂蛋白a(LPa)、空腹血糖(FBS)、空腹胰岛素(INS)、C肽(C-P),并分别计算出BMI、胰岛素抵抗指数(HOMA-IR).另设健康对照组44例,同法测量上述指标.将病例组与健康对照组、病例组治疗前后各项指标进行比较分析.结果:病例组INS、C-P及HOMA-IR均高于正常对照组,差异有统计学意义(P<0.05);病例组治疗后体重、BMI、腰围、腰臀比均较治疗前增加,差异有统计学意义(P<0.05);治疗后:病例组TG、INS、C-P、HOMA-IR均高于对照组,差异有统计学意义(P<0.05);且aPOA1低于对照组,差异有统计学意义(P<0.05).结论:精神分裂症患者本身可能存在有代谢异常;非典型抗精神病药物(APS)阿立哌唑对患者血糖、血脂代谢相对影响较小.%AIM: To study the metabolic risk of first-episode acute schizophrenia patients trea ted with aripiprazole.METHODS: 31 first-episode acute patients with schizophrenic were enrolled into case group and 44 healthy subjects were enrolled into controle group, all cases accepted treatment with oral aripiprazole.At the baseline and at the end, all patients were checked or tested for weight, waist circumference, waist-to-hipratio(WHR), TC, TG, high density lipoprotein(HDL), low density lipoprotein(LDL), apolipoprotein A1 ( Apo Al), apolipoprotein B (Apo-B100), lipoprotein a (LPa),fasting blood glucose (FBS), fasting insulin (INS)and c-peptide(C-P),respectively.The BMI and insulin resistance index (HOMA-IR) were calculated.All indexes were compared and analysed between the case group and controle group,pre and post treatment in the case group.RESULTS:The INS, C-P and HOMA

  4. 奥氮平对首发精神分裂症认知功能影响的多中心研究%A Multicenter Study of Olanzapine on Congnitive Function in First-episode Schizophrenia.

    Institute of Scientific and Technical Information of China (English)

    孙群星; 刘勇; 李四冬; 尹继续

    2011-01-01

    Objective To explore the influence of olanzapine on cognitive function in first-episode schizophrenia. Methods 100 cases of first-episode schizophrenia were conducted a multicenter, randomized clinical trial. The positive and negative scale (PANSS) and 10 neuropsychological tests such as Weschler Adult Intelligence Scale, Weschler Memory Scale, Iorn Nails Tank Test, Flnger Tapping Test, Motor Function Test, Coordinated Hand function Test, Connection Test A and B, Wisconsin Card Sort Test (WCST) and Verbal Fluency Test were adopted to assess these subjectsat baseline and the end of 4,8,12 weeks. Results The total score of PANSS in both groups showed significant difference after treatment than before (P < 0.01 ). The efficiency rate and markedly effective rate in study group was 98.0% and 82.0% respectively, while control group was 96.0% and 78.0%respectively. There were not significant differences in curative effect between the two groups, but clozapine group had more side effects than olanzapine group (P < 0.01 ). Both groups has gradually improved in neuropsychological tests since 81h weekends. Compared with pre-treatment, neuropsychological tests such as tapping test, motor function test, coordinated hand function test and Wisconsin Card Sort Test were significantly different in both groups, and the study group was better than control groups. ( P < 0.05 ). Conclusions Olanzapine can better improve the cognitive function of first-episode schizophrenia.%目的 探讨奥氮平对首发精神分裂症患者认知功能的影响.方法 对100例首发精神分裂症患者进行随机观察.于治疗前,治疗第4周末、8周末、12周末各做一次韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击试验、动作功能测验、手功能协调测验、连线测验a和b、威斯康星卡片分类测验(WCST)及言语流利性测验等10项神经心理测查及阳性与阴性症状量表(PANSS)评定.结果 两组PANSS总

  5. 氨磺必利与阿立哌唑治疗首发精神分裂症对照研究%A Comparative Study of Amisulpride and Aripiprazole in the Treatment of First Episode Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    仇红杰

    2014-01-01

    目的:探讨氨磺必利与阿立哌唑治疗首发精神分裂症的临床疗效与安全性。方法:将75例首发精神分裂症患者按照随机数字表法分成两组,氨磺必利组37例,阿立哌唑组38例,治疗8周。采用阳性与阴性症状量表(PANSS)评定疗效,采用治疗中出现的症状量表(TESS)评定不良反应。结果:氨磺必利组的治疗总有效率为89.19%,阿立哌唑组为92.11%,两组比较差异无统计学意义(P>0.05)。治疗第4、6、8周PANSS总分及各因子评分两组比较差异均无统计学意义(P>0.05)。结论:氨磺必利与阿立哌唑治疗首发精神分裂症均有良好效果,不良反应均较少。%Objective:To investigate the efficacy and safety of Amisulpride and Aripiprazole in the treatment of first episode schizophrenia. Method:75 patients of first opisode schizoprenia were randomly divided into two groups(amisulpride 37,aripiprazole 38).Both of the amisulpride and aripiprazole were administered to two groups respectively for 8 weeks. Their symptoms were assessed with PANSS and their side effects were assessed with TESS before and after the treatment. Result:The total cure rates were 89.19%in amisulpride group and 92.11%in aripiprazole group,with no significant difference between the two groups(P>0.05). PANSS score and each factor score in treatment of 4,6,8 weeks between the two groups had no statistical significance(P>0.05). Conclusion:Both of the amisulpride and aripiprazole have notable curative effect with less side-effect in the treatment of first episode schizophrenia.

  6. Study on glucose metabolism in first-episode, drug-naive patients with schizophrenia%首发未用药精神分裂症患者的糖代谢研究

    Institute of Scientific and Technical Information of China (English)

    权京菊; 兰菊; 杨晋梅

    2015-01-01

    significantly higher than normal people.The study examined the glucose metabolism in first-episode, drug-naive patients with schizophrenia. Methods Case-control study was employed.According to the 4th edition of American Diagnostic and Statistical Manual of Mental Disorders, 58 first-episode, drug-naive patients with schizophrenia hospitalized in our hospital were collected for the study.Brief psychiatric rating scale, Hamilton depressive scale and assessment of abnormal involuntary movement were used to assess the mental state and the degree of illness.Meanwhile, 60 hospitalized Han patients in the Second Hospital of Lanzhou University were selected as the control group. Fast plasma glucose (FPG) were detected in the morning on each patient along with oral glucose tolerance test (OGTT).Measure-ments were also made on height, body weight, waist circumference, hip circumference, as well as WHR and body mass index (BMI). Results No significant difference was found in gender, age, diet habit, activity, BMI and the number of education years between the groups(P>0.05).The average FPG of the patient group was higher than that of the control group(5.29 ±0.83 mmol/L vs 4.37 ±0.54 mmol/L);postprandial 2 hour glucose of the patient group was significantly higher than that of the control group ( 6.89 ±0.98 ) mmol/L vs 5.97 ±0.82 mmol/L, P0.05). Conclusions First-episode, drug-na-ive patients with schizophrenia have more impaired fasting glucose tolerance than normal people.In order to identify and intervene the abnormal glucose metabolism of schizophrenia patients, it is of great importance to measure relation index to glucose metabolism, espe-cially the oral glucose tolerance test.

  7. 利培酮口服液治疗首发精神分裂症急性期对照观察%A control study of risperidone oral solution in treating first-episode schizophrenia patients in acute phase

    Institute of Scientific and Technical Information of China (English)

    黄卓玮; 龚传鹏

    2011-01-01

    目的:探讨利培酮13服液治疗首发精神分裂症急性期的疗效和安全性.方法:96例精神分裂症的急性期患者随机分为两组,分别给予利培酮口服液(研究组,n=49)和氯氮平(对照组,n=47)单药治疗4周.采用阳性和阴性症状量表(PANSS)评定临床疗效,临床总体印象量表(CGI-SI)评定病情严重程度,治疗中出现的症状量表(TESS)评定不良反应,自编依从性量表评定依从性.结果:治疗后两组患者PANSS及CGI-SI评分显著下降(P0.05).治疗后第4天,研究组兴奋、敌对、不合作、冲动控制缺乏因子分下降较对照组显著(P<0.05);研究组不良反应发生率明显低于对照组(P<0.05);研究组治疗依从性在治疗14 d、28 d、3个月和6个月时均优于对照组(P<0.05).结论:利培酮口服液对首发精神分裂症急性期患者的疗效和氯氮平相当,但利培酮口服液改善兴奋、敌对性等因子分较迅速,耐受性和依从性较好.%Objective: To evaluate the efficacy and safety of risperidone oral solution in the treatment of patients on the acute phase with first-episode schizophrenia. Method:96 schizophrenia patients were randomly assigned to the group treated with risperidone oral solution group ( n = 49 ) and the other group treated with clozapine (n =47 ),respectively for 4 weeks. The positive and negative syndrome scale (PANSS) and clinical global impressions-severity of illness rating scale(CGI-SI) were used to rate the efficacy;the treatment emergent symptom scale (TESS) was used to measure side effects and the compliance scale was used to assess the subjects'compliance with the treatment. Results:Both risperidone and clozapine group significantly showed score decrease on PANSS and CGI-SI after 4 weeks (P <0.01 ), but no significant difference was found between two groups ( P > 0.05 ). Excitement, hostility, uncooperativeness and poor impulse control of PANSS significantly decreased more in risperidone oral solution group

  8. Structural brain abnormalities in early onset first-episode psychosis

    DEFF Research Database (Denmark)

    Pagsberg, A K; Baaré, W F C; Raabjerg Christensen, A M;

    2007-01-01

    BACKGROUND: Brain morphometry in children and adolescents with first-episode psychosis offer a unique opportunity for pathogenetic investigations. METHODS: We compared high-resolution 3D T1-weighted magnetic resonance images of the brain in 29 patients (schizophrenia, schizotypal disorder, delusi...

  9. Effects of amisulpride on the cognitive function in first-episode schizophrenia patients%氨磺必利对首发精神分裂症患者认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    黄继伟; 李林; 吕维忠; 韩自力

    2013-01-01

    目的 探讨氨磺必利对首发精神分裂症患者认知功能的影响.方法 对64例首发精神分裂症患者,按抛币法随机分为两组,分别给予氨磺必利和利培酮治疗,疗程12周.在治疗前及治疗后2,4,8,12周末分别采用阳性与阴性症状量表(PANSS),副反应量表(TESS)评定疗效和不良反应;治疗前后采用韦氏成人记忆量表(WMS-RC),威斯康星卡片分类测验(WCST),连线测验A和B等进行认知功能评定,并与正常对照组比较.结果 治疗12周后,氨磺必利组和利培酮组的PANSS总分分别为(44.7±6.7)分,(45.2±7.4)分,与治疗前比较均差异有统计学意义(P<0.01),两组间比较差异无统计学意义(P>0.05).治疗前,两患者组WMS-RC的长时记忆,短时记忆,瞬时记忆,记忆商(QM),WCST的持续错误数(Rpe),持续应答数(Rp),完成第一个分类所需应答数(R1st)和完成分类数(Cc)及TAT-A,TAT-B受损明显,与对照组比较均差异有统计学意义(P<0.05或<0.01).治疗12周后,患者组WMS-RC的再认,联想,理解,背数,记忆商(QM),及TAT-A,TAT-B与治疗前比较均明显改善接近正常(均P>0.05);患者组WCST的Rpe,Rp,R1st,Cc评分[氨磺必利组分别为(20.63 ±13.06)分,(28.75±15.72)分,(43.17±22.13)分,(3.62±2.21)分.利培酮组分别为(20.41±13.82)分,(29.31±16.12)分,(42.78±21.42)分,(3.67±2.32)分.]与正常对照组比较均差异有统计学意义(均P<0.05).两组间治疗前后认知功能各项评分比较无统计学意义(均P>0.05).结论 氨磺必利治疗精神分裂症疗效肯定,与利培酮相当,对精神分裂症的认知功能缺陷有改善作用.%Objective To explore the effects of amisulpride on the cognitive function in first-episode schizophrenia patients.Methods 64 patients in first-episode schizophrenia were divided into two groups randomly according to the method of tossing a coin,then treated with amisulpride or risperidone respectively for 12 weeks.The efficacy and adverse

  10. The Effect of Family Intervention on the Rehabilitation of Patients with First-episode Schizophrenia%家庭干预对首发精神分裂症患者康复的影响

    Institute of Scientific and Technical Information of China (English)

    张文娟; 刘培培; 李健成

    2014-01-01

    目的:探讨家庭干预对首发精神分裂症患者康复的作用。方法将90例首发期精神分裂症患者随机分为研究组和对照组各45例。对照组进行药物干预,研究组在药物干预的基础上进行家庭干预。所有患者均评定简明精神病量表( BPRS )、社会功能缺陷筛选量表(SDSS)和自知力与治疗态度问卷(ITAQ),并评定康复效果。结果9个月后,研究组BPRS评分低于对照组(t=2.74,3.85;P<0.01);6个月后,研究组SDSS评分和ITAQ评分均低于对照组(t=2.87,4.89,5.31,2.77,6.31;P<0.01);12个月后,总有效率研究组高于对照组(χ2=3.91,P<0.05)。结论家庭干预可以显著改善首发精神分裂症患者的社会功能和康复效果,延缓其社会功能衰退。%Objective To explore the effect of family intervention on the rehabilitation of patients with first -episode schizophrenia . Methods 90patientswithfirst-episodeschizophreniawererandomlydividedintostudygroup(45cases,treatedwithdrugtherapyplus family intervention) and control group(45cases,treated with drug therapy)for 12 months.All patients were assessed with Brief Psychiat-ric Rating Scale(BPRS),Social Disability Screening Schedule (SDSS)and Insight Treatment Attitude Questionnaire (ITAQ).Results After 9-months intervention,scores of BPRS in study group were significantly lower than those in control group ((t=2.74,3.85;P<0.01);After 6-months intervention,scores of SDSS and ITAQ in study group were significantly lower than those in control group (t=2.87,4.89,5.31,2.77,6.31;P<0.01);After 12-months intervention ,the total effective rate in study group was significantly higher than that in control group (χ2 =3.91,P<0.05).Conclusion Family intervention is beneficial for patients with first -episode schizo-phrenia in improving their social function and rehabilitation outcome .

  11. 阿立哌唑与利培酮治疗女性精神分裂症的临床疗效分析%Effective analysis of aripiprazole and risperidone for patients with first-episode female Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    张加明

    2014-01-01

    目的:对阿立哌唑与利培酮对女性首发精神分裂症的临床疗效以及对患者认知功能的影响进行观察和分析。方法:将我院2010年4月~2013年11月收治的128例女性首发精神分裂患者随机分为阿立哌唑组和利培酮组,每组各64例。2组患者分别于治疗前后采用阳性与阴性症状量表(PANSS)、临床总体印象量表(CGI)以及副反应量表(TESS)对患者的临床疗效和副反应进行评定和比较。结果:2组患者治疗后其阳性症状、阴性症状、一般病理、PANSS总分以及CGI总分均较治疗前显著降低(P<0.01),但组间比较并无明显差异(P>0.05)。治疗后阿立哌唑组和利培酮组的临床显效率和有效率分别为73.44%、96.88%和70.31%、90.62%,差异均不具有统计学意义( P>0.05),而TESS评定结果显示,阿立哌唑组患者评分8.31±4.20分明显低于利培酮组患者评分9.29±4.16分。结论:阿立哌唑和利培酮治疗女性首发精神分裂症上均可有效改善患者的阳性症状、阴性症状、一般病理而起到良好的临床疗效,但相比而言阿立哌唑在治疗过程中副反应更小,因而更加安全有效。%Objective:To explore the efficacy of aripiprazole and risperidone in the treatment of first -episode female schizophrenia . Methods:To select 128 cases of patients with first-episode female schizophrenia who were treated in our hospital from April 2010 to No-vember 2013,and were randomly divided into the saripiprazole group and the risperidone group ,each group was 64 cases.Two groups of patients were take the positive and negative symptoms scale ( PANSS) , the clinical general impression scale (CGI) and the treatment e-mergent symptom scale ( TESS) respectively before and after treatment to evaluated the clinical efficacy and the adverse event .Results:The positive symptoms , negative symptoms , general pathology , PANSS

  12. 精神分裂症首次发病患者错误监控功能改变的初步观察%A preliminary study on error-monitoring function changes in first episode schizophrenia patients

    Institute of Scientific and Technical Information of China (English)

    郑成应; 陈中鸣; 陈兴时; 唐云翔; 徐一峰; 张晨; 张明岛; 楼翡璎; 梁建华; 陈冲

    2012-01-01

    目的 探讨精神分裂症首次发病患者错误相关负电位(ERN)的变化特征.方法 应用德国Brain Products公司的事件相关电位记录与分析系统,以改良后的视觉Erikson Flanker范式为刺激材料,对58例首次发病精神分裂症患者(患者组)和62名对照者(对照组)进行ERN检测,比较2组间ERN潜伏期与波幅的差异.结果 (1)患者组的正确反应次数(476.59±162.47)次,明显低于对照组(641.27±154.58)次,t=5.69,P<0.01;正确反应和错误反应的反应时与对照组比较差异无统计学意义.(2)与对照组比较,患者组ERN潜伏期在Cz[(58±14) ms∶ (49±13) ms;t=3.63,P<0.01]、Fz[(60±11) ms∶(47±13) ms;t=5.91,P<0.01]、C3[(57±17) ms∶ (50±14) ms; t=2.43,P<0.05]和C4[(60±13) ms∶ (51 ±12) ms;t =4.08,P<0.01]上明显延迟,波幅在Cz[(5.0±2.8) μV∶(7.5±3.1)μV;t=4.73,P<0.01]、C3[(5.5±4.0) μV∶ (8.0±3.7) μV;t=3.58,P<0.01]、Fz[(5.0±3.1) μV∶(7.7±3.8) μV; t=4.24,P<0.01]、Pz[(4.5±3.3) μV∶(7.5±3.0) μV;t=5.17,P<0.01]较对照组低.(3)ERN潜伏期和波幅变化与阳性症状分和PANSS总分之间未见显著性相关.结论 精神分裂症首次发病患者的ERN潜伏期和波幅异常,可能反映了本组患者内在错误监控机制存在缺陷.%Objective To explore the variations of error-related negativity (ERN) in first episode schizophrenia patients.Methods The ERN was tested in 58 first episode schizophrenia (FES) patients and 62 normal controls (NC) using ERP recording system made by Brain Products Company (Germany).A modified Erikson Flanker paradigm was used as the stimulating material,and ERN latencies and amplitudes were compared between FES and NC.Results (1) The correct response rate was significantly lower in the FES group(476.59 ±162.47) than in the NC group(641.27 ± 154.58) (t =5.69,P<0.01),and no significant difference was found of reaction times of correct responses and incorrect responses between FES and NC subjects.(2

  13. 不同剂量利培酮治疗首发精神分裂症的疗效观察%Clinical observation of various dosages of risperidone in treatment of first episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    隗春玲

    2015-01-01

    Objective To observe the effect of various dosages of Risperidone Tablets in treatment of first episode schizophrenia and safety evaluation.Methods Patients (127 cases) with first episode schizophrenia from Beijing Fangshan District Mental Health Care Hospital from April 2012 to April 2014 were randomly divided into high-dosage group ( 62 cases) and low-dosage group (65 cases). The patients in the high-dosage group werepo administered with Risperidone Tablets 0.5 — 1 mg/d at beginning, then gradually added to 6 mg/d according to patient's condition and adverse reactions in the second and third day, and maintained the dosage of 6 mg/d. The patients in the low-dosage group were same to those in the high-dosage group except added dosage and maintenance dosage of 3 mg/d. Two groups were treated for 8 weeks. After treatment, the efficacy was evaluated, and PANSS score, EPS occurrence and TESS scores in two groups were compared.Results The efficacies in the high-dosage and low-dosage groups were 93.85% and 82.26%, respectively, and there were differences between two groups (P < 0.05). After treatment, negative symptom scale scores, positive symptom scale score, the psychopathology scale scores, and PANSS total score in two groups were significantly lower, and the difference was statistically significant in the same group (P < 0.05). The observational indexes of the low-dosage group were significantly lower than those in the same period in the high-dosage group treated for 4 and 8 weeks, with significant difference between two groups (P < 0.05). The incidence of EPS and TESS scores at 4 and 8 week in the low-dosage group were obviously lower than those in the high-dosage group, and the difference was statistically significant between two groups (P < 0.05).Conclusion Low-dosage of Risperidone Tablets has curative effect in treatment of first episode schizophrenia with better clinical efficacy, less PANSS score, incidence of EPS, and TESS scores, which be superior to

  14. Early detection of first-episode psychosis

    DEFF Research Database (Denmark)

    Larsen, Tor K; Melle, Ingrid; Auestad, Bjørn

    2006-01-01

    Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven.......Early intervention is assumed to improve outcome in first-episode psychosis, but this has not been proven....

  15. Meta analysis of comparative study of ziprasidone and clozapine for the treatment of first-episode schizophrenia%齐拉西酮与氯氮平治疗首发精神分裂症的 Meta分析

    Institute of Scientific and Technical Information of China (English)

    任培丽; 徐莉娟; 王蘅

    2014-01-01

    Objective To study the differences of efficacy and side effects between ziprasidone and clozapine for the treatment of first -epi-sode schizophrenia.Methods Nine comparative studies of ziprasidone and clozapine for the treatment of first -episode schizophrenia were rean-alyzed by meta analysis.Results The significant differences on symp-toms between prior and post treatment were found ( P<0.01 ) .Ziprasi-done was superior to clozapine in improving the total scores of positive and negative syndrome scale ( PANSS ) and the negative symptoms of schizophrenia ( P<0.05 ).The somnolence , constipation , salivation , ab-normal electrocardiogram , weight gain , blurred vision and abnormal liver function in ziprasidone group were significantly less than clozapine group (P<0.05 or P<0.01), but the extrapyramidal symptoms(EPS) in zi-prasidone group was significantly more than that of clozapine group ( P<0.01 ).Conclusion Ziprasidone has an advantage over clozapine in im-proving the total scores of PANSS and the negative symptoms in first -ep-isode schizophrenic , with less adverse drug effects.%目的:评价齐拉西酮与氯氮平治疗首发精神分裂症的疗效及不良反应。方法用Meta分析方法对9项齐拉西酮与氯氮平治疗首发精神分裂症对照研究的文献进行再分析。结果齐拉西酮、氯氮平在治疗首发精神分裂症方面均有显著的疗效(P<0.01)。齐拉西酮在改善阳性与阴性症状量表总分(PANSS)和阴性症状方面显著优于氯氮平( P<0.05)。齐拉西酮组在嗜睡、便秘、流延、心电图异常、体重增加、视物模糊和肝功异常等不良反应均显著少于氯氮平组(P<0.05或P<0.01);锥体外系反应(EPS),齐拉西酮组显著多于氯氮平组(P<0.01)。结论齐拉西酮在改善首发精神分裂症患者PANSS总分和阴性症状方面优于氯氮平,且不良反应较少。

  16. [First-episode psychosis, cognitive difficulties and remediation].

    Science.gov (United States)

    Vidailhet, P

    2013-09-01

    Cognitive difficulties are a core feature of schizophrenia. They are frequent, severe, and clearly associated with functional disabilities. They have been explored during different phases of the disease, but what we know essentially concerns the chronic period in middle-age patients. In this article we will specifically focus on cognition at the time of first episode. First episode is a key life period, occurring while social demands are increasing and more complex on the one hand, and while there are important changes in structural and functional cerebral anatomy on the other hand. Exploring cognitive difficulties at the time of first episode offers the opportunity to better know their time course, to avoid interpretative difficulties due to the chronicity of the disease and its treatments, and to develop early therapeutics in order to improve outcome. Cognitive difficulties are clearly present at the time of first episode; their nature and severity appear similar to those observed in more chronic patients. Therefore, they cannot be entirely explained by treatments, hospitalizations or chronicity, and appear more as an intrinsic feature of the disease. The course of their trajectory through the progression of the disease remains uncertain; while they are already present during childhood or adolescence in some subjects who will later declare schizophrenia, they seem to worsen during the period of early prodroms, that is years before psychotic symptoms emerge. Whether they aggravate again during the first episode process is still a matter of debate. While longer DUP is associated with a poor outcome, this does not seem to hold true for cognitive impairments. Cannabis or tobacco use are neither associated with worse cognitive abilities in first-episode patients; a reverse relationship even sometimes exists. Cognitive impairment appears as largely independent from other clinical dimensions, acknowledging its own physiopathology and requiring specific evaluation and

  17. 认知疗法对首发精神分裂症患者认知功能的影响%Influences of cognitive therapy on cognitive function of first-episode schizophrenia patient

    Institute of Scientific and Technical Information of China (English)

    孙健; 冯纳婷; 孙群星; 郭华

    2014-01-01

    目的:探讨认知疗法对首发精神分裂症患者认知功能的影响。方法将100例首发精神分裂症患者随机分为两组。两组均应用齐拉西酮治疗,研究组在此基础上联合认知疗法,观察12周。于治疗前后采用韦氏成人智力量表、韦氏记忆量表、铁槽铁钉测验、手指敲击试验、动作功能测验、手功能测验、连线测验A和B、威斯康星卡片分类测验及言语流利性测验等评定认知状况,采用阳性与阴性症状量表评定精神症状。结果两组治疗8周起铁槽铁钉测验、手指敲击测验、连线测验完成类别数、韦氏成人智力量表和研究组手功能协调测验得分均较治疗前显著改善( P<0.05或0.01);治疗12周末,两组动作功能测验和研究组视觉连线A得分较治疗前显著改善( P<0.05或0.01)。研究组治疗4周末起操作智商,治疗12周末铁槽铁钉(左右手)、总记忆商和手指敲击(左手)显著优于对照组( P<0.05或0.01)。结论认知治疗能显著改善首发精神分裂症患者的认知功能,效果优于单用药物治疗。%Objective To explore the influences of cognitive therapy on cognitive function of first-episode schizophrenia patient .Methods A total of 100 first-episode schizophrenics were randomly divided into two groups .Both groups were treated with ziprasidone , research group was plus cognitive therapy for 12 weeks .Before and after treatment cognitive status was assessed using the Wechsler Adult Intelligence Scale (WAIS) ,Wechsler Memory Scale (WMS) ,Iron Nails Tank Tests (INTT ) ,Finger Tapping Test (FTT) ,Motor Function Test (MFT) ,Hand Function Test (HFT) ,Tail Making Test A and B (TMTA/B) ,Wisconsin Card Sorting Test (WCST ) and Verbal Fluency Test (VF) and mental symptom with the Positive and Negative Syndrome Scale (PANSS) .Results Since the 8th week treatment the INTT ,FTT , completed sorts of the TM T ,WAIS scores of

  18. Neural markers of negative symptom outcomes in distributed working memory brain activity of antipsychotic-naive schizophrenia patients

    DEFF Research Database (Denmark)

    Nejad, Ayna B.; Madsen, Kristoffer H.; Ebdrup, Bjørn H.

    2013-01-01

    -back task. Spatial independent component analysis identified task-modulated brain networks. A linear support vector machine was trained with these components to discriminate six patients who showed improvement in negative symptoms from eight non-improvers. Classification accuracy and significance...... was estimated by leave-one-out cross-validation and permutation tests, respectively. Two frontoparietal and one default mode network components predicted negative symptom improvement with a classification accuracy of 79% (p = 0.003). Discriminating features were found in the frontoparietal networks...

  19. Efficacy of Atypical Antipsychotics on Memory Function in First-episode Schizophrenia%非典型抗精神病药对首发精神分裂症患者记忆功能的影响

    Institute of Scientific and Technical Information of China (English)

    杨绪娜; 朱峰; 李乐华

    2011-01-01

    Objective: To explore the efficacy of olanzapine, risperidone and aripiprazole on memory function in patients with first-episode schizophrenia.Methods: 91 first-episode patients with schizophrenia were randomized to olanzapine group (n=27), risperidone group (n=37) and aripiprazole group (n=27).All subjects were assessed with Positive and Negative Syndrome Scale(PANSS), Hopkins Verbal Learning Test-Revised(HVLT-R), Wechsler Memory Scale-Ⅲ (WMS-Ⅲ) and Spatial Span Task.Results: ①Compared with the baseline, all the scores of PANSS decreased significantly (P<0.001), but no significant difference was found among the three groups (P>0.05).②Compared with the baseline, the total score and the Anterograde score of Spatial Span Test increased significantly (P<0.05) in aripiprazole group, but no significant changes were found in olanzapine group and risperidone group (P>0.05).③Compared with the baseline, the scores of immediate recall, total recall and recognition about HVLT-R increased significantly(P<0.05~0.01) in olanzapine group and risperidone group, and all the scores of HVLT-R increased significantly(P<0.05~0.01) in aripiprazole group, but no significant difference was found among the three groups (P>0.05).Conclusion: The improvement in memory function of aripiprazole would be probably better than olanzapine and risperidone.%目的:探讨奥氮平、利堵酮和阿立哌唑三种非典型抗精神病药对首发精神分裂症患者认知功能的影响.方法:91例首发精神分裂症患者通过多中心随机分配,奥氮平组(n=27)、利培酮组(n=37)和阿立哌唑组(n=27).在治疗前和12周后完成如下测评:阳性与阴性症状量表(Positive and Negative Syndrome Scale,PANSS)、韦氏记忆量表-第三版(Wechsler Memory Scale,WMS-Ⅲ)的空间广度测验、霍普金斯词汇学习测验-修订版(Hopkins Verbal Learning Test-Revised.HVLT-R).结果:①治疗12周后,三组PANSS评分均较治疗前显著降低(P<0

  20. Structural brain abnormalities in early onset first-episode psychosis

    DEFF Research Database (Denmark)

    Pagsberg, A K; Baaré, William Frans Christian; Raabjerg Christensen, A M

    2007-01-01

    BACKGROUND: Brain morphometry in children and adolescents with first-episode psychosis offer a unique opportunity for pathogenetic investigations. METHODS: We compared high-resolution 3D T1-weighted magnetic resonance images of the brain in 29 patients (schizophrenia, schizotypal disorder......, delusional disorder or other non-organic psychosis), aged 10-18 to those of 29 matched controls, using optimized voxel-based morphometry. RESULTS: Psychotic patients had frontal white matter abnormalities, but expected (regional) gray matter reductions were not observed. Post hoc analyses revealed...... already at illness onset in young schizophrenia spectrum patients, suggests aberrant neurodevelopmental processes in the pathogenesis of these disorders. Gray matter volume changes, however, appear not to be a key feature in early onset first-episode psychosis....

  1. Aberrant anatomical brain network in first-episode schizophrenia and their healthy siblings%精神分裂症首次发病患者及其健康同胞的脑结构网络研究

    Institute of Scientific and Technical Information of China (English)

    国效峰; 郑俊杰; 齐景峰; 胡茂荣; 陈华富; 赵靖平

    2015-01-01

    Objective To determine whether the aberrant white matter network is shared by patients with schizophrenia and their healthy siblings.Methods Fourteen-three first-episode,treatment-naive patients with schizophrenia (patients),40 healthy siblings (siblings),and 55 healthy controls (controls)were scanned with 3.0T MRI scanner and diffusion tensor imaging tractography was used to construct the whiter matter brain network.The differences of white matter network were compared with analysis of variance among the 3 groups.Results The white matter network connectivity strength and the global efficiency significantly reduced in both patients (5.14 ±0.36,0.25 ±0.02) and their siblings (5.25 ±0.27,0.25 ±0.01) comparing to controls (5.41 ± 0.24,0.26 ± 0.01 ; F =16.55 P < 0.01),without significant difference between patients and siblings (P > 0.05).The degree in left precuneus,left anterior cingulate and right orbitofrontal gyrus was significantly lower in patients (7.42 ± 1.04,7.58 ± 1.25 and 3.72 ± 1.46)and siblings (7.51 ± 1.18,7.87 ± 1.10 and 4.42 ± 1.09) than controls (8.22 ± 1.07,8.31 ±0.99 and 4.80 ±0.92,P <0.05,FDR corrected); patients was also lower than siblings in right orhitofrontal gyrus (P < 0.05,FDR corrected).Additionally significantly reduced betweenness centrality in left precuneus,left anterior cingulate and right orbitofrontal gyrus in patients (0.31 ± 0.02,0.32 ± 0.03 and 0.25 ± 0.03) and siblings (0.31 ±0.02,0.33 ±0.02 and 0.27 ±0.03) compared to controls (0.32 ±0.02,0.34 ± 0.02and 0.28 ± 0.02,P < 0.05,FDR corrected) ; patients was also lower than siblings in right orbitofrontal gyrus (P < 0.05,FDR corrected).Conclusions These findings suggest that schizophrenia patients and their healthy siblings share the aberrant white matter network,which may be the susceptibility biological marker for schizophrenia.%目的 探讨精神分裂症患者及其未患病同胞是否存在相似的脑白质结构网络异常.方法 43例

  2. Caregiver psychoeducation for first-episode psychosis.

    LENUS (Irish Health Repository)

    McWilliams, Stephen

    2010-01-01

    International best-practice guidelines for the management of first-episode psychosis have recommended the provision of psychoeducation for multifamily groups. While there is ample evidence of their efficacy in multiepisode psychosis, there is a paucity of evidence supporting this approach specifically for first-episode psychosis. We sought to determine whether a six-week caregiver psychoeducation programme geared specifically at first-episode psychosis improves caregiver knowledge and attitudes.

  3. Deinstitutionalization revisited: a 5-year follow-up of a randomized clinical trial of hospital-based rehabilitation versus specialized assertive intervention (OPUS) versus standard treatment for patients with first-episode schizophrenia spectrum disorders

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Øhlenschlæger, Johan; Thorup, Anne Amalie Elgaard

    2010-01-01

    BACKGROUND: The effects of hospital-based rehabilitation including weekly supportive psychodynamic therapy compared with specialized assertive intervention and standard treatment has not previously been investigated in first-episode psychosis. The aim of the study was to examine long-term effect ...

  4. 家庭干预对首发精神分裂症患者预后的影响%Effect of family intervention on the prognosis of first-episode patients with schizophrenia

    Institute of Scientific and Technical Information of China (English)

    翁睿贞; 程晓雯; 江学锋; 熊祥玉; 张晨

    2013-01-01

    Objective To discuss the effect of family intervention on the prognosis of first-episode patients with schizophrenia.Methods Seventy-six first-episode schizophrenic patients were randomly assigned into two groups:the intervention group (n =38) and the control group (n =38).Both groups received drug treatment,while the intervention group had family intervention for a year as follow-up research.The Brief Psychiatric Rating Scale (BPRS) and Family Adaptability and Cohesion Scale (FACES Ⅱ-CV) were used to assess these patients at baseline before and after the intervention.Results At the end of follow-up,the total score of BPRS was (19.5 ± 7.7) and (21.8 ± 7.2) respectively in the intervention group and the control group,lower than its baseline as (34.5 ± 13.2) and (34.9 ± 14.3),but the score of anxiety and depression as well as lack of energy was better in the intervention group [(2.1 ±0.9) and (4.4 ±0.6)] than in the control group [(3.6 ± 0.8) and (7.6 ± 0.5)],and the differences were statistically significant (t =5.67,5.37,-8.9,-19.8,respectively; P < 0.01).The score of actual cohesion,ideal cohesion,actual adaptability and ideal adaptability in FACES Ⅱ-CV improved compared to the baseline in the intervention group,and the differences were statistically significant (t =-2.3,-2.8,-4.9,-4.3,respectively; P < 0.05).After the follow-up study,score of every factor was higher in the intervention group than in the control group,with statistically significant differences (t =2.2,2.6,4.0,3.8,respectively; P < 0.05).During the follow-up,the total score of BPRS was positively related to BPRS at the baseline (t =2.0,P < 0.05),and negatively related to actual cohesion at the baseline (t =-4.1,P < 0.01),actual cohesion during follow-up (t =-3.6,P < 0.01)and actual adaptability during follow-up (t =-6.6,P < 0.01).Conclusions Family intervention combined with drug treatment can improve schizophrenic patients' negative symptoms,family cohesion and

  5. Candida albicans exposures, sex specificity and cognitive deficits in schizophrenia and bipolar disorder

    Science.gov (United States)

    Severance, Emily G; Gressitt, Kristin L; Stallings, Catherine R; Katsafanas, Emily; Schweinfurth, Lucy A; Savage, Christina L; Adamos, Maria B; Sweeney, Kevin M; Origoni, Andrea E; Khushalani, Sunil; Leweke, F Markus; Dickerson, Faith B; Yolken, Robert H

    2016-01-01

    Immune aberrations in schizophrenia and bipolar disorder have led to the hypotheses that infectious agents or corresponding immune responses might contribute to psychiatric etiopathogeneses. We investigated case–control differences in exposure to the opportunistic fungal pathogen, Candida albicans, and examined associations with cognition, medication, lifestyle, and somatic conditions. We quantified C. albicans IgG antibodies in two cohorts totaling 947 individuals and evaluated odds ratios (OR) of exposure with psychiatric disorder using multivariate regressions. The case–control cohort included 261 with schizophrenia, 270 with bipolar disorder, and 277 non-psychiatric controls; the second included 139 with first-episode schizophrenia, 78 of whom were antipsychotic naive. No differences in C. albicans exposures were found until diagnostic groups were stratified by sex. In males, C. albicans seropositivity conferred increased odds for a schizophrenia diagnosis (OR 2.04–9.53, P⩽0.0001). In females, C. albicans seropositivity conferred increased odds for lower cognitive scores on Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in schizophrenia (OR 1.12, P⩽0.004), with significant decreases on memory modules for both disorders (P⩽0.0007–0.03). C. albicans IgG levels were not impacted by antipsychotic medications. Gastrointestinal (GI) disturbances were associated with elevated C. albicans in males with schizophrenia and females with bipolar disorder (P⩽0.009–0.02). C. albicans exposure was associated with homelessness in bipolar males (P⩽0.0015). In conclusion, sex-specific C. albicans immune responses were evident in psychiatric disorder subsets. Inquiry regarding C. albicans infection or symptoms may expedite amelioration of this treatable comorbid condition. Yeast exposure as a risk factor for schizophrenia and its associated cognitive and GI effects require further investigation including the possible contribution of

  6. 哌罗匹隆与利培酮治疗首发精神分裂症对照研究%A control study of perospi rone vs .risperidone in the treatment of first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    杨冬冰; 马元业; 王军

    2014-01-01

    目的:探讨哌罗匹隆与利培酮治疗首发精神分裂症患者的临床疗效和安全性。方法将70例首发精神分裂症患者随机分为两组,分别口服哌罗匹隆和利培酮治疗,观察8周。采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应。结果治疗8周末,哌罗匹隆组总有效率87.9%,利培酮组为85.3%,两组比较差异无显著性(χ2=0.10,P>0.05)。哌罗匹隆组不良反应发生率为60.0%,利培酮组为62.9%,两组比较差异无显著性(χ2=0.06,P>0.05),但哌罗匹隆组内分泌改变及体质量增加发生率显著低于利培酮组(χ2=5.08、5.08,P<0.05)。结论哌罗匹隆与利培酮治疗首发精神分裂症疗效显著,安全性高,依从性好,但哌罗匹隆较少引起内分泌改变和体质量增加,尤其适用于女性首发精神分裂症患者。%Objective To explore the efficacy and safety of perospirone and risperidone in first-episode schizophrenia (FES) .Methods Seventy FES patients were randomly divided into two groups ,they took orally perospirone and risperidone respectively for 8 weeks .Clinical efficacies were assessed with the Posi-tive and Negative Syndrome Scale (PANSS) and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results At the end of the 8th week total effective rate was respectively 87 .9% in perospi-rone and 85 .3% in risperidone group ,which showed no significant difference (χ2 =0 .10 ,P>0 .05) .Inci-dences of adverse reactions were 60 .0% in perospirone and 62 .9% in risperidone group ,which showed no significant difference (χ2 =0 .06 ,P>0 .05) ,but those of endocrine alteration and weight gain were signifi-cantly lower in perospirone than risperidone group (χ2 =5 .08 ,5 .08 ;P<0 .05) .Conclusion Perospirone has an evident effect equivalent to risperidone ,higher safety and better compliance in FES ,but the former causes

  7. Apathy in first episode psychosis patients

    DEFF Research Database (Denmark)

    Evensen, Julie; Røssberg, Jan Ivar; Barder, Helene

    2012-01-01

    Apathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10 years after the first psychotic episode remain unexplored.......Apathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10 years after the first psychotic episode remain unexplored....

  8. The comparison of impairment of cognitive function in first-episode schizophrenia, bipolar disorder and major depressive disorder%首发精神分裂症与双相障碍及抑郁障碍认知功能比较

    Institute of Scientific and Technical Information of China (English)

    陈大春; 陈科; 张荣珍; 冯薇; 高岚; 杨甫德; 张向阳

    2016-01-01

    Objective To evaluate impairment of cognitive function in first-episode schizophrenia, bipolar disor⁃der and major depressive disorder. Methods Sixty one first-episode schizophrenia patients, fifty seven bipolar disorder patients, forty eight major depressive disorder patients and fifty nine healthy controls were recruited. Cognitive function of all subjects was assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The psychiatric symptoms of schizophrenia patients and the depressive, anxiety symptoms and manic symptoms of bipolar dis⁃order patients and major depressive patients were assessed using positive and negative syndrome scale (PANSS), Hamil⁃ton depression scale (HAMD), Hamilton anxiety scale (HAMA) and Bech-Rafaelsen mania scale (BRMS), respectively. Results The total score of RBANS (F=5.18,P<0.01). and the factor scores of immediate memory (F=9.53,P<0.01), de⁃layed memory (F=3.87,P=0.01) and language function (F=9.86,P<0.01) were significantly different in four groups. Com⁃pared to healthy controls, the total score of RBANS were significantly lower in first-episode schizophrenia group and bi⁃ polar disorder group (P<0.01), and the factor scores of immediate memory, delayed memory and language function were significantly lower in first-episode schizophrenia group, bipolar disorder group and major depressive group (P<0.05). Ma⁃jor depressive group performed worse than first-episode schizophrenia group in language function factor (P<0.01). The factor score of attention in first-episode schizophrenia group was significantly lower than major depressive and control group (P<0.01). Conclusions First-episode schizophrenia, bipolar disorder and major depressive disorder are associated with significant cognitive impairments. Cognitive function impairments in the patients with first-episode schizophrenia are worse than patients with major depressive disorder, but better than patients with bipolar disorder.%目的

  9. Predictors of recovery in first episode psychosis

    DEFF Research Database (Denmark)

    Austin, Stephen F; Mors, Ole; Secher, Rikke Gry

    2013-01-01

    Recovery, the optimal goal in treatment, is the attainment of both symptomatic and functional remission over a sustained period of time. Identification of factors that promote recovery can help develop interventions that facilitate good outcomes for people with first episode psychosis.......Recovery, the optimal goal in treatment, is the attainment of both symptomatic and functional remission over a sustained period of time. Identification of factors that promote recovery can help develop interventions that facilitate good outcomes for people with first episode psychosis....

  10. Deinstitutionalization revisited: a 5-year follow-up of a randomized clinical trial of hospital-based rehabilitation versus specialized assertive intervention (OPUS) versus standard treatment for patients with first-episode schizophrenia spectrum disorders

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Øhlenschlæger, Johan; Thorup, Anne Amalie Elgaard;

    2010-01-01

    in a special part of the Copenhagen OPUS trial and randomized to either the specialized assertive intervention program (OPUS), standard treatment or hospital-based rehabilitation. RESULTS: It was a stable pattern that patients randomized to hospital-based rehabilitation spent more days in psychiatric wards......BACKGROUND: The effects of hospital-based rehabilitation including weekly supportive psychodynamic therapy compared with specialized assertive intervention and standard treatment has not previously been investigated in first-episode psychosis. The aim of the study was to examine long-term effect...... and in supported housing throughout the 5-year follow-up period compared with the two other groups. Patients in OPUS treatment spent significantly fewer days in psychiatric wards and supported housing in the first 3 years compared with patients in hospital-based rehabilitation. Due to attrition and small sample...

  11. 首发精神分裂症患者使用阿立哌唑后血清IL-2、IL-4水平变化的探讨%Explore the level changes of IL-2,IL-4 in the first-episode schizophrenia after the treatment of arip-iprazole

    Institute of Scientific and Technical Information of China (English)

    刘倩倩; 李亚飞; 朱祥路; 蒋天玉

    2014-01-01

    Objective To explore the differences of serum IL-2 ,IL-4 in the first-episode schizo-phrenia and healthy controls were explored ,and to compare the changes of symptoms before and after aripiprazole treatment and the changes of serum IL-2 ,IL-4 .Methods Serum of IL-2 ,IL-4 was exam-ined with Flow Cytometry in 35 healthy volunteers and 35 first episode patients .The symptoms of pa-tients were evaluated with Positive and Negative Syndrome Scale .Results There were no statistical sig-nificantly differents in the serum of IL-2 ,IL-4 in the first-episode schizophrenia than normal .controls (P>0 .05) .The serum levels of IL-4 was lower in patients with first-episode schizophrenia after aripi-prazole treatment (P<0 .01) .IL-2 and IL-4 levels were increased in positive symptoms of schizophre-nia patients before aripiprazole treatment (positive symptoms) than normal controls (P<0 .05) .IL-2 and IL-4 levels were different in positive symptoms of schizophrenia patients before and after aripi-prazole treatment (P<0 .05) .Conclusion The patients with schizophrenia have immune dysfunction ;Aripiprazole of antipsychotics have lowered the level of IL-2 ,IL-4 and positive symptoms also im-proved .Conclusion.%目的:探讨首发精神分裂症患者血清细胞因子IL-2、IL-4与正常人的差异,比较分析首发精神分裂症患者经过阿立哌唑治疗前后症状改变及细胞因子IL-2、IL-4的变化。方法选择35例首发精神分裂症患者作为研究组,35例健康志愿者作为对照组,通过流式细胞学技术测定血清标本中IL-2、IL-4的水平,用PANSS量表评定精神症状。结果(1)首发精神分裂症患者IL-2、IL-4水平与正常对照组相比,差异无统计学意义(P>0.05)。(2)首发精神分裂症患者阿立哌唑治疗后较治疗前IL-4水平降低,差异有统计学意义(P<0.01)。(3)首发精神分裂症阳性症状患者血清IL-2、IL-4水平在治疗前均高于对照组(P<0.05

  12. Neurocognition and occupational functioning in patients with first-episode psychosis

    DEFF Research Database (Denmark)

    Tandberg, Marte; Ueland, Torill; Sundet, Kjetil

    2011-01-01

    Neurocognitive deficits are a core feature of schizophrenia that is associated with poor occupational functioning. Few studies have investigated this relationship in patients with first-episode psychosis. The current study examined the characteristics of employed and unemployed patients with first......-episode psychosis at baseline and 2-year follow-up, and the predictive value of neurocognition on employment status. One-hundred and twenty-two first-episode psychosis patients were assessed with clinical and neurocognitive measures at baseline. Occupational status was assessed at baseline and 2-year follow...

  13. Detection of peripheral blood Reelin gene methylation in patients with first-episode schizophrenia%首发精神分裂症患者外周血Reelin基因甲基化检测

    Institute of Scientific and Technical Information of China (English)

    杨悦; 宋志伟; 韩丽; 马学华; 李秋平; 冯磊光

    2015-01-01

    目的:通过精神分裂症患者外周血中Reelin基因启动子区DNA甲基化状态的研究,探讨DNA甲基化与精神分裂症的关联。方法收集精神分裂症患者76例(患者组)和健康对照者60例(健康对照组),采用甲基化特异性PCR方法检测Reelin基因启动子区DNA甲基化状态。结果患者组甲基化阳性率为78.95%(60例),健康对照组甲基化阳性率为35%(21例),两组差异有统计学意义(χ2=4.971,P=0.026);Logistic回归分析显示, Reelin基因甲基化与精神分裂症有关(OR=13.084,95% CI:5.079~26.308)。结论 Reelin基因启动子区DNA甲基化与精神分裂症有关,精神分裂症患者外周血中Reelin基因启动子区DNA呈超甲基化状态,Reelin基因DNA甲基化是精神分裂症的危险因素。%Objective To study the relationship between DNA methylation with schizophrenia by investigating the DNA methylation status of peripheral blood Reelin gene promoter in the patients with schizophrenia .Methods The Reelin gene promoter DNA methylation was measured in 76 patients with schizophrenia(patients group) and 60 healthy controls(healthy control group) by adopting methylation‐specific PCR .Results The methylation positive rate in the patients group was 78 .95% (60 cases) ,which in the healthy control group was 35% (21 cases) ,the differ‐ence was statistically significant(χ2 =4 .971 ,P=0 .026);the Logistic regression analysis showed that the Reelin gene methylation was correlated with schizophrenia(OR=13 .084 ,95% CI:5 .079-26 .308) .Conclusion The Reelin gene promoter DNA methylation is associated with schizophrenia ,and the peripheral blood Reelin gene promoter DNA methylation presents the supermethylation status in the patients with schizophrenia .Reelin gene DNA methylation is the risk factor for schizophrenia .

  14. Subjective cognitive dysfunction in first-episode and chronic schizophrenic patients.

    Science.gov (United States)

    Moritz, S; Lambert, M; Andresen, B; Böthern, A; Naber, D; Krausz, M

    2001-01-01

    Previous studies indicate that first-episode and chronic schizophrenic patients do not differ regarding neuropsychological performance as assessed with standard cognitive tasks. For the present study, it was investigated whether first-episode and chronic schizophrenics report similar subjective cognitive deficits. The Frankfurt Complaint Questionnaire (FCQ), a scale devised for assessing subjective cognitive disturbances in schizophrenia, was administered to 20 first-episode and 36 chronic schizophrenic patients, as well as 20 healthy controls. The schizophrenic subsamples did not differ on any of the FCQ subscales or on a "lie scale," measuring illness denial. Psychopathological ratings were comparable for both groups. As expected, healthy subjects reported significantly less cognitive and perceptual problems than schizophrenic patients. In marked contrast to a Kraepelinian view of schizophrenia, the present data confirm previous studies conducted with objective neuropsychological tests that schizophrenia is a neurodevelopmental rather than a neurodegenerative disorder.

  15. Effect of ziprasidone and risperidone on the blood lipid of first-episode male patients with schizophrenia%齐拉西酮与利培酮对首发男性精神分裂症患者血脂的影响

    Institute of Scientific and Technical Information of China (English)

    张超; 张彦华

    2015-01-01

    Objective:To explore the effect of ziprasidone and risperidone on the blood lipid of first-episode male patients with schizophrenia.Methods:100 first-episode male patients with schizophrenia were randomly divided into the ziprasidone group and the risperidone group with 50 cases in each.Before treatment and at 4,8,12 weeks of treatment,the blood lipid levels of patients were compared between the two groups.Results:At 4,8,12 weeks of treatment,the ziprasidone group and the risperidone group all had effect on the each indicators of blood lipid.But with the extension of the treatment,the increased value had a downward trend, and the ziprasidone group had less increased effect,it had significant difference(P<0.05).Conclusion:The ziprasidone and risperidone all have effects on the blood lipid of first-episode patients with schizophrenia,but the effect of ziprasidone is lighter.%目的:探讨齐拉西酮与利培酮对首发男性精神分裂症患者血脂的影响。方法:将100例首发男性精神分裂症患者随机分为齐拉西酮组和利培酮组各50例。于治疗前及治疗第4、8、12周,对两组患者的血脂水平进行比较。结果:齐拉西酮组与利培酮组对血脂各项指标在治疗第4、8、12周均有影响,但是随着治疗的延长,升高的值有下降趋势,且齐拉西酮组升高值较小,差异具有统计学意义(P<0.05)。结论:齐拉西酮与利培酮对首发精神分裂症患者血脂均有影响,但齐拉西酮的影响较轻。

  16. Control study of effect and safety of olanzapine and amisulpride in the treatment of first-episode schizophrenia%奥氮平与氨磺必利治疗首发精神分裂症的效果和安全性对照研究

    Institute of Scientific and Technical Information of China (English)

    马周

    2014-01-01

    目的:探讨奥氮平与氨磺必利治疗首发精神分裂症的临床效果和安全性。方法选取2008年3月~2013年4月本院收治的的首发精神分裂症患者200例,将其随机分为实验组和对照组,每组各100例。实验组给予奥氮平治疗,对照组给予氨磺必利治疗,比较两组的治疗效果和不良反应发生情况。结果两组的治疗效果、不良反应发生情况、复发时间、持续治疗时间比较,差异无统计学意义(P>0.05)。结论奥氮平与氨磺必利治疗首发精神分裂症均可以获得满意的临床效果,不良反应较少,具有临床推广价值。%Objective To discuss the clinical effect and safety of olanzapine and amisulpride in the treatment of first-episode schizophrenia. Methods Two hundred patients with first-episode schizophrenia who accepted treatment in our hospital from March 2008 to April 2013 were selected and randomly divided into experimental group (n=100) and the control group (n=100).The experimental group was treated with olanzapine,while the control group was treated with amisulpride. The clinical effect and adverse reaction in both groups were compared. Results There was no statistical difference of therapeutic effect,adverse reaction,recurrence time and continuous curative time in the two groups (P>0.05). Conclusion Olanzapine and amisulpride can obtain a satisfied clinical effect on treating first-episode schizophre-nia with few adverse reaction,and it has clinical promotion value.

  17. 帕利哌酮缓释片和奥氮平治疗首发精神分裂症的对照研究%A control study of paliperidone extended - release tablets and olanzapine in the treatment of first - episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    毛智群; 李达; 查智群; 顾曙光; 季萍

    2011-01-01

    Objective To compare efficacy and safety of paliperidone extended -release tablets and olanzapine in the treatment of first - episode schizophrenia. Methods 90 adult patients with first - episode schizophrenia in accordance with CCMD - HI were randomized into study group treated with paliperidone extended - release tablets and control group treated with olanzapine for 8 weeks. The Positive and Nenative Syndrome Scale ( PANSS) and Treatment Emergent Side effect Scale ( TESS) were used to evaluate efficacy and side effects respectively at the baseline and at the ends of the 2nd, 4th and 8th weekends of the treatment. Results There was no significant difference in effective rate between study group and control group (91. 2% vs. 96. 5% , P >0. 05). Total score and factor scores of PANSS at each interview - point showed no significant differences between the two groups ( P > 0.05 ). The incidence rate of side effects in both groups was low and the severity was mild. Conclusion Paliperidone extended - release tablets have equivalent efficacy and safety in the treatment of first - episode schizophrenia.%目的 评价帕利哌酮缓释片和奥氮平治疗首发精神分裂症的疗效和安全性.方法 对符合CCMD -3中首发精神分裂症诊断标准的90例患者,随机分为帕利哌酮缓释片组和奥氮平组,分别治疗8周.采用阳性和阴性症状量表( PANSS)和副反应量表(TESS)评定疗效及副反应.结果 帕利哌酮缓释片组有效率为91.2%,奥氮平组有效率为96.5%,差异无统计学意义(P>0.05);两组治疗前后各时点PANSS总分及各因子分比较差异均无统计学意义(P>0.05).两组治疗中的不良反应发生率低、程度轻.结论 帕利哌酮缓释片与奥氮平治疗首发精神分裂症疗效相当,不良反应轻.两种药物均为疗效好、安全性高的抗精神病药.

  18. Comparison of Efficacy of Ziprasidone and Risperidone in Patients with First-episode Schizophrenia%齐拉西酮与利培酮对首发精神分裂症患者对照研究

    Institute of Scientific and Technical Information of China (English)

    刘娜

    2016-01-01

    目的::探讨齐拉西酮与利培酮治疗首发精神分裂症疗效及不良反应。方法:将100例首发精神分裂症患者随机分为齐拉西酮组和利培酮组各50例,分别于治疗前、治疗12周评定 PANSS 量表,评估不良反应发生率。结果:齐拉西酮组和利培酮组疗效相仿,差异无统计学意义(P >0.05)。齐拉西酮组的不良反应显著少于利培酮组,差异有统计学意义(P 0.05),which has no statis-tical significance.The adverse reactions of ziprasidone group were significantly less than that of the risperi-done group(P <0.05),which is statistically significant.Conclusion:Ziprasidone and risperidone have equal effect in the treatment of First-episode schizophreni,however,the clinical safety and adverse reactions of zi-prasidone are superior to those of the risperidone.Therefore,ziprasidone is worth widely used in the clinical practice.

  19. How successful are first episode programs?

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Rasmussen, Jesper Østrup; Melau, Marianne

    2014-01-01

    PURPOSE OF REVIEW: It has been hypothesized that the first 5 years after first episode of psychosis are a critical period with opportunities for ameliorating the course of illness. On the basis of this rationale, specialized assertive early intervention services were developed. We wanted to inves...

  20. Family Intervention in First-Episode Psychosis

    Directory of Open Access Journals (Sweden)

    Anvar Sadath

    2015-11-01

    Full Text Available Family interventions have produced benefits on clinical and family outcomes in long standing psychosis. However, little is known about the efficacy of such interventions in the early stages of psychosis. This article reviews published research over the last two decades on family intervention in first-episode psychosis. Electronic databases, such as PubMed, PsycINFO, and ScienceDirect, have been systematically searched. In addition, an exhaustive Internet search was also carried out using Google and Google Scholar to identify the potential studies that evaluated family interventions in first-episode psychosis. We have identified seven reports of five randomized controlled trials (RCTs and five non-randomized and uncontrolled studies of family intervention. Our review on 12 reports of family intervention studies has shown mixed effects on outcomes in first-episode psychosis. Most of the reports showed no added benefits or very short-term benefits on primary clinical or family outcome variables. There is a dearth of family intervention studies in first-episode psychosis. More RCTs are needed to reach reliable conclusions.

  1. Depressive symptoms in first-episode psychosis

    DEFF Research Database (Denmark)

    Sönmez, Nasrettin; Røssberg, Jan Ivar; Evensen, Julie

    2016-01-01

    AIMS: The present study examined if any patient characteristics at baseline predicted depressive symptoms at 10 years and whether patients prone to depressive symptoms in the first year of treatment had a different prognosis in the following years. METHOD: A total of 299 first-episode psychosis...

  2. 首发青少年精神分裂症心理防御机制与父母养育方式的相关性研究%A correlation study of mental defense mechanism with parental rearing pattern in adolescent patients with first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    刘军; 周云

    2012-01-01

    Objective To explore the relationship of mental defense mechanisms with parental rearing pattern in patients with first-episode adolescent schizophrenia. Methods A total of 46 adolescent patients with first-episode schizophrenia and 46 healthy controls were assessed with the Defense Style Questionnaire (DSQ) and Egma Minnen av Bardndosnauppforstran ( EMBU). Results Score of warmth and understanding in parental rearing pattern were positively related with mature defense styles ( father: r = 0. 449, P < 0. 01; mother: r = 0. 471, P < 0. 01) and were negatively related with immature defense styles (father:r= -0.312,P<0.05;mother:r = -0.349,P<0.01). Score of punishment, over interference,refusal were negatively related with mature defense styles (P<0.05) and were positively related with immature defense styles ( P < 0. 05 ). Conclusion The defense styles and parental rearing patterns in adolescent first-episode schizophrenics were different from those of healthy individuals. The defense styles in patients with first-episode schizophrenia are related with their parents' rearing patterns.%目的 探讨首发青少年精神分裂症患者的防御机制与父母养育方式的相关性.方法 采用防御方式问卷和父母养育方式评价量表,对46例首发青少年精神分裂症患者进行问卷调查,并与46例正常受试者加以比较.结果 父母亲的情感温暖理解与成熟防御方式呈正相关(父:r =0.449,P<0.01,母:r=0.471,P<0.01),与不成熟防御方式呈负相关(父:r=-0.312,P<0.05,母:r=-0.349,P<0.01);而惩罚、过分干涉保护、拒绝否认与成熟防御方式呈负相关(P<0.05或P<0.01),与不成熟防御方式呈正相关(P<0.05或P<0.01).结论 首发青少年精神分裂症的防御机制和父母养育方式与正常人有着明显的不同,且防御机制和父母养育方式之间有一定的相关性.

  3. Controlled study of mismatched negativity in first-episode deficit and non-deficit forms schizophrenia patients who not received treatment%缺陷型及非缺陷型精神分裂症首次发病未服药患者失匹配负波的对照研究

    Institute of Scientific and Technical Information of China (English)

    李喆; 邓伟; 李寅飞; 丁蕾; 刘祥; 郑重; 李涛

    2013-01-01

    Objective:To explore the characteristics of mismatched negativity (MMN) and correlation with clinical status in first-episode deficit and non-deficit forms schizophrenia patients who not received treatment.Method:According to the assessed by deficit form schizophrenia diagnosis scale (SDS),100 first-episode schizophrenia patients who not received treatment were classified as deficit form schizophrenia (DS) group (45 cases) and non-deficit form schizophrenia (NDS) group (55 cases).MMN of the patients was measured by brain evoked potentiometer,and the results were compared with 50 normal controls (control group).The relationships between MMN changes and age,course of disease,condition and functioning status of the patients were analyzed.Results:Compared to control group,MMN latency and amplitude in DS and NDS groups were significantly delayed and decreased (F =21.72,F =5.95 ; all P =0.00) ; but there were no significantly differences of MMN latency and amplitude between groups of DS and NDS(all P > 0.05).Non correlation had been found between variables of MMN latency and amplitude with age of onset,course of disease,the scores of positive and negative syndrome scale (PANSS,including total score,positive symptoms score,negative symptoms score and general psychopathology score),score of global assessment functioning(GAF) in groups of DS and NDS(all P > 0.05).Conclusion:Abnormalities of MMN are existed in patients with deficit type and nondeficit type schizophrenia.It maybe the trait marker of patients with schizophrenia.%目的:探讨缺陷型与非缺陷型精神分裂症首次发病未服药患者失匹配负波(MMN)的特征及与临床状态的相关性. 方法:根据缺陷型精神分裂症诊断量表评分将100例首发精神分裂症患者分为缺陷型(缺陷组,45例)和非缺陷型(非缺陷组,55例);采用脑诱发电位仪检测MMN,并与50名正常对照者(对照组)比较;分析患者MMN改变与其发病年龄、病

  4. Association study of brain-derived neurotrophic factor Val66Met polymorphism and clinical characteristics of first episode schizophrenia%脑源性神经营养因子Val66Met基因多态性与首发精神分裂症临床特征的关联研究

    Institute of Scientific and Technical Information of China (English)

    孙萌萌; 刘兰芬; 杨丽敏; 王妍; 崔开艳; 王丽娜; 李翠鸾; 乔冬冬; 王汝展

    2012-01-01

    Objective To assess the association between brain-derived neurotrophic factor (BDNF) gene Val66Met polymorphism and clinical characteristics of first episode schizophrenia in a Chinese Han population.Methods Genotyping of BDNF Val66Met polymorphism was carried out for 135 schizophrenic patients and 483 healthy controls with TaqMan probe technology.The patients' psychotic symptoms were assessed using the positive and negative syndrome scale (PANSS).Results A significant difference was found in genotype distribution and allelic frequency of the Val66Met polymorphism between the two groups (P<0.01).In patients,Met homozygotes had a significantly higher score in anxiety/depression factor,cognitive factor and total score of PANSS than Val carriers: Conclusion BDNF gene Val66Met polymorphism is associated with the pathogenesis of schizophrenia.The Met/Met genotype of BDNF Val66Met variant may be a risk factor for symptoms in first episode schizophrenia patients.%目的 探讨脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)基因Val66Met多态性与首发精神分裂症临床特征的关联性.方法 应用TaqMan荧光探针技术对135例首发精神分裂症患者及483名正常对照者进行基因分型;采用阳性与阴性症状量表(positive and negative syndrome scale,PANSS)评估精神分裂症患者临床特征.结果 精神分裂症患者组与正常对照组BDNF Val66Met基因型及等位基因分布频率的差异具有统计学意义(P<0.01);Met/Met基因型患者的PANSS总分、焦虑(抑郁)因子分及认知损害因子分均高于Val/Val和Val/Met基因型患者,差异有统计学意义(P<0.01).结论 BDNF基因Val66Met多态性可能与精神分裂症的发病有关;首发精神分裂症患者中Met/Met基因型者临床症状可能更重.

  5. A comparison of six kinds of antipsychotic drugs′effects on the cognitive function in patients with first-episode schizophrenia%6种抗精神病药对精神分裂症首次发病患者认知功能影响的比较

    Institute of Scientific and Technical Information of China (English)

    储文革; 陈燕; 赵宜生; 赵兵; 许志平; 邱睿; 梁涛; 程利民; 王卫民

    2015-01-01

    目的:比较利培酮、奥氮平、奎硫平、阿立哌唑、齐拉西酮、氨磺必利6种抗精神病药对急性期首发精神分裂症患者认知功能的影响。方法:120例精神分裂症首发患者分为6个药物组,每组各20例,分别给予6种抗精神病药治疗,观察12周。采用阳性和阴性症状量表( PANSS)、韦氏成人智力测验( WAIS-RC)、威斯康星卡片分类测验( WCST)、临床记忆量表( CMS)在治疗前后评估疗效及认知功能。结果:与治疗前相比,各药物组PANSS阳性症状、阴性症状及总分在治疗后各时点均明显下降(P0.05)。结论:6种新型抗精神病药均能改善首发精神分裂症患者的认知功能。%Objective:To make a comparison of the effects of the acute treatment with six kinds of antip-sychotic drugs,risperidone,olanzapine,quetiapine,aripiprazole,ziprasidone and amisulprid,on the cognitive function in patients with first-episode schizophrenia. Method:One hundred and twenty schizophrenic patients were divided into 6 groups,each group made up of 20 cases. Cases from each group receive medical treatment with one of the six antipsychotic drugs respectively and undergo the medical observation for 12 weeks. Positive and negative syndrome scale( PANSS),Wechsler adult intelligence scale-revised-China( WAIS-RC),Wisconsin card sort test(WCST)and clinical memory scale(CMS)were applied to make an assessment of the patients′therapeutic effectiveness and the improvement of cognitive function before and after the treatment. Resuits:After the treatment with different kinds of antipsychotic drugs,the PANSS positive,negative and total treatment scale scores of schizophrenia patients on each group at all time points declined obviously( P 0. 05). Conciusion:The six kinds of newly-developed antipsychotic drugs can improve the cognitive function of first-episode schizophrenia patients.

  6. Supportive Psychodynamic Psychotherapy versus Treatment as Usual for First-Episode Psychosis

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Harder, Susanne; Knudsen, Per

    2012-01-01

    for psychosis with standard treatment in patients with a first-episode schizophrenia spectrum disorder. The study was designed as a prospective, comparative, longitudinal multi-site investigation of consecutively referred patients who were included during two years. The patients were treated with either...

  7. 氨磺必利对首发精神分裂症临床疗效及糖脂代谢的影响%The influence of amisulpride on clinical efficacy and glucolipid metabolism of first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    邓良华; 许世欢; 徐健; 唐立岩

    2015-01-01

    Objective Objective To explore the influence of amisulpride on clinical efficacy and glucolipid metabolism of first‐episode schizophrenia .Methods Seventy first‐episode schizophrenics were randomly divided into two groups of 35 ones each ,research group took orally amisulpride and control group did ris‐peridone for 8 weeks .Efficacies were assessed with the Positive And Negative Syndrome Scale (PANSS) before and after treatment and adverse reactions with the Treatment Emergent Symptom Scale (TESS) , and changes of blood‐fasting sugar ,cholesterol total ,triacylglycerol ,serum insulin and body mass index (BMI) detected at the same time .Results After treatment the total and each factor scores of the PANSS of both groups significantly lowered compared with pretreatment (P 0 .05) ,but those heightened more significantly after treatment com‐pared with pretreatment in control group (P0 .05) .Conclusion Amisulpride has an evident effect in schizophrenia and less influence on glucolipid metabolism .%目的:探讨氨磺必利对首发精神分裂症患者的临床疗效及糖脂代谢的影响。方法将70例首发精神分裂症患者随机分为两组,每组35例,研究组口服氨磺必利治疗,对照组口服利培酮治疗,观察8周。于治疗前后采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应,同时检测空腹血糖、总胆固醇、三酰甘油、血清胰岛素及体质量指数的变化。结果治疗后两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降(P<0.01)。治疗8周末研究组糖脂代谢各项指标检测结果与治疗前比较均无显著变化(P>0.05),而对照组各项指标检测结果均较治疗前显著升高(P<0.05或0.01),研究组各项指标检测结果均显著低于对照组(P<0.05或 P<0.01);两组其他不良反应发生率比较差异无显著性(χ2=0.32,P>0.05)。结论氨磺必

  8. A control study of amisulpride in the treatment of female first-episode schizophrenia%氨磺必利治疗女性首发精神分裂症对照研究

    Institute of Scientific and Technical Information of China (English)

    徐东; 王秀丽; 杨靖; 万宏颖

    2015-01-01

    Objective To explore the clinical efficacy and safety of amisulpride in the treatment of female first‐episode schizophrenia .Methods Eighty‐four female first‐episode schizophrenics were randomly as‐signed to two groups of 42 ones each ,research group took orally amisulpride and control group did risperi‐done for 7 weeks .Efficacies were assessed with the Brief Psychiatric Rating Scale (BPRS) before and after treatment and adverse reactions with the Treatment Emergent Symptom Scales (TESS) .Results Since the end of the 1st week the BPRS scores of both groups lowered more significantly compared with pretreat‐ment (P0.05) .Adverse reactions of both groups were mild ,but the incidence of tremor ,akathisia and myo‐tonia as well as the increase value of body mass were significantly lower in research than control group (P<0.05) .Conclusion Amisulpride takes effect rapidly ,has an evident effect ,higher safety and less in‐fluence on body mass in female schizophrenia ,and is favorable to the improvement of compliance of female patient .%目的:探讨氨磺必利治疗女性首发精神分裂症患者的临床疗效和安全性。方法将84例首发精神分裂症患者随机分为两组,每组42例,研究组口服氨磺必利治疗,对照组口服利培酮治疗,观察7周。采用简明精神病量表评定临床疗效,副反应量表评定不良反应。结果治疗1周末起两组简明精神病量表评分均较治疗前显著下降(P<0.01),治疗7周末研究组显效率95.2%、有效率100%,对照组分别为92.9%、100%,两组比较差异无显著性( P>0.05)。两组不良反应均较轻,但研究组震颤、静坐不能、肌强直发生率及体质量增加值显著低于对照组( P<0.05)。结论氨磺必利治疗女性首发精神分裂症起效快,疗效显著,安全性高,对体质量影响较小,有利于提高女性患者的治疗依从性。

  9. 氨磺必利与阿立哌唑治疗首发精神分裂症对照研究%A controlled study of amisulpride vs aripiprazole in the first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    陆强

    2015-01-01

    Objective To explore the efficacy and safety of amisulpride and aripi‐prazole in the treatment of first‐episode schizophrenia .Methods Using randomized ,double‐blind ,double‐dummy parallel controlled method 124 first‐episode schizophrenics were assigned to two groups taking o‐rally amisulpride and aripiprazole respectively for 8 weeks .Efficacies were assessed with the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression (CGI) and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results After treatment the PANSS and CGI scores of both groups lowered more significantly compared with pretreatment (P 0 .05) .Ad‐verse reactions were mild ,there were no group significant difference in incidence of adverse reaction (P>0 .05) .Conclusion Both amisulpride and aripiprazole have an equivalent evident effect in first‐episode schizophrenia ,take effect rapidly ,and have higher safety and better compliance .%目的:探讨氨磺必利与阿立哌唑治疗首发精神分裂症的疗效及安全性。方法将124例首发精神分裂症患者按随机数字表分为两组,采用双盲、双模拟平行对照的方法分别口服氨磺必利和阿立哌唑治疗,观察8周。采用阳性与阴性症状量表、临床疗效总评量表评定临床疗效,副反应量表评定不良反应。结果治疗后两组阳性与阴性症状量表和临床疗效总评量表评分均较治疗前显著性下降( P<0.05或0.01);治疗8周末氨磺必利组显效率63.3%、总有效率88.3%,阿立哌唑组分别为64.4%、91.5%,两组比较差异无显著性(χ2=0.01、0.33,P>0.05)。不良反应均较轻微,发生率比较差异无显著性(P>0.05)。结论氨磺必利与阿立哌唑治疗首发精神分裂症疗效显著,总体疗效相当,起效快,安全性高,依从性好。

  10. Observation of early curative effect of cognitive behavior therapy combined with olanzapine on female first-episode paranoid schizophrenia%认知行为治疗对女性首发偏执型精神分裂症的早期疗效观察

    Institute of Scientific and Technical Information of China (English)

    邱玲玲; 王继丰; 吴迎春; 刘大威; 朱德超

    2014-01-01

    目的:观察认知行为治疗( CBT)对首发偏执型精神分裂症的早期疗效和预后观察。方法:选取首发偏执型精神分裂症患者60例,随机分为研究组和对照组,研究组( CBT合并奥氮平组)和对照组(奥氮平组)各30例,研究组在口服奥氮平基础上,进行为期12周的CBT治疗,随访6个月。采用阳性与阴性症状量表(PANSS)评价疗效,社会功能缺陷量表(SDSS)评定社会功能,副反应量表(TESS)评定不良反应。结果:治疗12周末及随访结束时,研究组与对照组同期对比,PANSS各项评分显著降低(P<0.05或P<0.01)。半年随访时,研究组SDSS大部分项目评分显著低于对照组(P<0.01);研究组与对照组复发率分别为23.3%和51.7%,研究组与对照组停药率分别为6.7%和31.0%,均有显著性差异(P<0.05)。结论:CBT合用奥氮平治疗首发偏执型精神分裂症,比单一药物治疗更具有优越性,近期疗效更明显,治疗依从性更好,复发率明显降低。%Objective:To observe early curative effects and prognosis of cognitive behavior therapy ( CBT ) on first-episode paranoid schizophrenia. Methods:60 cases of first episode paranoid schizophrenia were randomly divided into study group (30 cases, CBT combined with olanzapine group) and control group (30 cases, olanzapine group). The cases in study group were treated by CBT combined with olanzapine for 12 weeks whereas those in control group were only treated by olanzapine, and they were all followed up for 6 months. Positive and negative symptoms scale ( PANSS) was used to assess the efficacy, social function defect scale ( SDSS) was used to evaluate the social function, and treatment emergent symptom scale ( TESS) was used to assess the adverse reactions. Results:12 weeks after the treatment and at the end of the follow-up, the PANSS scores of study group and control group in the same period de-creased significantly (P<0. 05 or P<0. 01). When the six-month follow-up was

  11. 氨磺必利联合重复经颅磁刺激治疗首发精神分裂症的随机对照研究%Clinical controlled study on amisulpride combined with repetitive transcranial magnetic stimulation in the treatment of first - episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    焦金; 金毅琼; 马素杰; 成艳红

    2015-01-01

    Objective To investigate the clinical efficacy of amisulpride combined with Repetitive Transcranial Magnetic Stimu-lation(rTMS)for patients with first - episode schizophrenia. Methods Using random number table,88 patients of first - episode schizophrenia were randomly assigned to study group(44 cases)and control group(44 cases),the study group was treated with amisulpride combined with rTMS,and the control group was treated with amisulpride. The efficacy were assessed by Positive and Nega-tive Syndrome Scale(PANSS)before and after treatment for 2,4,6,8 weeks,and the adverse reactions were evaluated with Treatment Emergent Symptom Scale(TESS). Results After 8 weeks treatment,the scores of PANSS in both groups decreased significantly com-pared to the baseline(P 0. 05). The scores of negative symptom in study group decreased signifi-cantly compared to the control group,and there was statistically significant difference(P 0. 05). Conclusion Amisulpride combined with rTMS is as effective as amisulpride for the treatment of positive symptoms of first - episode schizophrenia patients,but it is more effec-tive than amisulpride in the treatment of the negative symptoms.%目的:探讨氨磺必利合并重复经颅磁刺激(rTMS)治疗精神分裂症的效果。方法采用随机数字表法将符合《国际疾病分类(第10版)》(ICD -10)精神分裂症诊断标准的88例首发精神分裂症患者分为研究组和对照组各44例,研究组采用氨磺必利联合重复经颅磁刺激(rTMS)治疗,对照组单用氨磺必利治疗,采用阳性与阴性症状量表(PANSS)于治疗前及治疗后第2、4、6、8周评定疗效,采用副反应量表(TESS)评定不良反应。结果经8周治疗,两组 PANSS 总评分均较治疗前低(P 均0.05)。但研究组阴性症状评分减分与对照组比较,差异有统计学意义(P 0.05)。结论氨磺必利合并 rTMS 对首发精神分裂症阳性症状的疗效与单用氨磺

  12. A comparative study of perospirone and amisulpride in the treatment of female patients with schizophrenia in first-episode%哌罗匹隆与氨磺必利治疗首发女性精神分裂症对照研究

    Institute of Scientific and Technical Information of China (English)

    陈龙涛; 曹九英; 许律琴; 谭常赞; 朱建忠; 范鲁; 娄元菊; 宋西俊; 黄秋明

    2015-01-01

    Objective To explore the efficacy of perospirone and amisulpride in treatment of female patients with schizophrenia in first-episode.Methods A total of 100 female patients with schizophrenia in first -episode were randomly divided into perospirone group with perospirone and amisulpride group with amisulpride for treatment of 8 weeks.They were assessed with positive and negative symptom scale ( PANSS) and side effects scale ( TESS) before treatment and in the 8th weekend of treatment, quality of life scale (QOL-100)in the 12th month end after treatment.Results In the 8th weekend of treatment, there was no difference in the total effective rate between perospirone group(88%) and amisulpride group(86%) ( P>0.05), but the rate of side effects in perospirone group were significantly less than those in amisulpride group(P<0.05).In the 12th month end after treatment, the total scores of QOL-100 in perospirone group were significantly more than those in amisulpride group(P <0.05).Conclusion It’ s effective for perospirone and amisulpride to treat the female patients with schizophrenia in first-episode, but perospirone is more safe and helpful to improve the quality of life in the patients.%目的:探讨哌罗匹隆与氨磺必利对首发女性精神分裂症患者的临床疗效及安全性。方法将100例首发女性精神分裂症患者随机分为哌罗匹隆组和氨磺必利组各50例,分别给予哌罗匹隆和氨磺必利治疗,分别于治疗前和治疗后第8周末应用阳性和阴性综合征量表( PANSS)及治疗中需处理的不良反应症状量表( TESS)进行评分,在治疗12个月末采用生存质量测定量表( QOL-100)量表评定患者的生活质量。结果治疗后第8周末,两组总有效率比较差异无统计学意义(P>0.05),哌罗匹隆组总不良反应发生率(22.00%)低于氨磺必利组(48.00%)(P<0.05)。治疗12个月末,哌罗匹隆组QOL-100量表总

  13. 氨磺必利对首发精神分裂症患者脑脊液和血清细胞因子的影响%Influence of Amisulpride on Cerebrospinal Fluid and Serum Cytokine LeVels in Patients with First-Episode Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    孙玉涛; 刘海军; 张学志

    2015-01-01

    目的 探讨氨磺必利对首发精神分裂症患者脑脊液和血清细胞因子水平的影响.方法 选择医院收治的首发精神病患者100例,随机分为对照组和观察组,各50例.对照组予舒必利片,观察组予氨磺必利片,均根据患者症状类型调整剂量,均治疗8周.结果 治疗后,观察组总有效率为88. 00%,明显高于对照组的74. 00%( P<0. 05);两组患者血清以及脑脊液中白细胞介素( IL ) -1β,IL-6,IL-2,肿瘤坏死因子-α( TNF-α)表达水平明显降低,且观察组降低更明显( P<0. 05);两组患者不良反应症状均较轻微,不影响治疗,但观察组不良反应总发生率明显低于对照组( P<0. 05).结论 氨磺必利治疗首发精神分裂症能显著提高临床疗效,其作用机制可能与降低患者血清、脑脊液中特定细胞因子的表达水平有关,不良反应较小,安全性高,值得推广.%Objective To discuss the influence of amisulpride on the cerebrospinal fluid and serum cytokine levels in patients with first-episode schizophrenia. Methods 100 cases of first-episode schizophrenia patients admitted to the hospital were randomly divided into control group and observation group, 50 cases in each group. The two groups were given risperidone, based on this the observation group were given amisulpride tablets orally. The dosage of the drugs were adjusted based on the type of symptoms of the patients;the two groups were treated for 8 weeks. Results The total effective rate of the observation group was 88. 00%, which was higher than 74. 00% of the control group ( P < 0. 05 );IL-1β, IL-6, IL-2, TNF-α of the two groups were significantly improved compared with before treatment, and the improvement in the observation group was more obvious than the control group ( P < 0. 05 ) . The adverse re-actions of the two groups were mild and did not affect the treatment course, but the occurrence rate of the observation group was sig-nificantly less than the control group

  14. 首发精神分裂症患者治疗前后血清脑源性神经营养因子的变化%Effects of atypical antipsychotics on first-episode antipsychotic-naïve schizophrenia:brain-derived neurotrophic factor study

    Institute of Scientific and Technical Information of China (English)

    段惠峰; 甘景梨; 连亚军; 史振娟; 高存友; 高延伦; 张毅

    2015-01-01

    Objective To evaluate the effects of 6-week atypical antipsychotics treatment on serum brain-derived neurotrophic factor (BDNF)level,and the correlation between BDNF level and clinical efficiency in first-episode antipsychotic-naïve schizophrenia.Methods We recruited 39 hospitalized patients with first-episode antipsychotic-naïve schizophrenia that met with Diagnostic and Statistical Manual of Mental Disorders—4th Edition (DSM-IV).Both Positive and Negative Syndrome Scale (PANSS)and the level of serum BDNF were measured before and after 6 weeks’treatment with atypical antipsychotics.We also studied 30 healthy controls.Serum BDNF was assayed at baseline.Results Pre-treatment BDNF level was significantly lower in the schizophrenic patients than in the controls [(6.82±2.1 5 )μg/L vs .(1 1.6 ± 3.32 )μg/L,t = 7.239,P 0.05),or duration of illness (r = - 0.058,P > 0.05 ).Changes in BDNF levels with treatment were correlated with the duration of illness (r =-0.345,P 0.05).Conclusion BDNF level is significantly lower in patients with first-episode antipsychotic-naïve schizophrenia than in normal controls.It could be improved by using antipsychotics.Higher pre-treatment BDNF level may predict better response to antipsychotics.%目的:探讨精神分裂症首发未服药患者血清脑源性神经营养因子(BDNF)的特点及其与临床疗效的关系。方法研究组39例患者,符合 DSM-Ⅳ中精神分裂症的诊断标准,首次发病未进行过药物治疗,均给予单一非典型抗精神病药物治疗6周,治疗前、治疗6周末完成阳性和阴性症状量表(PANSS)评估和 BDNF 含量测定。健康对照30例,入组时完成血清 BDNF 含量测定。结果研究组血清 BDNF 含量治疗前、后分别为(6.82±2.15)μg/L、(8.16±2.84)μg/L,治疗后高于治疗前,差异有统计学意义(t=2.349,P =0.021),但均低于对照组的(11.6±3.32)μg/L,差异有统计学意义(t=7.239,P 0.05);治疗前后的血清 BDNF 含量变

  15. Efficacy and quality of life comparative study of amisulpride and sulpride in treatment of first-episode schizophrenia%氨磺必利与舒必利治疗首发精神分裂症的疗效及生活质量对照研究

    Institute of Scientific and Technical Information of China (English)

    杨靖; 张勇; 王秀丽; 邵玉单

    2014-01-01

    目的 探讨氨磺必利与舒必利治疗精神分裂症的疗效及对其生活质量的影响.方法 将94例首发精神分裂症患者随机分为氨磺必利组和舒必利组,观察8周.分别于治疗前及治疗2、4、8周末采用阳性和阴性症状量表(PANSS)评定疗效,用治疗时出现的症状量表(TESS)评定不良反应,用生活质量综合评定问卷(GQOLI-74)于治疗前和治疗8周末评定生活质量.结果 两组PANSS分值治疗前后差异均有统计学意义(P<0.01),但两组间比较差异无统计学意义(P>0.05);两组GQOLI-74评定除物质生活维度无明显变化,总分及躯体健康维度、心理健康维度、社会功能维度均显著升高(P <0.05或<0.01),氨磺必利组优于舒必利组,差异有统计学意义(P<0.05或<0.01).结论 氨磺必利与舒必利治疗首发精神分裂症疗效相当,但氨磺必利组安全性高,依从性好,对患者的生活质量改善明显.%Objective To investigate the efficacy and of amisulpride and sulpiride on treatment of patients with first-episode schizophrenia and its effect on patients' quality of life.Methods Ninetyfour patients with first-episode schizophrenia were randomly divided into sulpride group and amisulpride group.The treatment course was 8 weeks.Treatment efficacy and tolerability was evaluated using positive and negative syndrome scale(PANSS) and the treatment emergent symptom scale (TESS) at baseline and 2,4,8 weeks after treatment,respectively.Quality of life was evaluated using generic quality of life inventory-74(GQOLI-74) before treatment and 8 weeks after treatment.Results There were signiticant differences in the scores of PANSS before and after treatment in both groups(P <0.01).But there was no significant difference in PANSS scores between the two groups after treatment(P > 0.05).There were significant differences in total score of GQOLI-74 and quality of physical health,psychological life and social function between the two

  16. 首发儿童精神分裂症患者病前行为特征与事件相关电位的关系%The relationship between event related potentials and the premorbid behavior of the first-episode child schizophrenia

    Institute of Scientific and Technical Information of China (English)

    郭芳; 郭素芹; 朱俊敬

    2014-01-01

    Objective:To study the relationship between event related potentials and the premorbid behavior of the first-episode child schizophrenia.We reviewed the behavior characteristics of the first-episode child schizophrenia when they were 6 to 11 years old,who were detected by Achenbach Child Behavior Checklist.We assessed the cognitive function of patients by the event-related potential P300.We used t test to compare the difference of each P300 data before and after the treatment between the group with the CBCL scale high achievers and low achievers.Results:The difference of social competence scores,the total score of cbcl,the score of depression factor,the score of social withdrawal factor,the score of aggressive factor of the CBCL scale between the study group and the control group were statistically significant(Z=-2.820,-2.325,-2.561,-2.837,-2.759;P<0.05).The total score of social capacity and the P300 latency before the treatment was negatively correlated(r=-0.231,P<0.05).Conclusion:There are some correlation between the social abilities and cognitive function of the first-episode child schizophrenia.The lower of social ability,the more serious damage of cognitive.%目的:研究儿童精神分裂症首发患者病前行为特征与事件相关电位的关系。方法:采用Achenbach儿童行为量表,回顾性调查儿童精神分裂症首发患者在6~11岁时的行为特征。采用事件相关电位P300对患者的认知功能进行评估。用t检验比较CBCL量表高分组与低分组患者治疗前后P300各数据间的差别。结果:研究组与对照组CBCL量表社会能力总分、行为问题总分、抑郁因子分、社会退缩因子分、攻击性因子分之间差异具有统计学意义(Z=-2.820,-2.325,-2.561,-2.837,-2.759;P<0.05),社会能力总分与治疗前 P300潜伏期呈负相关(r=-0.231, P<0.05)。结论:首发儿童精神分裂症患者病前社会能力与认知功能存在相关关系,社会能力较

  17. 首发未服药精神分裂症患者脑弥散张量成像的基于体素分析%A voxel-based diffusion tensor imaging study of first-episode medication-free patients with schizophrenia

    Institute of Scientific and Technical Information of China (English)

    魏钦令; 郑俩荣; 胡冰; 康庄; 国效锋; 胡茂荣; 韩自力

    2011-01-01

    Objective To explore the changes of white matter integrity in first-episode medication-flee patients with schizophrenia. Methods Diffusion tensor images (DTI) of whole brains of 40 first-episode medication-flee patients with schizophrenia and 68 healthy controls were acquired with a single-shot echo planar imaging (EPI) sequence aligned to the straight axial plane. Two-sample t-test by with voxel-based analysis in SPM5 software was performed on the fractional anisotropy (FA)images of the 2 groups after being preprocessed with DTI-studio and SPM5 software.Results Subjects of schizophrenia showed reduced white matter FA in these regions: the right amygdale (MNI:24, 2, -14; cluster=347 voxels), bilateral anterior cingulate (MNI: 6, 42, 2; cluster=586 voxels), right orbitofrontal (MNI: 20, 18, -10; cluster=166 voxels) as compared with healthy controls. Conclusion Abnormal white matter in the corticolimbic system circuit exists in patients with schizophrenia, which maybe involve in the neural mechanism of schizophrenia.%目的分析首发未服药精神分裂症患者脑白质完整性的变化。 方法对40例首发未服药精神分裂症患者和68例健康对照者进行脑弥散张量磁共振成像检查,以DTI-studio软件和统计参数图(SPM)软件对所得图像进行预处理,得到的各向异性分数(FA)图像在SPM软件中进行两样本t检验,获得两组患者FA值差异统计参数图。 结果在P值小于0.001(未校正)水平下,首发未服药精神分裂症患者右侧杏仁核区(MNI:24,2,-14,cluster=347 voxels)、双侧前扣带区(MNI:6,42,2,cluster=586 voxels)、右侧前额叶眶上回区域(MNI:20,18,-10,cluster= 166 voxels)白质FA值较健康对照者下降,且未发现前者有脑区白质FA值较后者增高。 结论精神分裂症患者皮层一边缘系统环路存在结构连接障碍,这可能是精神分裂症的神经机制。

  18. 首发精神分裂症患者体质量指数与脑灰质体积比率的相关性%Relationship Between Body Mass Index and Volume Ratio of Brain Gray Matter in Patients with First-episode Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    李娜; 邓伟; 何宗岭; 李名立; 黄明敏; 李涛; 邓红

    2013-01-01

    目的 分析未经治疗的首发精神分裂症患者体质量指数(body mass index,BMI)与年龄、脑体积指标、精神病性症状的相关性,以探讨首发精神分裂症的特征性BMI异常.方法 未用药首发精神分裂症患者97例及与之相匹配的健康对照97例纳入本研究.测评BMI,做磁共振扫描,评定患者的精神病性症状.结果 ①两组间BMI值、白质体积值、灰质体积值、灰质体积比率差异无统计学意义.②相关分析:健康对照组BMI与年龄呈正相关(r=0.42,P=0.001),与脑灰质体积(r=-0.33,P=0.012)及脑灰质体积比率呈负相关(r=-0.39,P=0.003),与白质体积不存在相关性.患者组上述相关性消失,且没有发现BMI与阳性与阴性症状量表总量表分或各因子分存在相关性.结论 对正常青壮年BMI的研究,发现其与年龄呈正相关,与灰质体积比率呈负相关.首发精神分裂症患者BMI与年龄和脑灰质体积比率的相关性消失,且该异常独立于临床症状存在.%Objective To analyze the relationship between psychotic symptoms and body mass index (BMI) and brain mass index in patients with first-episode schizophrenia. Methods We identified 97 patients with first-episode and drug-free schizophrenia and compared their BMI and scare MRI results with 97 healthy participants. Results There were no statistically significant differences in BMI, volume of white matter and volume of grey matter between the patients with schizophrenia and healthy participants. BMI was positively correlated with age and negatively correlated with gray matter volume and the ratio of gray matter volume in the healthy participants. No such correlations were found in the patients with schizophrenia. BMI were not correlated with the total score of PANSS, nor with the factor score of PANSS. Conclusion BMI is positive correlated with age, but negatively correlated with gray matter volume and the ratio of gray matter volume in healthy adult. But such

  19. 氨磺必利与氯氮平对首发精神分裂症患者社会功能的影响%Effects of amisulpride and clanzapine on social function of pa-tient with first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    吴国伟; 张程赪

    2014-01-01

    Objective To explore the effects of amisulpride and clanzapine on social function of patient with first-episode schizophrenia .Methods A total of 100 patients with first-episode schizophrenia were randomly divided into two groups of 50 ones each ,research group took orally amisulpride and control group did clanzapine for 12 weeks .Efficacies were assessed with the Positive and Negative Syndrome Scale (PANSS) and social functions with the Personal and Social Performance Scale (PSP) .Results After treatment total scores and each factor scores of PANSS of both groups lowered more significantly compared with pretreatment (P0 .05);After treatment the PSP total scores of both groups heightened more significantly (P<0 .01) ,so did those in research than control group (P<0 .05) .Conclusion Both amisulpride and clozapine could im-prove positive and negative symptoms of schizophrenic ,but the former has an advantage in social functions over the latter .%目的:探讨氨磺必利与氯氮平对首发精神分裂症患者社会功能的影响。方法将100例首发精神分裂症患者随机分为两组,每组50例,研究组口服氨磺必利治疗,对照组口服氯氮平治疗,观察12周。于治疗前后采用阳性与阴性症状量表评定精神症状,个人与社会功能量表评定社会功能。结果治疗后两组阳性与阴性症状量表总分及各因子分均较治疗前显著下降(P<0.01),同期两组评分比较差异无显著性(P>0.05);治疗后两组个人与社会功能量表总分均较治疗前显著升高(P<0.01),研究组较对照组升高更显著(P<0.05)。结论氨磺必利与氯氮平均能够改善精神分裂症患者的阳性、阴性症状,但氨磺必利改善患者的社会功能显著优于氯氮平。

  20. A control study of psychological traits of patients with anxie-ty,depression and first-episode schizophrenia%焦虑症抑郁症与首发精神分裂症患者心理特质对照研究

    Institute of Scientific and Technical Information of China (English)

    杨云斌; 周朝当

    2014-01-01

    Objective To explore the differences of psychological traits of patients with anxiety ,depres-sion and first-episode schizophrenia .Methods Assessments were carried out Minnesota Multiphasic Per-sonality Inventory (M M PI) in 39 anxiety and depression patients and 32 first-episode schizophrenics .Re-sults Scores of neuroticism ,paranoia and psychopathic personality scale in anxiety and depression patients were significantly higher than norm (P<0 .01) ,so was that of neuroticism than schizophrenia (P<0 .01);neuroticism scale scores of anxiety and depression patients were positively related to psychopathic personal-ity notably (P<0 .01) and negatively to paranoia (P<0 .01) .Conclusion Neuroticism of anxiety and de-pression patients is more outstanding than that of schizophrenics ,they have two different psychological traits of neuroticism-psychopathic personality and paranoia .%目的:探讨焦虑症、抑郁症患者与首发精神分裂症患者心理特质的差异性。方法对39例焦虑症、抑郁症患者及32例首发精神分裂症患者采用明尼苏达多相人格测验附加量表进行测评分析。结果焦虑症、抑郁症患者神经质、偏执及病态人格量表评分显著高于常模(P<0.01),神经质量表评分显著高于精神分裂症(P<0.01);焦虑症、抑郁症患者神经质量表评分与病态人格量表评分呈显著正相关(P<0.01),与偏执量表评分呈显著负相关(P<0.01)。结论焦虑症、抑郁症患者的神经质较精神分裂症患者突出,可能存在神经质-病态人格、偏执2种不同的心理特质。

  1. Cognitive effectiveness of risperidone and olanzapine in first-episode schizophrenia%利培酮和奥氮平对首发精神分裂症患者治疗前后认知功能的对比观察

    Institute of Scientific and Technical Information of China (English)

    赵瑾; 吕路线; 张燕; 晁阳阳; 马骏; 杨勇锋; 赵晶媛; 杜云红; 李文强; 宋学勤

    2016-01-01

    目的:观察首发精神分裂症患者部分认知功能领域损害情况以及利培酮和奥氮平对其治疗前后认知功能的潜在作用。方法选取2015年1—10月在新乡医学院第二附属医院住院治疗的57例首发精神分裂症患者和周边社区年龄、性别匹配的30名健康人(健康对照组),采用随机数字表法将患者分为2组,分别给予利培酮和奥氮平单一治疗。因不良反应难以耐受、药物疗效不佳、换用药物共脱落4例,53例患者完成研究。患者组分别于治疗前和治疗8周后评估患者临床症状(PANSS)和认知功能(连线测试、符号编码、言语记忆、工作记忆、Stroop 测试),健康对照组仅评估一次。结果 PANSS 减分率对比两组并无显著差异。治疗前,利培酮组和奥氮平组均较健康对照组表现出显著的操作速度、言语记忆(t =3.191,t =3.743)、工作记忆(t =2.151,t =2.602)和执行功能领域的差异(P <0.05);经过8周的抗精神病药物治疗,利培酮治疗组表现出连线测试(t =3.862, P <0.05)、言语记忆领域(t =-3.073,P <0.05)功能的改善,奥氮平治疗组表现出连线测试(t =3.587,P <0.05)和工作记忆(t =-2.891,P <0.05)功能的改善。抗精神病药物剂量与认知功能减分率相关分析发现利培酮服用剂量与患者连线测试减分率呈负相关(r =-0.391,P =0.048)。结论利培酮和奥氮平对首发精神分裂症患者临床症状和整体认知功能在8周内作用差异无统计学意义,首发精神分裂症患者存在显著的认知功能损害,利培酮和奥氮平能够在改善精神症状的同时一定程度上改善患者的某些认知领域损害,利培酮服用剂量越大,操作速度领域改善情况越差。%Objective To study the impairments of cognitive function in first-episode schizophrenia and the potential effectiveness of risperidone and olanzapine

  2. Longitudinal follow-up of asymmetric changes by proton magnetic resonance spectroscopy in first-episode schizophrenia patients%首发精神分裂症额叶白质和海马氢质子波谱的非对称性异常及其治疗1年后的变化

    Institute of Scientific and Technical Information of China (English)

    崔立谦; 龚启勇; 李涛; 邓伟; 蒋莉君; 黄朝华; 陈壮飞; 李名立; 王强; 王英成; 马小红

    2012-01-01

    目的 探讨首发精神分裂症患者脑代谢物非对称性的改变及其受非典型抗精神病药物治疗的影响.方法 对符合美国精神障碍诊断与统计手册第4版(Diagnostic and Statistical Manual of Mental Disorders,DSM-Ⅳ)诊断标准的21例首发精神分裂症患者和21名健康对照进行氢质子磁共振波谱扫描,并在治疗1年后对患者再次进行扫描,检测双侧额叶白质和海马的N-乙酰天门冬氨酸(N-Acetylaspartate,NAA)、胆碱(choline,Cho)和肌酸(creatine,Cr),以Cr为参照物,分别计算双侧NAA/Cr、Cho/Cr比值.在治疗前后对患者进行阳性和阴性量表(positive and negcotive symtoms scale,PANSS)、大体功能量表(global assessment function,GAF)评定.采用配对t检验进行脑代谢物非对称性分析.结果 非对称性分析发现基线期健康对照组左侧海马NAA/Cr比右侧高[(1.41±0.09)vs.(1.32±0.10),P< 0.05],首发精神分裂症组左、右侧海马代谢物比较,差异无统计学意义;而经过1年治疗后,与治疗前相比首发精神分裂症组PANSS评分显著降低(68.57±27.74vs.97.95±13.81) 、GAF量表评分显著增加(58.76±23.07vs.28.05±8.99),均P<0.05,精神分裂症组左侧海马NAA/Cr比右侧高[(1.41±0.10)vs.(1.31±0.13),P<0.05].健康对照组及首发精神分裂症组治疗前后双侧额叶白质代谢物差异均无统计学意义(P>0.05).结论 首发精神分裂症患者海马NAA/Cr的非对称性消失,经非典型抗精神病药物治疗后,在精神症状改善的同时海马NAA/Cr的非对称性恢复.%Objective To investigate asymmetric changes of the prefrontal lobes and hippocampus before and after treatment in first-episode schizophrenia patients using proton magnetic resonance spectroscopy (1H-MRS). Method 21 first-episode schizophrenia patients and 21 healthy subjects matched for age, gender, and years of education were included in the study. 'H-MRS was performed in two sides of the hippocampus and frontal lobes

  3. Apathy is associated with executive functioning in first episode psychosis

    Directory of Open Access Journals (Sweden)

    Agartz Ingrid

    2009-01-01

    Full Text Available Abstract Background The underlying nature of negative symptoms in psychosis is poorly understood. Investigation of the relationship between the different negative subsymptoms and neurocognition is one approach to understand more of the underlying nature. Apathy, one of the subsymptoms, is also a common symptom in other brain disorders. Its association with neurocognition, in particular executive functioning, is well documented in other brain disorders, but only studied in one former study of chronic patients with schizophrenia. This study investigates the association between apathy and neurocognitive functioning in patients with first episode psychosis (FEP, with the hypothesis that apathy is more associated with tests representing executive function than tests representing other neurocognitive domains. Methods Seventy-one FEP patients were assessed with an extensive neuropsychological test battery. Level of apathy was assessed with the abridged Apathy Evaluation Scale (AES-C-Apathy. Results AES-C-Apathy was only significantly associated with tests from the executive domain [Semantic fluency (r = .37, p Conclusion We replicated in FEP patients the relationship between apathy and executive functioning reported in another study for chronic patients with schizophrenia. We also found apathy in FEP to have the same relationship to executive functioning, as assessed with the Verbal fluency tests, as that reported in patients with other brain disorders, pointing to a common underlying nature of this symptom across disorders.

  4. Personality disorders in first-episode psychosis

    DEFF Research Database (Denmark)

    Simonsen, Erik; Haahr, Ulrik; Mortensen, Erik Lykke

    2008-01-01

    or more personality disorders, while one-third of the patients did not fulfil the criteria for any personality disorder. The schizoid and the avoidant were the most frequent personality disorders and both were associated with social withdrawal during childhood and adolescence. The limitation of the study......The aim of the study was to determine the prevalence of personality disorders in the early course of first-episode psychosis and their likely presence in the premorbid period. Fifty-five patients were enrolled at baseline and premorbid function was evaluated by the Premorbid Adjustment Scale....... Thirty-three of these of the patients were assessed at two-year follow-up for comorbid personality disorders by the Structured Clinical Interview for DSM-IV Personality Disorders and by the self-report instrument Millon Clinical Multiaxial Inventory-II. Half of the patients met the criteria of two...

  5. Higher Death Rate Among Youth With First Episode Psychosis

    Science.gov (United States)

    ... Releases News Release Thursday, April 6, 2017 Higher death rate among youth with first episode psychosis NIH- ... experiencing first episode psychosis have a much higher death rate than previously thought. Researchers analyzed data on ...

  6. Therapeutic effects of aripiprazole and olanzapine on the patients with first-episode acute schizophrenia and their influence on plasma prolactin level%阿立哌唑与奥氮平对首发精神分裂症 急性期疗效及对催乳素的影响

    Institute of Scientific and Technical Information of China (English)

    吴小立; 王继辉; 钟智勇; 韩自力

    2011-01-01

    AIM:To study the efficacy on first-episode acute schizophrenia treated with aripiprazole and olanzapine and the effect on plasma prolactin level. METHODS: 65 inpatients with first-episode acute schizophrenia were divided into either olanzapine group [n = 42, M21, F21; age(23. 9±6. 6)year] or aripiprazole group[(n=23, M1l, F12; age (23. 7 ± 7. 2) year] for 4 week treatment. The plasma prolactin level, the Positive and Negative Syndrome Scale (PANSS) and clinical global impressionglobal improvement (CGI-I) were measured before and after 4 week treatment. RESULTS: The score of PANSS (59 ± 13) after therapy in olanzapine group was significantly lower than that before therapy (103+15) (P 0.05) in the CGI-I score between the two groups. The difference of negative symptoms and general psychopathological sub-scale scoreschanging from base to end between the two groups was statistically significant (P<0. 01). Compared with the prolactin baseline level (547 ±382) uIu/mL,the plasma prolactin level (418 ±362) ulu/mL in olanzapine group was significantly decreased after treatment, and there was no difference. Compared with the prolactin baseline level (351 ±299) ulu/mL, the plasma prolactin level (123 ±114) ulu/mL in aripiprazole group was significantly decreased after treatment, and there was significant difference ( P < 0.01). CONCLUSION: The therapeutic effects were similar in the aripiprazole and olanzapine group for first-episode acute schizophrenia. Olanzapine is better for the general psychopathological symptoms, and aripiprazole is better for the negative symptoms. Aripiprazole maybe decrease the plasma prolactin level of first-episode acute schizophrenia.%目的:研究奥氮平和阿立哌唑对首发精神分裂症患者急性期疗效及对血中催乳素(PRI)水平的影响.方法:65例首发精神分裂症患者分为奥氮平组42例[男21例,女21例;年龄(23.9±6.6)岁]和阿立哌唑组23例[男11例,女12例;年龄(23.7±7.2)岁].分别给予奥

  7. 首发偏执型精神分裂症事件相关电位P300与记忆功能和精神病理症状关系的研究%Event-related potentials P300 with memory function and psychopathology in first-episode naranoid schizophrenia

    Institute of Scientific and Technical Information of China (English)

    刘微波; 陈巧珍; 尹厚民; 郑磊磊; 俞少华; 陈一萍; 李惠春

    2011-01-01

    Objective: To investigate the variability of event-related potentials P300 and the relationship with memory function/psychopathology in patients with first-episode paranoid schizophrenia. Methods: Thirty patients with first-episode paranoid schizophrenia ( patient group) and twenty health subjects (control group) were enrolled in the study. The auditory event-related potentials P300 at the scalp electrodes Cz, Pz and Wechsler Memory Scale ( WMS) were examined in both groups, Positive And Negative Syndrome Scale (PANSS) was evaluated in patient group. Results: In comparison with control group,patients had longer latency of P300[ (390.6 ±47.6)ms at Cz and (393.3 ±50. L)ms at Pz](P< 0. 01),lower amplitude of P300 (7.7 ±3.4)μV at Cz and (8.5 ±3.9) μV at Pz] (P <0.05 -0. 01).The memory quotient (88.1 ± 10.0) scores and short-term memory, immediate memory in patient group were damaged significantly (P < 0. 05 - 0. 01). In patient group, the latency of P300 was correlated positively with PANSS scores and negatively with WMS scores (P <0.05 -0.01). Conclusions: First -episode paranoid schizophrenia has memory deficit, which can be evaluated comprehensively by P300 and WMS. The longer latency of P300 might be associated with the increased severity of first-episode paranoid schizophrenia.%目的:探讨首发偏执型精神分裂症事件相关电位P300指标的变异情况以及与记忆功能和精神病理症状的关系.方法:对30例首发偏执型精神分裂症患者(患者组)和20例健康对照者(对照组),进行Cz(中央点)、Pz(顶叶点)电极位置的P300检测和韦氏记忆量表(WMS)测定,并应用阳性和阴性症状量表(PANSS)评定患者组的精神病理症状.结果:①患者组Cz、Pz点的P300潜伏期分别为( 390.6±47.6) ms和(393.3±50.1)ms,均较对照组延长(P<0.01),波幅分别为(7.7±3.4)μV和(8.5±3.9) μV,均较对照组降低(P<0.05—0.01);②患者组记忆商数(88.1±10.0)分及短时记忆

  8. Comparison of Short-term Metabolic Risk in First-episode Young-adult Schizophrenia Treated with Aripiprazole and Olanzapine%阿立哌唑与奥氮平对首发年轻成人精神分裂症患者短期内代谢风险的比较

    Institute of Scientific and Technical Information of China (English)

    吴小立; 魏钦令; 钟智勇; 张晋碚

    2011-01-01

    摘要:[目的]比较阿立哌唑与奥氮平对首发年轻成人精神分裂症患者短期内的代谢风险.[方法]采用开放对照的临床观察方法,对符合美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)精神分裂症诊断标准的首发住院精神分裂症患者,分别使用阿立哌唑(21例)和奥氮平(42例)治疗,自然观察时间不低于2周,不大于4周,于治疗前后各检测一次体质量、腰围、空腹血脂血糖及胰岛素、C肽.[结果]观察结束时:阿立哌唑组的体质量、体质量指数(BMI)、腰围、腰臀比均有增高(P<0.05),糖脂改变无统计学差异,男女患者间各项代谢指标的变化无统计学差异(P>0.05);奥氮平组的体质量、体质量指数(BMI)、腰围、腰臀比、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白AI和B100及脂蛋白LPa较治疗前增高(P<0.0l),且胰岛素(INS)水平和胰岛素抵抗指数(IR)增高(P<0.05),多元逐步回归分析显示胰岛素抵抗与甘油三脂的增高有关(R2 =0.107,P=0.007);奥氛平组男性患者的空腹胰岛素和C肽、胰岛素抵抗指数均增高(P<0.05),女性患者则没有.[结论]阿立哌唑和奥氮平对首发年轻成人精神分裂症患者短期内的代谢风险即有差异,性别差异可能影响着非典型抗精神病药物的代谢风险.%[Objective] To compare the short-term metabolic risk in the first-episode young-adult schizophrenia treated with Aripiprazole and Olanzapine. [ Methods] The open-lable, natural observed, compared method was designed for this study. All of these cases were diagnosed as first-episode schizophrenia in accordance with the DSM-IV diagnosis criteria and respectively allocated into two groups for either Aripiprazole or Olanzapine treatment. The natural observed period was from two weeks to four weeks. Weight, waist circumference, fasting glucose, and lipid concentration, fasting insulin and C peptide

  9. Gender differences in first episode psychosis

    DEFF Research Database (Denmark)

    Koster, A.; Lajer, M.; Lindhardt, A.

    2008-01-01

    In the description of 1 episode schizophrenia patients, female gender is associated with better social function and a higher degree of compliance, while males exhibit more negative symptoms and a higher degree of abuse. The question is raised whether gender specific differences exist which should...

  10. Prevention of negative symptom psychopathologies in first-episode schizophrenia

    DEFF Research Database (Denmark)

    Melle, Ingrid; Larsen, Tor K; Haahr, Ulrik;

    2008-01-01

    The duration of untreated psychosis (DUP)-the time from onset of psychotic symptoms to the start of adequate treatment--is consistently correlated with better course and outcome, but the mechanisms are poorly understood....

  11. 利培酮对首发精神分裂症患者血清α-肿瘤坏死因子的影响%Effect of risperidone and chlorpromazine on plasma level of TNF-α in patients with first-episode schizophrenia.

    Institute of Scientific and Technical Information of China (English)

    田博; 陆晓姿

    2011-01-01

    目的 探讨抗精神病药物对首发精神分裂症患者血清α-肿瘤坏死因子(TNF -α)的影响,并探讨TNF -α与精神病理之间的关系.方法 90例首发精神分裂症患者随机分为利培酮组(45例)和氯丙嗪组(45例),进行8周治疗,采用酶联免疫吸附法对治疗前后α-肿瘤坏死因子(TNF-α)进行检测,以40例健康志愿者为对照.同时采用阳性和阴性症状量表(PANSS)评估患者精神症状及其变化.结果 精神分裂症患者治疗前TNF -α水平显著高于对照组(t=3.08,P<0.01),治疗后4周末及8周末与对照组比较均无显著性差异(t=0.11,0.52,P>0.05),均较治疗前显著降低(P <0.05,P<0.01).治疗前及治疗后4周末血清TNF -α水平与对应PANSS总分及各因子分无显著相关(P>0.05),治疗后8周末TNF -α与阳性症状分及总分呈正相关.利培酮组患者TNF -α水平治疗后4周末无显著变化,治疗后8周末显著低于治疗前(P<0.05);氯丙嗪组患者治疗后4周末及8周末均显著低于治疗前(P<0.01).治疗后4周末血清TNF -a变化率与氯丙嗪日剂量呈显著正相关(P<0.05),利培酮日剂量与TNF -α变化率无相关,8周末两药日剂量与TNF - α变化率均无相关.结论 抗精神病药物对首发精神分裂症患者血TNF -α有抑制作用,血清TNF -α水平与精神病理之间有着一定关系.%Objective To explore the effect of antipsychotic drugs on plasma level of tumor necrosis factor-α (TNF-α ) in patients with first - episode schizophrenia, and to explore the relationship between TNF-a and the psychopathology of schizophrenia. Methods 90 patients with first - episode schizophrenia were randomized into risperidone group (45 cases) and chlorpromazine group (45 cases) treated with risperidone or chlorpromazine respectively for 8 weeks. Plasma level of TNF-a of patients was measured with ELISA at baseline and endpoint of the treatment, then was compared with that of 40 healthy volunteers

  12. Clinical Efficacy of Risperidone and Olanzapine in the Treatment of first Episode Schizophrenia%利培酮与奥氮平治疗首发精神分裂症患者的临床疗效与安全性

    Institute of Scientific and Technical Information of China (English)

    任丽

    2015-01-01

    Objective To investigate the effect of risperidone and olanzapine in the treatment of first-episode clinical eficacy and safety in patients with schizophrenia.Methods Methods 68 patients with first episode schizophrenia were randomly divided into risperidone group in 34 cases and 34 cases of olanzapine group, risperidone group were treated with oral risperidone treatment,olanzapine group were treated with oral olanzapine treatment,after 8 weeks of treatment with PANSS reduction rate of curative effect evaluation.Results Risperidone group of patients,the total effective rate was 94.1%(32/34),olanzapine group of patients,the total effective rate was 91.2%(31/34),the difference between the two groups had no statistical significance(P>0.05).Olanzapine group drowsiness,dry mouth and body mass increase adverse effects than risperidone group,risperidone group akathisia, insomnia and headache adverse reactions than olanzapine group(P<0.05).Conclusion Equivalent efficacy of olanzapine and risperidone on schizophrenia,but the adverse reactions of two different,clinicians should take according to the regimen of according to the clinical characteristics of the patients with.%目的:探讨利培酮与奥氮平治疗首发精神分裂症患者的临床疗效与安全性。方法将68例首发精神分裂症患者随机分为利培酮组34例及奥氮平组34例,利培酮组患者给予口服利培酮进行治疗,奥氮平组患者给予口服奥氮平进行治疗,治疗8周后采用阳性和阴性症状量表(PANSS)减分率评估疗效。结果利培酮组患者总有效率为94.1%(32/34),奥氮平组患者总有效率为91.2%(31/34),两组比较差异无统计学意义(P>0.05)。奥氮平组嗜睡、口干和体质量增加不良反应多于利培酮组,利培酮组静坐不能、失眠和头痛不良反应多于奥氮平组(P<0.05)。结论奥氮平与利培酮对首发精神分裂症的疗效相当,但二者不良反应不同,临床

  13. 五种常用二代抗精神病药物对首发精神分裂症患者泌乳素的近期影响%The short term effects of five second-generation antipsychotics on serum prolactin in the first-episode schizophrenia patients

    Institute of Scientific and Technical Information of China (English)

    王厚亮; 赵靖平; 韩洪赢; 温盛霖; 张俊成

    2015-01-01

    目的:探讨目前临床常用的5种二代抗精神病药物对首发精神分裂症患者血清泌乳素(prolactin, PRL)水平的近期影响。方法250例首发精神分裂症患者随机分为5组,分别采用利培酮、奥氮平、帕利哌酮、喹硫平、齐拉西酮治疗6周,检测基线(入组时)和治疗每周末血清泌乳素水平,并在基线和治疗第6周末采用阳性与阴性症状量表(positive and negative symptom scale,PANSS)和副反应量表(treatment emergent symptom scale,TESS)评估各药物疗效与安全性。结果患者泌乳素水平经重复测量方差分析示,时间因素主效应、分组因素主效应和时间与分组的交互效应均具有统计学意义(均P0.05)。结论抗精神病药物治疗使患者泌乳素水平逐渐增高;不同二代抗精神病药物对泌乳素的近期影响不同,利培酮和奥氮平在治疗早期就能明显升高泌乳素水平。%Objective To explore the short term effects of five second-generation antipsychotics on the serum pro⁃lactin levels of first-episode schizophrenia patients. Methods Two hundred fifty first-episode schizophrenia patients were randomly divided into five groups and were then treated with risperidone, olanzapine, paliperidone, quetiapine or ziprasidone, respectively. The serum prolactin were tested at baseline, and every week following initiation of treatment. The positive and negative symptom scale (PANSS) and the treatment emergent symptom scale (TESS) were used to evalu⁃ate the effect and side effect of treatment. Results Repeated measure ANOVA for serum prolactin showed that the main effects of time, the main effect of group, and the interactive effect of time and group were significant (all P0.05). Conclusion The level of serum prolactin gradually increases in schizophrenia patients receiving treatment of antipsychotics. The short term effects of different second generation antipsy⁃chotics on serum prolactin

  14. The comparative study of cognitive functions between familial and sporadic patients with first-episode schizophrenia%首发家族性和散发性精神分裂症患者认知功能的对照研究

    Institute of Scientific and Technical Information of China (English)

    王梅; 李寅飞; 雷威; 韩媛媛; 邓红; 邓伟; 李涛; 李名立; 李娜; 林鄞; 任虹燕; 黄朝华

    2014-01-01

    目的:探讨首发家族性与散发性精神分裂症患者的认知功能差异。方法纳入首发精神分裂症患者127例,其中家族性患者40例,散发性患者87例;同时纳入96名正常对照。采用修订的韦氏成人智力测验中部分量表对所有受试者进行认知功能评估,阳性与阴性症状量表(positive and negative syndrome scale , PANSS)评定患者症状的严重程度,并分析认知功能与精神症状的相关性。结果家族性组与散发性组患者PANSS总分[(91.51±14.07)vs.(87.23±16.37)]、阳性症状分[(25.89±6.70)vs.(23.72±6.04)]、阴性症状分[(18.19±6.43)vs.(19.07±8.01)]差异无统计学意义(P>0.05);两患者组全智商量表分、言语智商量表分和操作智商量表分均低于对照组(均P0.05)。结论首发精神分裂患者在发病初期认知功能即存在显著损害,散发性患者在智力方面受损较重,其受损程度与临床症状严重程度相关,而家族性患者智力的损害则独立于临床症状。%Objective To investigate the difference in cognitive functions between first-episode schizophrenia pa-tients with and without family history. Methods One hundred twenty-seven patients with first-episode schizophrenia were recruited, including 40 patients with family history and 87 sporadic patients. Ninety-six matched normal subjects served as controls. Seven subscales of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) were used to assess the cognitive functions of all subjects. Positive and Negative Symptom Scale (PANSS) was used to assess patients ’ symptoms. The relationship between clinical symptoms and cognitive deficits was analyzed. Results There was no signifi-cant difference in the PANSS scores between familial patients and sporadic patients [(91.51±14.07) vs. (87.23±16.37), P>0.05]. The scores of full intelligence quotient (IQ), verbal IQ and operation IQ were lower in patient

  15. 健康管理随访对门诊首发精神分裂症患者服药依从性及复发的影响%Influence of the health management follow-up visits on medication compliance and the recurrence in the first-episode schizophrenia outpatients

    Institute of Scientific and Technical Information of China (English)

    陈姬; 韦娟娟; 张毅

    2015-01-01

    目的:了解门诊首发精神分裂症患者实施健康管理随访干预对服药依从性及复发的影响。方法对136例经精神科门诊规范治疗后稳定的首发精神分裂症患者,随机分为研究组(68例)及对照组(68例),对照组进行常规门诊随访;研究组在此基础上实施健康管理随访干预。两组进行为期1年的随访,分别于入组时、24周、52周进行简明精神病量表(BPRS)、服药依从性量表(MARS)、疾病复发的评定,并分析影响服药依从性的相关因素。结果研究组患者在24周、52周M A RS量表评分为(8.98±1.80)分,(7.02±1.90)分,明显高于对照组且差异有统计学意义( P<0.01);52周时研究组复发率为22.05%,对照组复发率为51.47%,两组比较差异有统计学意义(P<0.01);Logistic回归分析结果显示服药依从性与健康教育、服药次数、自知力、BPRS量表分值等因素有相关性。结论通过对门诊首发精神分裂症患者实施健康管理随访,能够提高患者服药依从性,降低疾病复发风险。%Objective To investigate the influence of the health management follow -up visits on the medication compliance and the recurrence of the outpatients with first-episode schizophrenia .Meth‐ods One hundred and thirty -six outpatients with first -episode schizophrenia with a steady condition after a regular therapy were randomly chosen ,and divided into the intervene group(68 patients) and the control group (68 patients) .The patients in the control group were treated in a regular way ;while those in the intervene group had health management follow -up visits as well as the regular treatment .After a one-year research ,both groups were evaluated with BPRS ,MARS and recurrence at the beginning ,at the end of six months and at the end of twelve months of the study .And the relevant factors of the medi‐cation compliance were analyzed

  16. 首发精神分裂症治疗前后血清 NGF、BDNF、GFAP与临床症状的相关性研究%Correlation between pre-and post-treatment serum levels of NGF,BDNF,GFAP and severity of clinical symptoms in ;patients with first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    牛莉莉; 温科奇; 熊鹏; 曾勇; 徐飞; 李明; 黄晓江

    2015-01-01

    Objective To explore the changes of serum levels of Nerve Growth Factor (NGF),Brain-Derived Neurotrophic Factor (BDNF),Glial Fibrillary Acidic Protein (GFAP)in patients with first-episode schizophrenia,and to explore the correlation with severity of clinical symptoms pre-and post-treatment.Methods Serum levels of NGF,BDNF and GFAP were measured by using ELISA in 50 patients with first-episode schizophrenia (study group)and 78 healthy controls (control group), and were re-measured in subjects in study group after 3-month risperidone treatment.All patients in study group were assessed with Positive and Negative Syndrome Scale(PANSS)at baseline and at the end of the 3-month treatment to evaluate the severity of clinical symptoms.Results The pre-treatment serum level of GFAP in study group was significantly higher than that in control group (P <0.01),pre-treatment serum levels of NGF and BDNF in study group were significantly lower than those in control group (P <0.01).Serum levels of the 3 protein factors at the end of the treatment in study group were significantly lower than those at the baseline (P <0.05).Total score of PANSS and factor scores of positive symptoms,negative symptoms and general psychopathology at endpoint in study group were significantly lower than those at baseline (P <0.01).In study group,the pre-treatment serum level of NGF and GFAP were significantly positively correlated with factor score of negative symptoms of PNASS (P <0.05 ).The post-treatment NGF level was significantly negatively correlated with factor score of negative symptoms of PNASS (P =0.000 ).Post -treatment BDNF level was significantly positively correlated with factor score of general psychopathology (P =0.002),while post-treatment GFAP level was significantly negatively correlated with it (P =0.024). Conclusion Serum levels of NGF,BDNF and GFAP change with the improvement of clinical symptoms in patients with first-episode schizophrenia.NGF,BDNF and GFAP may be involved into

  17. Childhood trauma and cognitive function in first-episode affective and non-affective psychosis.

    LENUS (Irish Health Repository)

    Aas, Monica

    2011-06-01

    A history of childhood trauma is reportedly more prevalent in people suffering from psychosis than in the general population. Childhood trauma has also been linked to cognitive abnormalities in adulthood, and cognitive abnormalities, in turn, are one of the key clinical features of psychosis. Therefore, this study investigated whether there was a relationship between childhood trauma and cognitive function in patients with first-episode psychosis. The potential impact of diagnosis (schizophrenia or affective psychosis) and gender on this association was also examined.

  18. Comparison of processing speed efficacy first - episode schizophrenia between three atypical antipsychotics%比较3种非典型抗精神病药对精神分裂症首次发作患者处理速度测验的影响

    Institute of Scientific and Technical Information of China (English)

    杨绪娜; 朱峰; 李乐华

    2012-01-01

    Objective To compare the efficacy of olanzapine,risperidone and aripiprazole on processing speed in patients with first-episode schizophrenia. Methods 91 first-episode patients with schizophrenia were randomized to olanzapine group (n = 27) ,risperidone group (n = 37) and aripiprazole group (n =21). All subjects were assessed with Positive and Negative Syndrome Scale (PANSS) ,Groove Pegboard Test (GPT) ,Trail Making Test (TMT) ,Stroop Color Word Test,Symbol Coding Test (SCT) ,Category Fluency Test (CFT). Results (1) Compared with the baseline,all the scores of PANSS decreased significantly (P 0. 05). (2) Compared with the baseline,the scores of Processing Speed improved significantly (P <0. 05 ~0. 001) in the olanzapine group including Handedness,Line Test A,Color Line Test 1 and 2 and Stroop Test B. The change was found in the risperidone group including Line test A,Color line test 1 and 2,Stroop test C and digit symbolic coding. In the aripiprazole group,only the score of Color line test 2 improved significantly ( P < 0. 05 ). Conclusions The improvement on processing speed of olanzapine and risperidone would be probably better than aripiprazole.%目的 比较奥氮平、利培酮和阿立哌唑三种非典型抗精神病药对精神分裂症首次发作患者处理速度测验成绩的影响.方法 91例精神分裂症首发患者随机分配至阿立哌唑组(n=27)、利培酮组(n=37)和奥氮平组(n=27),在治疗前和治疗12周末完成如下测验:阳性与阴性症状量表、沟槽钉板测验、连线测验、Stroop色词测验、数字符号编码测验和范畴流利测验.结果 (1)治疗12周后,三组PANSS评分均较治疗前显著降低(P <0.001),三组间PANSS减分率的差异无统计学显著性;(2)奥氮平组治疗后的利手、连线A、颜色连线1、颜色连线2以及Stroop测验B得分均较治疗前显著改善(P <0.05 ~0.001);利培酮组治疗后的连线A、颜色连线1、颜色连线2、Stroop测验C以及数字符号

  19. The applied research of strengths model of case management in patients with first-episode schizophrenia%个案管理优势模式在首发精神分裂症患者康复护理中的应用研究

    Institute of Scientific and Technical Information of China (English)

    陈锦成; 黎彩萍

    2015-01-01

    ObjectiveTo understand the impact of the advantages of strengths model of case management for patients with first-episode schizophrenia. Methods A medication compliance questionnaire, social disability screening schedule(SDSS) and world health organization quality of life summary table(WHOQOL-BREF) were preformed to compare the two groups of patients.Results The medication compliance of the study group was higher (P<0.05), SDSS score was lower(P<0.05), and the quality of life of the study group was higher than the control group(P<0.05).ConclusionThe strengths model of case management will help patient to adherence to treatment, maintain social function of patients and improve their quality of life.%目的:了解个案管理优势模式对首发精神分裂症患者影响。方法采用自制服药依从性调查表、社会功能缺陷筛选量表(SDSS)、世界卫生组织生活质量简表(WHOQOL-BREF),对两组患者进行测评。结果研究组患者的服药依从性更高(P<0.05),SDSS评分更低(P<0.05),在生活质量的各个评分中均显著高于对照组患者(P<0.05)。结论引进个案管理优势模式有利于改善患者对治疗的依从性,保持患者的社会功能和提高其生活质量。

  20. 全病程医疗服务模式对军队首发精神分裂症患者2年疗效随访%Follow-up study on two-year curative effects of whole-course medical management model on military patients with first episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    胡光涛; 宋航; 王国威; 陈许波; 贺英

    2013-01-01

    目的 研究全病程医疗服务模式对军队精神分裂症患者长期疗效、服药依从性和社会功能的影响.方法 126例军队首发精神分裂症患者随机分配至全病程医疗服务模式组(实验组)63例,传统医疗服务模式组(对照组)63例,随访研究2年.在基线,入组后第4、8 w入组后第3、6、12、18、24个月时进行疗效和社会功能评定.疗效评定主要指标为阳性与阴性症状量表(PANSS)评分、持续治疗时间,次要指标为停药率、复发率,社会功能评定采用社会功能缺陷筛选量表(SDSS).结果 组间疗效平行对照,2组在基线及入组后第4 w时PANSS总分无显著性差异(P>0.05);入组第8 w起,实验组PANSS总分显著低于对照组;组内疗效前后对照,第12、18、24个月PANSS总分与第3个月比较,实验组有显著性差异(P<0.05),对照组差异无显著性(P>0.05).入组后第6、12、18、24个月,实验组SDSS评分显著低于对照组(P<0.05或P<0.01);实验组1年内停药率及复发率均显著低于对照组(P<0.05),停药前持续治疗时间(TTD)显著高于对照组(t=2.93,P<0.01).结论 "全病程医疗服务模式"能有效提高军队首发精神分裂症患者的疗效和依从性,改善预后,值得推广.%Objective To study the effects of the whole course medical management model on the long term curative effect, medication compliance, and social function of military patients with first episode schizophrenia. Methods 126 military patients with first episode schizophrenia were randomly divided into whole course medical management model group( experimental group,63 cases ) and traditional medical management model group( control group,63 cases ). The follow - up was carried out for 2 years. The curative effects and social function were evaluated at the beginning,4,8 w,3,6,12,18,24 months after the grouping. The key indicators of curative effect evaluation included positive and negative syndrome scale( PANSS )scoring

  1. 奥氮平对首次发病精神分裂症患者肝脏脂肪含量的影响%Effects of olanzapine treatment upon liver fat content in first-episode schizophrenia patients: a preliminary study

    Institute of Scientific and Technical Information of China (English)

    陈方斌; 陈琪; 潘园园; 孙剑; 徐乐平; 王焕林

    2014-01-01

    目的 观察奥氮平对首次发病精神分裂症患者肝脏脂肪含量(liver fat content,LFC)的影响.方法 首次发病精神分裂症25例患者(患者组)接受奥氮平单药治疗,剂量为10~ 20 mg/d,疗程8周.患者组分别于治疗前、治疗后(第8周末),采用质子磁共振波谱分析测定LFC,并与25名健康人(对照组)进行比较;患者组另予测定人体学指标[体质量指数(body mass index,BMI)、腰围/身高比(waist-height ratio,WHR)]、血清代谢指标(空腹血糖、甘油三酯、胆固醇)及稳态模型评估的胰岛素抵抗指数(homeostasis model assessment of insulin resistance,HOMA-IR).结果 (1)治疗后患者组LFC较治疗前增高(分别为4.99%±1.79%、3.98%±0.83%,=2.958,P <0.01),并高于对照组(4.02%±0.80%,t=2.436,P<0.05),差异有统计学意义;(2)治疗后患者组BMI、WHR、甘油三酯、胆固醇、HOMA-IR较治疗前增高;(3)治疗前患者组LFC值与HOMA-IR、BMI、WHR、甘油三酯呈正相关(r=0.447、0.424、0.421、0.413,均P<0.05);治疗后LFC值与HOMA-IR、甘油三酯呈正相关(r=0.425、0.400,均P<0.05);治疗前后LFC变化值与HOMA-IR、WHR变化值呈正相关(r=0.478,P<0.01;r =0.430,P <0.05);(4)治疗后患者组有4例(4/25,16%)LFC高于脂肪肝诊断临界值(LFC>5.5%).结论 奥氮平治疗可能增加精神分裂症患者肝脏的脂肪沉积.%Objective To observe the effects of olanzapine treatment upon liver tat content (LFC)in first-episode schizophrenia patients.Methods A total of 25 first-episode schizophrenia patients were administered olanzapine alone with dosage ranging from 10 to 20 mg per day for eight weeks.1H-magnetic resonance spectroscopy (1H-MRS) was used for LFC measurements before and after eight-week olanzapine treatment.The results were compared with those of the normal control group (n =25).Other indicators,including body mass index (BMI),waist-height ratio (WHR),fasting plasma glucose (FPG),triglyceride (TG

  2. Increased serum S100B protein in the first-episode medication-free patients with schizophrenia%首发未服药精神分裂症患者血清S100B蛋白浓度变化

    Institute of Scientific and Technical Information of China (English)

    韩笑乐; 谭云龙; 杨甫德; 王志仁; 李英丽; 陈松; 王玥婵; 邹义壮; 周东丰

    2009-01-01

    Objective To investigate the correlation of the serum S100B protein levels with psychopathological symptoms in first-episode medication-free patients with schizophrenia. Methods The serum S100B protein levels in 64 first-episode medication-free schizophrenic patients (schizophrenic group) and 66 healthy volunteers (control group) were examined by enzyme-linked immuno-sorbent assay (ELSIA). Psychopathological symptoms were assessed by using the Positive and Negative Symptom Scale(PANSS) , the relationship of the serum S100B levels and the PANSS scores were analyzed in schizophrenic group. Results ①The serum S100B levels in schizophrenic group(0.27±0.13)μg/L were significantly higher than those of the control group(0.11±0.04) μg/L(P <0.001) ; ②Significant differences were found among four sub-groups in schizophrenics(F=4.63, P=0.006) , the serum S100B levels of the patients with residential sub-type were significantly higher than those of the patients with paranoid(P=0.001) and disorganized(P=0.012) ; Moreover, the serum S100B levels four sub-types group were significantly higher than those of the control group(P<0.001) ③The serum S100B levels markedly correlated with age, ill duration and negative and total score of the PANSS(all P <0.005)in schizophrenic group. Conclusions The serum S100B protein levels in first-episode medication-free patients with schizophrenia are increased, and correlated with psychopathological symptoms which indicate that serum S100B protein level might reflect the severity of schizophrenia in some degree.%目的 探讨血清S100B蛋白浓度与首发未服用抗精神病药的精神分裂症患者精神病理症状间的关系.方法 采用酶联免疫(ELISA)方法 检测64例首发未服用抗精神病药精神分裂症患者和66名正常对照的血清S100B蛋白浓度,比较2组间的差异;采用阳性和阴性症状量表(PANSS)评定精神病理症状,分析血清S100B蛋白浓度与PANSS评分、患者年龄、发病

  3. 利培酮、奥氮平、喹硫平对首发精神分裂症患者认知功能和社会功能的影响%Influence of three antipsychotics on cognitive function and social functioning in patients with first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    宁布; 许明智; 林勇强; 全东明; 林海程; 冯梅珍; 刘武汉; 贾福军

    2009-01-01

    Objective To compare the influence of risperidone,olanzapine and quetiapine on cognitive function and social functioning in patients with first-episode schizophrenia. Methods Total of 61 patients diag-nosed with first-episode schizophrenia were evaluated on efficacy, social functioning and cognitive function in 6 weeks,and 42 healthy controls were given a same cognitive function assessment. Results Mean doses were 4.2 mg/d, 18.6 mg/d,and 561.3 mg/d for risperidone,olanzapine,and quetiapine respectively. The mean change from baseline to end point in PANSS and PSP total score in three groups were 19.7±20.2,20.2±21.0,15.8±19.4 and 7.8±16.3,8.2±15.2,6.8±14.8 respectively. Significant improvements from baseline to end point were observed on the CGI-S scale in the three treatment groups (P<0.05). All the patients before treatment compare with normal controled group in cognitive function measurement such as WCST,TMT and WMS,were sig-nificant differences (P<0.05). Executive function and memory after treatment had not improved in risperidone and quetiapine group, while three indices of WCST has improved in olanzapine group (P<0.05) ,rate of motion percep-tion,attention and capacity of concept conversion had be improved in all groups (P<0.05). The most frequently adverse events reported in Risperidone group was EPS which were mild in severity,in olanzapine and quetiapine group,the most frequently adverse events were somnolence. Conclusion Risperidone,olanzapine and quetiapine can improve part of cognitive function and social functioning in patients with first-episode schizophrenia, and the effects of them were similar.%目的 比较利培酮、奥氮平、喹硫平对首发精神分裂症患者认知功能和社会功能的影响.方法 对61例确诊为首发精神分裂症的患者进行为期6周的研究,评定认知功能和评定社会功能及疗效评定,并以42名健康人群进行对照.结果 利培酮组、奥氮平组和喹硫平,平均日剂量分别为4

  4. 汉族女性精神分裂症首发患者利培酮治疗所致闭经的危险因素%Risk factors for medication-induced amenorrhea in first-episode female Chinese patients with schizophrenia treated with risperidone

    Institute of Scientific and Technical Information of China (English)

    陈海支; 任丽华; 沈仲夏; 钱敏才; 沈鑫华; 杨胜良; 杨剑虹; 宋娟芬; 费小聪; 陶百平; 宋宝华

    2013-01-01

    Background:Amenorrhea is a common adverse effect of treatment with antipsychotic medications that influences both fertility and adherence to medication regimens. Most research suggests that medication-induced prolactinemia is the main cause of amenorrhea but few prospective studies have assessed this hypothesis. Aim:Identify risk factors for amenorrhea following treatment with antipsychotic medication. Methods:The study used a prospective, nested case-control design. First-episode, drug naïve female patients with schizophrenia who were in the middle of their menstrual cycle at the time of admission were enrolled. Serum levels of six reproductive hormones were assessed before and after a 12-week course of treatment with risperidone:progesterone, estradiol, prolactin, follicular stimulating hormone, luteinizing hormone, and testosterone. The hormone levels of 31 patients who had no menstruation during the entire 12 weeks of treatment (the amenorrhea group) were compared to those of 31 age-matched subjects who had normal menstrual periods over the 12 weeks of treatment (the control group). Results:We found a dramatic 4-fold increase in prolactin levels in women of childbearing age treated with risperidone, but the pretreatment and posttreatment levels of prolactin were not different between patients who did and did not develop amenorrhea with treatment. However, there were significantly lower pretreatment levels of estradiol and progesterone in patients who subsequently developed amenorrhea with risperidone treatment than in patients who did not develop amenorrhea. A conditional logistic regression analysis found that pretreatment levels of estradiol remained significantly associated with the development of amenorrhea during treatment even when adjusting for the pretreatment levels of the other five reproductive hormones assessed. Conclusion:These findings do not support the suggestion that amenorrhea associated with the use of antipsychotic medication is the result

  5. The study of the association of impairment of cognition and performance-based skills with clinical symp- toms in drug-naïve first-episode schizophrenia patients%首发未用药精神分裂症认知功能及生活技能与临床特征的关系

    Institute of Scientific and Technical Information of China (English)

    陈大春; 杨可冰; 李艳丽; 王宁; 聂鹰; 崔界峰; 陈楠; 张向阳

    2015-01-01

    Objective To evaluate cognitive impairment and performance-based skills and to explore their rela⁃tionships with clinical phenotypes in drug-naïve first-episode patients with schizophrenia. Methods One hundred and forty-five inpatients and 65 healthy controls matched for age, gender and education were recruited. The MATRICS Con⁃sensus Cognitive Battery (MCCB), Stroop, digit span test, emotional recognition test, University of California, San Diego, Performance-based Skill Assessment (UPSA) and Positive Negative Syndrome Scale scale (PANSS) were used to evaluate cognitive function, life skill and symptoms, respectively. Results Compared with the controls, total score of MCCB and scores of 10 subscales, scores of digit span, emotional recognition and Stroop were significantly lower in patients (all P<0.05). The UPSA total score and scores of financial skill and communication skill were lower in patients than in controls (all P<0.05). Verbal memory, visual memory , Stroop, communication skill scores and total UPSA standard score were sig⁃nificantly higher in patients with paranoid subtype of schizophrenia than in patients with non-paranoid subtype of schizo⁃ phrenia (all P<0.05). The score of MCCB associated with education years (OR=1.29, 95%CI: 1.13~1.47) and PANSS (OR=0.95, 95%CI:0.92~0.97). Conclusions First-episode, drug-naive patients with schizophrenia have markedly cog⁃nitive and performance-based skills deficits, which are associated with clinical symptoms. These deficits are differences between paranoid subtype and non-paranoid subtype of schizophrenia.%目的:探讨首发未用药精神分裂症患者认知功能、生活技能状况及其与临床特征的关系。方法纳入首发精神分裂症住院患者145例和65名正常对照,采用精神分裂症认知功能成套测验中文版(MATRICS consensus cognitive battery,MCCB)、Stroop色词测验等评估两组认知功能,加州大学圣地亚哥分校基于任

  6. 氨磺必利与丁二酸洛沙平治疗首发精神分裂症对照研究%A control study of amisulpride vs . loxapin succinate in the treatment of first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    王华永; 王刚平

    2014-01-01

    Objective To explore the efficacy and safety of amisulpride vs .loxapin succinate in the treat-ment of first-episode schizophrenia .Methods Sixty-five first-episode schizophrenics were randomly as-signed to two groups took orally amisulpride or loxapin succinate for 6 weeks .Before and after treatment efficacies were assessed with the Positive and Negative Syndrome Scale (PANSS ) and adverse reactions with the Treatment Emergent Symptom Scale (TESS) .Results After treatment the total scores of the PANSS of both groups lowered continuously compared with pretreatment (P0 .05) .Adverse reactions of both groups were mild ,tremor incidence was significantly lower in research than control group (χ2 =4 .04 ,P0 .05) . Conclusion Amisulpride has an efficacy equivalent to loxapin succinate ,but the former has higher safety and better compliance .%目的:探讨氨磺必利与丁二酸洛沙平治疗首发精神分裂症患者的临床疗效和安全性。方法将65例首发精神分裂症患者随机分为两组,分别口服氨磺必利与丁二酸洛沙平治疗,观察6周。治疗前后采用阳性与阴性症状量表评定临床疗效,副反应量表评定不良反应。结果治疗后两组阳性与阴性症状量表总分均较治疗前呈持续性下降(P<0.01);治疗6周末研究组显效率80.0%、有效率93.3%,对照组分别为76.7%、90.0%,两组比较差异无显著性( P>0.05)。两组不良反应均较轻,研究组震颤发生率显著低于对照组(χ2=4.04,P<0.05),其他不良反应与对照组比较差异无显著性(P>0.05)。结论氨磺必利与丁二酸洛沙平治疗首发精神分裂症疗效显著且相当,但氨磺必利安全性更高,依从性更好。

  7. Supportive psychodynamic psychotherapy versus treatment as usual for first-episode psychosis: two-year outcome.

    Science.gov (United States)

    Rosenbaum, Bent; Harder, Susanne; Knudsen, Per; Køster, Anne; Lindhardt, Anne; Lajer, Matilde; Valbak, Kristian; Winther, Gerda

    2012-01-01

    During recent decades, the field of treatment of schizophrenia has lacked empirical, systematic outcome studies that support psychodynamic psychotherapy as an evidence-based intervention for patients with schizophrenia. The Danish schizophrenia project (DNS) compared psychodynamic psychotherapy for psychosis with standard treatment in patients with a first-episode schizophrenia spectrum disorder. The study was designed as a prospective, comparative, longitudinal multi-site investigation of consecutively referred patients who were included during two years. The patients were treated with either manualized individual supportive psychodynamic psychotherapy (SPP) in addition to treatment as usual or with treatment as usual alone (TaU). Symptoms and functional outcomes were measured using the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning scale (GAF). The study included 269 consecutively admitted patients, age 18-35, of whom 79% remained in the study after two years. The intervention group improved significantly on measures of both PANSS and GAF scores, with large effect sizes at two years follow-up after inclusion. Further, improvement on GAF(function) (p = 0.000) and GAF(symptom) (p = 0.010) significantly favored SPP in combination with TaU over TaU alone. In spite of limitations, this study speaks in favor of including supportive psychodynamic psychotherapy in the treatment for patients with schizophrenic first-episode psychoses.

  8. Effects of amisulpride and quetiapine on serum sex hormone,bone mineral density and body weight in female patients ;with first-episode schizophrenia%氨磺必利和喹硫平对首发女性精神分裂症性激素、骨密度及体质量的影响

    Institute of Scientific and Technical Information of China (English)

    亓高超

    2016-01-01

    Objective To explore the effects of amisulpride and quetiapine on serum sex hormone,bone mineral density and body weight in female patients with first-episode schizophrenia.Methods A total of 96 female patients with first-episode schizophrenia were randomly divided into amisulpride group(n=46)and quetiapine group(n=50)for treatment of 12 months. They were examined with serum prolactin,estradiol,progesterone,bone mineral density and Body Mass Index (BMI)before and at the 6th,12th month end of treatment.Results At the 6th and 12th month end of treatment,the level of prolactin in amisulpride group was significantly higher than that before treatment (P<0.05 )and the levels of estradiol and progesterone in amisulpride group were significantly lower than those before treatment(P<0.05).At the 6th and 12th month end of treatment,the level of prolactin in amisulpride group was significantly higher than that in quetiapine group and the level of estradiol in amisulpride group was significantly lower than that in quetiapine group(P<0.05).At the 6th and 12th month end of treatment,the Body Mass Index (BMI)in two groups were all significantly higher than those before treatment(P<0.05).At the 12th month end of treatment, the level of bone mineral density in amisulpride group was significantly lower than that before treatment(P<0.05)and that in quetiapine group (P<0.05).At the 12th month end of treatment,the change rate of bone mineral density in amisulpride group was negatively related to the change rate of prolactin(P<0.05 ),and was positively related to the change rate of estradiol and BMI(P<0.05).At the 12th month end of treatment,the change rate of bone mineral density in quetiapine group was positively related to the change rate of BMI (P<0.05 ).Conclusion Amisulpride can significantly influence the level of serum sex hormone,bone mineral density and body weight in female patients with schizophrenia.%目的:探讨氨磺必利和喹硫平对首发女性精神分裂症患

  9. 家庭综合因素与首发精神分裂症患者出院后病情变化关系的临床分析%Clinical analysis of the effect of family factors on the recurrence of patients with first episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    徐良雄; 高卉; 曾德志; 黄翠萍

    2015-01-01

    Objective To explore the effect of family factors on the recurrence of patients with first episode schizophrenia. Meth-ods 100 patients with schizophrenia who were treated by hospitalization were evaluated with Positive and Negative Syndrome Scale (PANSS)every 3 months after discharge. The patientsˊ families were evaluated with Family Assessment Device(FAD)and Family Environment Scale - Chinese Version(FES - CV)at 1 years after discharge. Results 100 patients were discharged from the hospital after 35 cases of recurrence,the recurrence rate was 35% . The conflict and control scores of FES - CV families in recurrent group were significantly higher than those in stable group(t = 3. 236,2. 364,P < 0. 01),but the emotional expression,intimacy,independence, success and entertainment were lower than those of stable group(t = - 3. 452 ~ - 3. 126,P < 0. 05 or 0. 01). FAD problem solving, communication,emotional reaction,emotional involvement,and total score of 5 components were higher than that of stable group(t =2. 321 ~ 3. 231,P < 0. 05 or 0. 01). Conclusion Family comprehensive factors are associated with recurrence in the first episode of schizophrenia patients,a good family environment(such as family members of intimacy,entertainment,control,etc. )and family functions(such as emotional involvement,behavior control level,emotional reaction)can reduce recurrence,so that patients can re-turn to society well.%目的:探讨家庭综合因素与首发精神分裂症患者出院后病情变化的关系。方法纳入100例经住院治疗后痊愈的首发精神分裂症患者,在出院后以每3个月为1周期采用阳性与阴性症状量表(PANSS)进行测评,了解其1年内病情变化,采用家庭环境量表中文版(FES - CV)和家庭功能评定量表(FAD)在患者出院后1年末对其家属进行测评,比较病情复发组与病情稳定组的评分情况。结果100例患者出院后有35例复发,复发率为35%。复发组 FES - CV

  10. Reduced prefrontal activation during tower of London (TOL) in first-episode schizophrenia: a multi-channel near-infrared spectroscopy study%首发精神分裂症患者伦敦塔测试的近红外光谱成像研究

    Institute of Scientific and Technical Information of China (English)

    刘璇; 祝晔; 王惠玲; 戴力; 蒋田仔; 方悦; 胡汉彬; 王高华; 王晓萍

    2010-01-01

    Objective To investigate the executive function of the patients with first-episode schizophrenia,and their relationships with the positive and negative symptoms. And to evaluate the activation characteristics of prefrontal cortex(PFC) in the schizophrenia. Methods Near-infrared spectroscopy(NIRS) was used to assess the activation of the bilateral PFCs during the computerized version of Tower of London(TOL) tasks in schizophrenia and controls. The Positive and Negative Syndrome Scale(PANSS) was used to assess the psychiatric symptoms of the schizophrenia. 40 schizophrenic patients and 40 age- and gender-matched healthy subjects participated in this study. Results ( 1 ) The number of correct TOL responses in patients ( one-move ( 7.35 ± 1. 94 ), two-move ( 7.30 ± 2.53 ), three-move ( 6.58 ± 2.53 ), four-move ( 2.90 ± 1.89 ) ) was significantly less than the healthy controls( one-move (8.82 ± 1.48 ), two-move ( 8.38 ± 1.59 ), three-move ( 7.68 ± 1.47 ), four-move ( 3.73 ±1.71 ); P<0. 05 ). ( 2 ) There was a significant negative correlation between the patients' task performance and the negative symptom scores(P < 0.05 ). (3) The majority of the prefrontal area was activated in health subjects.Patients were characterized by significant decreased activation in the left PFC during the TOL task compared to healthy subjects. Conclusion Schizophrenic patients have executive function disorder at the initial stage of the disease.The results support that schizophrenia patients have hypofrontality ,and executive function is significantly negatively correlated with negative symptoms. NIRS my be a useful tool for research and clinical assessment for major psychoses.%目的 了解首发精神分裂症患者的执行功能,及其与阴阳性症状之间的关系,探讨患者前额叶激活状态的特点.方法 采用电子版伦敦塔(TOL)测试对40名首发精神分裂症患者和40名健康对照进行测试并记录正确回答数,在测试同时使用近红外光

  11. Prospective study of the course of delusional themes in first-episode non-affective psychosis

    DEFF Research Database (Denmark)

    Ellersgaard, Ditte; Mors, Ole; Thorup, Anne;

    2014-01-01

    AIM: The stability of delusional themes in psychotic disorders is only sparsely lit. The study aims to investigate the stability of delusional themes over a period of time in patients with first-episode non-affective psychosis. METHODS: The data were drawn from a randomized controlled trial of 547...... principal component analysis to the patients' scores on 12 items of delusions from the Scale for the Assessment of Positive Symptoms in Schizophrenia, SAPS. The course of the patients' predominant delusional themes was analysed afterwards. RESULTS: The 12 delusional themes from SAPS were converted into five...... at baseline. CONCLUSIONS: The predominant delusional theme at the time of first treatment contact was seen to be only of some predictive value to the predominant delusional theme at the later follow-up points in patients with first-episode non-affective psychosis. This stresses the importance of a systematic...

  12. Association between polymorphisms of rs194072,rs187269 in GABRB2 gene and first-episode schizophrenia and the efficacy of risperidone%GABRB2基因 rs194072和 rs187269位点遗传多态性与首发精神分裂症及利培酮疗效的关联性研究

    Institute of Scientific and Technical Information of China (English)

    刘延辉; 寇海燕; 王福华; 田博; 张心华

    2015-01-01

    Objective To explore the association between polymorphisms of Gamma-aminobutyric acid receptor subunit beta-2 (GABRB2 ) gene and first-episode schizophrenia,as well as the association with efficacy of risperidone.Methods Polymorphisms of rs194072 and rs187269 in GABRB2 gene was genotyped by using a SYBR Green based real time PCR assay in 277 schizophrenic patients (study group)and 315 healthy controls (control group).Patients in study group were treated with risperidone for 8 weeks and were assessed with Positive and negative Syndrome Scale (PANSS)at baseline and at the end of the treatment.Results There were significant differences in genotypic frequency and allelic frequency of rs194072 (χ2 =7.93,8.64 respectively;P =0.02,0.003 respectively)and rs187269 (χ2 =9.79,8.23 respectively;P =0.008,0.004 respectively) between study group and control group.The haplotype frequency of CC in study group was significantly higher than that in control group (P =0.003)and the haplotype frequency of TT in study group was significantly lower than that in control group (P =0.004).There were significant differences in distribution of genotypes and alleles of rs187269 between patients response to risperidone and patients invalid to risperidone (P =0.003,0.004 respectively).Conclusion The polymorphisms of rs194072 and rs187269 in GABRB2 gene are likely associated with the pathogenesis of schizophrenia and polymorphism of rs187269 is likely associated with the efficacy of risperidone.%目的:探讨γ-氨基丁酸β2受体(GABRB2)基因多态性与首发精神分裂症及其利培酮疗效的相关性。方法采用 SYBR Green I 荧光等位基因特异性实时 PCR 基因分型法完成277例精神分裂症患者(研究组)和315例正常对照者(对照组)的 GABRB2基因 rs194072和 rs187269两个位点多态性的测定。研究组采用利培酮治疗8周,于治疗前及治疗后第8周末用阳性和阴性综合征量表(PANSS)评估疗效。结果两组 rs

  13. Depression and quality of life in first-episode psychosis.

    LENUS (Irish Health Repository)

    Renwick, Laoise

    2012-07-01

    Quality of life (QOL) has gained recognition as a valid measure of outcome in first-episode psychosis (FEP). This study aimed to determine the influence of specific groups of depressive symptoms on separate domains of subjectively appraised QOL.

  14. First episode psychosis and psychological development in young adulthood

    OpenAIRE

    McEachran, Andrea Karen

    2006-01-01

    Despite the consistent emergence of a psychotic illness during late adolescence and young adulthood, attempts to understand first episode psychosis and psychological disturbances and needs have historically neglected this rich developmental context. When present, disturbances in a young adults' psychological functioning are likely to interfere with the successful negotiation of age-appropriate tasks and complicate the recovery process following a first episode of psychosis. The current study ...

  15. Reducing the duration of untreated first-episode psychosis

    DEFF Research Database (Denmark)

    Melle, Ingrid; Larsen, Tor K; Haahr, Ulrik

    2004-01-01

    Most studies on first-episode psychosis show an association between a long duration of untreated psychosis (DUP) and poorer short-term outcome, but the mechanisms of this relationship are poorly understood.......Most studies on first-episode psychosis show an association between a long duration of untreated psychosis (DUP) and poorer short-term outcome, but the mechanisms of this relationship are poorly understood....

  16. Are depot as effective as oral antipsychotics on first-episode psychosis?

    Science.gov (United States)

    Orus, Cristián; Aceituno, David

    2016-05-23

    Depot antipsychotics have been generally used in patients with chronic schizophrenia with adherence problems to oral therapy. However, it has been suggested they can be a good alternative in earlier stages too. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified three systematic reviews including two pertinent randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded it is not clear whether there are differences between depot and oral antipsychotics in first-episode psychosis because the certainty of the available evidence is very low.

  17. The abnormalities of regional homogeneity in the resting-state of first-episode medication-na(i)ve schizophrenia%首次发病未服药精神分裂症患者静息态脑功能活动局部一致性分析

    Institute of Scientific and Technical Information of China (English)

    何宗岭; 李名立; 邓伟; 王强; 李寅飞; 陈壮飞; 韩媛媛; 蒋莉君; 李涛

    2014-01-01

    目的 探讨精神分裂症患者在静息状态下脑活动局部一致性(ReHo)特点.方法 对104例首次发病未服药精神分裂症患者(病例组)和104名健康对照者(对照组)进行静息态脑fMRI扫描,利用ReHo的方法分析数据并进行组间比较.采用偏相关分析功能活动异常脑区ReHo值与PANSS各因子间的相关性.结果 与对照组相比,病例组ReHo降低的区域位于右侧前额叶眶额皮质(ReHo值:0.7±0.1,t=-3.502,P<0.05)及背外侧皮质(ReHo值:1.0±0.1,t=-4.613,P<0.05)、左侧前额叶眶额皮质(ReHo值:0.8±0.1,t=-4.778,P<0.05)、后扣带回/楔前叶(ReHo值:1.2±0.1,t=-3.838,P<0.05)、右侧顶下小叶(ReHo值:1.1±0.1,t=-4.275,P<0.05)和右侧中央后回(ReHo值:0.9±0.1,t=-3.520,P<0.05).ReHo增高的区域位于左侧小脑前叶(ReHo值:1.1±0.1,=4.081,P<0.05)和后叶(ReHo值:1.0±0.1,t=3.660,P<0.05)、右侧小脑后叶(ReHo值:0.8±0.1,t=3.359,P<0.05)、以舌回为中心的左侧枕叶(ReHo值:0.7±0.1,t =3.986,P<0.05)和右侧枕叶(ReHo值:1.1±0.1,t=3.362,P<0.05),左侧颞上回/颞中回(ReHo值:1.1±0.1,=3.708,P <0.05)、左侧壳核/豆状核(ReHo值:1.0±0.1,t=4.457,P<0.05).病例组右侧中央后回ReHo与阴性症状因子(r=-0.262,P<0.01)、瓦解性症状因子(r=-0.219,P<0.01)相关,右侧前额叶眶额皮质的ReHo与退缩性因子相关(r=-0.242,P <0.01).结论 精神分裂症患者静息状态下的脑功能活动ReHo异常广泛分布,功能活动异常的脑区大多位于功能网络的节点脑区,可能与精神分裂症的病理机制有关.%Objective To explore the regional homogeneity (ReHo) of resting state brain activity in schizophrenia by using functional magnetic resonance imaging (fMRI).Methods One hundred and four first-episode treatment-naive schizophrenia (FES) patients,and 104 age/gender/education-matched healthy controls were examined by fMRI scans.ReHo of the resting-state brain activity was compared between the two

  18. The economic cost of pathways to care in first episode psychosis.

    LENUS (Irish Health Repository)

    Heslin, Margaret

    2011-01-01

    Few studies have examined the economic cost of psychoses other than schizophrenia and there have been no studies of the economic cost of pathways to care in patients with their first episode of psychosis. The aims of this study were to explore the economic cost of pathways to care in patients with a first episode of psychosis and to examine variation in costs. Data on pathways to care for first episode psychosis patients referred to specialist mental health services in south-east London and Nottingham between 1997-2000. Costs of pathway events were estimated and compared between diagnostic groups. The average costs for patients in south-east London were £54 (CI £33-£75) higher, compared to patients in Nottingham. Across both centres unemployed patients had £25 (CI £7-£43) higher average costs compared to employed patients. Higher costs were associated with being unemployed and living in south-east London and these differences could not be accounted for by any single factor. This should be considered when the National Health Service (NHS) is making decisions about funding.

  19. Retrospective study on structural neuroimaging in first-episode psychosis

    Directory of Open Access Journals (Sweden)

    Ricardo Coentre

    2016-05-01

    Full Text Available Background. No consensus between guidelines exists regarding neuroimaging in first-episode psychosis. The purpose of this study is to assess anomalies found in structural neuroimaging exams (brain computed tomography (CT and magnetic resonance imaging (MRI in the initial medical work-up of patients presenting first-episode psychosis. Methods. The study subjects were 32 patients aged 18–48 years (mean age: 29.6 years, consecutively admitted with first-episode psychosis diagnosis. Socio-demographic and clinical data and neuroimaging exams (CT and MRI were retrospectively studied. Diagnostic assessments were made using the Operational Criteria Checklist +. Neuroimaging images (CT and MRI and respective reports were analysed by an experienced consultant psychiatrist. Results. None of the patients had abnormalities in neuroimaging exams responsible for psychotic symptoms. Thirty-seven percent of patients had incidental brain findings not causally related to the psychosis (brain atrophy, arachnoid cyst, asymmetric lateral ventricles, dilated lateral ventricles, plagiocephaly and falx cerebri calcification. No further medical referral was needed for any of these patients. No significant differences regarding gender, age, diagnosis, duration of untreated psychosis, in-stay and cannabis use were found between patients who had neuroimaging abnormalities versus those without. Discussion. This study suggests that structural neuroimaging exams reveal scarce abnormalities in young patients with first-episode psychosis. Structural neuroimaging is especially useful in first-episode psychosis patients with neurological symptoms, atypical clinical picture and old age.

  20. Prevalence of item level negative symptoms in first episode psychosis diagnoses.

    LENUS (Irish Health Repository)

    Lyne, John

    2012-03-01

    The relevance of negative symptoms across the diagnostic spectrum of the psychoses remains uncertain. The purpose of this study was to report on prevalence of item and subscale level negative symptoms across the first episode psychosis (FEP) diagnostic spectrum in an epidemiological sample, and to ascertain whether items and subscales were more prevalent in a schizophrenia spectrum diagnoses group compared to an \\'all other psychotic diagnoses\\' group. We measured negative symptoms in 330 patients presenting with FEP using the Scale for Assessment of Negative Symptoms (SANS), and ascertained diagnosis using the Structured Clinical Interview for DSM IV. Prevalence of SANS items and subscales were tabulated across all psychotic diagnoses, and logistic regression analysis determined which items and subscales were predictive of schizophrenia spectrum diagnoses. SANS items were most prevalent in schizophrenia spectrum conditions but frequently presented in other FEP diagnoses, particularly substance induced psychotic disorder and Major Depressive Disorder. Brief psychotic disorder and bipolar disorders had low levels of negative symptoms. SANS items and subscales which significantly predicted schizophrenia spectrum diagnoses, were also frequently present in some of the other psychotic diagnoses. Conclusions: SANS items have high prevalence in FEP, and while commonest in schizophrenia spectrum conditions are not restricted to this diagnostic subgroup.

  1. Patient satisfaction with treatment in first-episode psychosis

    DEFF Research Database (Denmark)

    Haahr, Ulrik; Simonsen, Erik; Røssberg, Jan Ivar

    2012-01-01

    Purpose: To examine first-episode psychotic patients' satisfaction with elements of a comprehensive 2-year treatment program. Subjects and method: The TIPS (Early Treatment and Intervention in Psychosis) project provided a 2-year treatment program consisting of milieu therapy (inpatient), individ......Purpose: To examine first-episode psychotic patients' satisfaction with elements of a comprehensive 2-year treatment program. Subjects and method: The TIPS (Early Treatment and Intervention in Psychosis) project provided a 2-year treatment program consisting of milieu therapy (inpatient...... in satisfaction for specific interventions. In this sample of first-episode psychosis patients, there was general satisfaction with treatments based on one-to-one relationships while multi-family group intervention was consistently valued less enthusiastically....

  2. 氨磺必利与奥氮平治疗首发男性精神分裂症的疗效及对糖脂代谢的影响%Efficacy of Amisulpride,Olanzapine on First-episode Male Patients with Schizophrenia and Glucolipid Metabolism

    Institute of Scientific and Technical Information of China (English)

    凌仲民

    2015-01-01

    Objective:To explore the effect of amisulpride,olanzapine on first-episode male patients with schizophrenia and glucolipid metabolism.Methods:The first 64 cases of male patients with schizo-phrenia were randomly divided into amisulpride and olanzapine group.Before treatment,2,4,6,8 week-end,using the PANSS assessment of psychiatric symptoms,while collecting the data of fasting blood col-lected fasting blood glucose(FBS),total cholesterol(TC),high density lipoprotein(HDL),triglycerides (TG),low density lipoprotein(LDL).Results:61 cases were completed in 8 weeks.At 2nd weekend, olanzapine group's PANSS positive factor scored below the amisulpride group(16.19 ±4.51、19.10 ± 5.68,t=2.216,P=0.031).At 4th,6th,8th weekend,amisulpride group's PANSS negative factor scored below the olanzapine group(P<0.05).To the end of the study,there were no significance between the two groups in total psychopathology scores.Olanzapine group had higher TG in the first two weekends( P<0.05) and higher FBS, TC,TG at 4th weekend than the amisulpride group ( P <0.05 ) .Olanzapine group had higher FBS,TC,TG than before treatment whereas,there were no difference in FBS,TC,TG be-tween after and before treatment in amisulpride group .Conclusion:Olanzapine and amisulpride have the similar effect.Olanzapine has better effect on acute positive symptoms and amisulpride is suited for nega -tive symptoms and have less influence on glucolipid metabolism.%目的:对比氨磺必利、奥氮平对首发男性精神分裂症患者的疗效特点和对糖脂代谢的影响。方法:将64例首发男性精神分裂症患者采用随机分组方法,分为氨磺必利治疗组和奥氮平治疗组,于治疗前,治疗第2、4、6、8周末,使用PANSS量表对精神症状评定,同时采空腹血测定空腹血糖(FBS),总胆固醇(TC),高密度脂蛋白( HDL),三酰甘油( TG),低密度脂蛋白( LDL)。结果:8周末实际完成61例,第2周末奥氮平组PANSS

  3. The Phenomenology of Emotion Experience in First-Episode Psychosis

    DEFF Research Database (Denmark)

    Vodušek, V V; Parnas, J; Tomori, M

    2014-01-01

    BACKGROUND: Although it has been suggested that disturbances in emotion experience and regulation play a central role in the aetiology and psychopathology of schizophrenia spectrum disorders, the phenomenology of emotion experience in schizophrenia remains under-researched. SAMPLING AND METHODS: ...

  4. Substance abuse in first-episode non-affective psychosis

    DEFF Research Database (Denmark)

    Larsen, Tor K; Melle, Ingrid; Auestad, Bjørn

    2006-01-01

    Abuse of alcohol and drugs is an important and clinically challenging aspect of first-episode psychosis. Only a few studies have been carried out on large-sized and reliably characterized samples. These are reviewed, and the results are compared with a sample of 300 first-episode psychosis patients...... recruited for the TIPS (Early Treatment and Identification of Psychosis) study from Norway and Denmark. Prevalence rates from the literature vary from 6% to 44% for drugs and 3% to 35% for alcohol. In our sample, 23% abused drugs and 15% abused alcohol during the last 6 months. When compared to non-abusers......, the drug-abusing group is characterized by the following: male gender, younger age, better premorbid social, poor premorbid academic functioning, and more contact with friends in the last year before onset. Alcohol abusers were the oldest group and they had the least contact with friends. A group...

  5. Positive and negative caregiver experiences in first-episode psychosis

    DEFF Research Database (Denmark)

    Jansen, Jens Einar; Lysaker, Paul H.; Harder, Susanne

    2014-01-01

    Objectives While caregivers of persons with first-episode psychosis often report a range of negative experiences, little is known about what psychological factors are involved. The aim of this study was to examine how caregivers' general wellbeing, emotional overinvolvement and metacognition...... influenced their reports of both positive and negative caregiving experiences. Design A prospective consecutive cross-sectional study. Methods Forty caregivers of patients with first-episode psychosis were interviewed using semi-structured interview and questionnaires. Results Greater levels of distress...... metacognitive capacity does not necessarily alleviate the suffering and distress, which is a healthy and normal reaction to having a close one suffering from psychosis. But it might help broaden the perspective, allowing for both negative and positive experiences. Clinical implications in terms of expanding...

  6. Service engagement in first episode psychosis: clinical and premorbid correlates.

    Science.gov (United States)

    Macbeth, Angus; Gumley, Andrew; Schwannauer, Matthias; Fisher, Rebecca

    2013-05-01

    Engagement can be understood as a multifactorial process, incorporating acceptance of treatment, therapeutic rapport, and collaboration in a shared goal of clinical and functional recovery. Difficulties in engagement with clinical services represent a risk factor for treatment discontinuation in first episode psychosis. The current study explored the associations between engagement, clinical, and preonset variables. We report the cross-sectional data on a Scottish sample with first episode psychosis, characterized in terms of psychotic symptoms, premorbid adjustment, duration of untreated psychosis, and clinician-rated engagement. Poorer clinician-rated engagement was associated with greater positive and negative symptoms, greater general psychopathology, and poorer premorbid social adjustment. In a regression analysis, only severity of negative symptoms predicted engagement. The study highlights the role of negative symptoms and impairments in social functioning as factors associated with poorer engagement with clinical services. The value of detailed assessment of social and premorbid functioning is highlighted.

  7. Der er forandringer i hjernens ledningsbaner ved skizofreni

    DEFF Research Database (Denmark)

    Ebdrup, Bjørn H; Skovgaard, Nana; Raghava, Jayachandra M;

    2014-01-01

    Schizophrenia is a brain disorder characterized by fundamental changes in thinking and beliefs. Alterations in white matter integrity may underlie the characteristic psychotic symptoms. This review focuses on diffusion tensor imaging studies in schizophrenia patients. Overall, schizophrenia appears...... to be associated with white matter deficits particularly in the fronto-temporal connections. To dissect potential medication effects from myelination deficits related to symptoms, longitudinal studies in initially antipsychotic-naive first-episode patients with schizophrenia are needed....

  8. Emotional perception and theory of mind in first episode psychosis: the role of obsessive-compulsive symptomatology.

    Science.gov (United States)

    Ntouros, Evangelos; Bozikas, Vasilios P; Andreou, Christina; Kourbetis, Dimitris; Lavrentiadis, Grigoris; Garyfallos, George

    2014-12-15

    The aim of the present study was to investigate the effects of comorbid obsessive-compulsive symptoms on emotional perception and theory of mind (ToM) in patients with first-episode psychosis. Participants were 65 patients with non-affective first episode psychosis (FEP) and 47 healthy controls. The patient group was divided into two subgroups, those with (FEP+; n=38) and those without obsessive-compulsive symptomatology (FEP-; n=27). Emotion perception and ToM were assessed with the Perception of Social Inference Test. Severity of psychotic and obsessive-compulsive symptoms was assessed with the Positive and Negative Syndrome Scale (PANSS) and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), respectively. Deficits in emotion recognition and theory of mind were confirmed in patients with non-affective first-episode psychosis compared to healthy controls. In patients, comorbidity with obsessive-compulsive symptoms was associated with worse performance on certain aspects of social cognition (ToM 2nd order) compared to FEP- patients. Our findings of impaired emotion perception and ToM in patients with first-episode psychosis support the hypothesis that deficits are already present at illness onset. Presence of OCS appears to have further deleterious effects on social cognition, suggesting that these patients may belong to a schizo-obsessive subtype of schizophrenia characterized by more extensive neurobiological impairment.

  9. Metacognition, social cognition, and symptoms in patients with first episode and prolonged psychoses.

    Science.gov (United States)

    Vohs, J L; Lysaker, P H; Francis, M M; Hamm, J; Buck, K D; Olesek, K; Outcalt, J; Dimaggio, G; Leonhardt, B; Liffick, E; Mehdiyoun, N; Breier, A

    2014-03-01

    While it has been documented that persons with prolonged schizophrenia have deficits in metacognition and social cognition, it is less clear whether these difficulties are already present during a first episode. To explore this issue we assessed and compared metacognition using the Metacognition Assessment Scale-Abbreviated (MAS-A) and social cognition using the Eyes, Hinting and Bell-Lysaker Emotional Recognition Tests (BLERT) in participants with first episode psychosis (FEP; n=26), participants with a prolonged psychosis (n=72), and a psychiatric control group consisting of persons with a substance use disorder and no history of psychosis (n=14). Analyses revealed that both psychosis cohorts scored lower than controls on the MAS-A total and all subscales except metacognitive mastery. Compared to the FEP group, the persons with prolonged psychosis demonstrated greater metacognitive capacities only in those MAS-A domains reflective of the ability to understand the mental state of others and to see that others may have motivations and desires separate from their own. Other domains of metacognition did not differ between psychosis groups. The Eyes, Hinting and BLERT scores of the two psychosis groups did not differ but were poorer than those produced by the control group. Exploratory correlations in the FEP group showed a pattern similar to that previously observed in prolonged psychosis. Taken together, these findings suggest that while certain domains of metacognition could improve with prolonged psychosis, difficulties with global metacognition and social cognition may be stable features of the disorder and perhaps unique to psychosis.

  10. Emotional Intelligence in a Group of Patients with First-Episode Psychosis in Iran

    Directory of Open Access Journals (Sweden)

    Hamid Reza Pooretemad

    2012-02-01

    Full Text Available This study was aimed to evaluate the Emotional Intelligence (EI of a group of patients with first episode psychosis in Iran as compared with a healthy control group. A case-control design was used. EI was assessed using Persian version of Bar-On Emotional Quotient inventory (EQ-i administered on 25 patients with history of a single psychotic episode in the last two years, as well as 64 healthy participants. The mean (±SD of EI scores of patients and healthy controls group was 319.8 (±40.9 and 328.8 (±33.3, respectively. Two-independent sample t-test revealed no significant difference in the EI scores of two groups (P=0.29. In contrast with chronic schizophrenia, the patients with first-episode psychosis were not different from the healthy subjects in terms of emotional intelligence score. It might be implied that the low emotional intelligence of the patients with chronic psychotic disorders is an accumulative result of the underlying disease over time.

  11. Psychometric evaluation of the Danish and Swedish Satisfaction with Life Scale in first episode psychosis patients

    DEFF Research Database (Denmark)

    Hochwälder, Jacek; Mattsson, Maria; Holmqvist, Ragnhild;

    2012-01-01

    PURPOSE: To psychometrically evaluate the Satisfaction with Life Scale in two cohorts of first-episode psychosis patients in the Danish National Schizophrenia Project and in the Swedish Parachute Project. METHOD: Four properties of the Satisfaction with Life Scale were examined in the Danish cohort...... (explorative investigation) and then confirmed in the Swedish cohort: (1) the factor structure; (2) correlations between subscales; (3) internal consistencies of subscales; and (4) main tendencies (arithmetic means) and variations (standard deviations) of subscales. The relations between the Satisfaction...... with Life Scale and various life conditions were investigated in the Swedish cohort. RESULTS: For both samples, the analysis indicated that the obtained four-dimensional 11-item scale had satisfactory properties. Moderately high scores were obtained in the four subscales: "living," "social relationships...

  12. Examining the Factors Associated with Paid Employment of Clients Enrolled in First Episode of Psychosis Programs

    Directory of Open Access Journals (Sweden)

    Carolyn S. Dewa

    2012-01-01

    Full Text Available Schizophrenia is one of the most debilitating mental disorders. For a significant portion of individuals who suffer from this disorder, onset occurs in young adulthood, arresting important social and educational development that is necessary for future successful labor force participation. The purpose of this paper is to contribute to the literature about clients enrolled in first episode psychosis programs and psychosocial outcomes by examining the factors associated with paid employment among young adults who have experienced their first psychotic episodes. In this paper, we consider the association of socioeconomic factors to employment. Our results suggest that in addition to treatment, socioeconomic factors such as receipt of public disability benefits and educational attainment are associated with employment status. These results can help to inform future directions for the enhancement of psychosocial programs in FEP models to promote paid employment.

  13. Schizophrenia

    Science.gov (United States)

    ... local NAMI About NAMI + x IN THIS SECTION Esquizofrenia Share NAMI Share Home Learn More Mental Health Conditions Schizophrenia IN THIS SECTION Esquizofrenia Schizophrenia Overview Treatment Support Discuss Schizophrenia is a ...

  14. Intrinsic motivation and amotivation in first episode and prolonged psychosis.

    Science.gov (United States)

    Luther, Lauren; Lysaker, Paul H; Firmin, Ruth L; Breier, Alan; Vohs, Jenifer L

    2015-12-01

    The deleterious functional implications of motivation deficits in psychosis have generated interest in examining dimensions of the construct. However, there remains a paucity of data regarding whether dimensions of motivation differ over the course of psychosis. Therefore, this study examined two motivation dimensions, trait-like intrinsic motivation, and the negative symptom of amotivation, and tested the impact of illness phase on the 1) levels of these dimensions and 2) relationship between these dimensions. Participants with first episode psychosis (FEP; n=40) and prolonged psychosis (n=66) completed clinician-rated measures of intrinsic motivation and amotivation. Analyses revealed that when controlling for group differences in gender and education, the FEP group had significantly more intrinsic motivation and lower amotivation than the prolonged psychosis group. Moreover, intrinsic motivation was negatively correlated with amotivation in both FEP and prolonged psychosis, but the magnitude of the relationship did not statistically differ between groups. These findings suggest that motivation deficits are more severe later in the course of psychosis and that low intrinsic motivation may be partially independent of amotivation in both first episode and prolonged psychosis. Clinically, these results highlight the importance of targeting motivation in early intervention services.

  15. Ten year neurocognitive trajectories in first-episode psychosis

    DEFF Research Database (Denmark)

    Barder, Helene E; Sundet, Kjetil; Rund, Bjørn R

    2013-01-01

    Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitud......Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year...... longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory. Method: Forty-three FEP subjects (51% male, 28 ± 9 years...... of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that the majority of patients do not show significant change in cognitive performance during the first 10 years after being diagnosed....

  16. Incentive motivation in first-episode psychosis: A behavioural study

    Directory of Open Access Journals (Sweden)

    Blackwell Andrew D

    2008-05-01

    Full Text Available Abstract Background: It has been proposed that there are abnormalities in incentive motivational processing in psychosis, possibly secondary to subcortical dopamine abnormalities, but few empirical studies have addressed this issue. Methods: We studied incentive motivation in 18 first-episode psychosis patients from the Cambridge early psychosis service CAMEO and 19 control participants using the Cued Reinforcement Reaction Time Task, which measures motivationally driven behaviour. We also gathered information on participants' attentional, executive and spatial working memory function in order to determine whether any incentive motivation deficits were secondary to generalised cognitive impairment. Results: We demonstrated the anticipated "reinforcement-related speeding" effect in controls (17 out of 19 control participants responded faster during an "odd-one-out" task in response to a cue that indicated a high likelihood of a large points reward. Only 4 out of 18 patients showed this effect and there was a significant interaction effect between reinforcement probability and diagnosis on reaction time (F1,35 = 14.2, p = 0.001. This deficit was present in spite of preserved executive and attentional function in patients, and persisted even in antipsychotic medication free patients. Conclusion: There are incentive motivation processing abnormalities in first-episode psychosis; these may be secondary to dopamine dysfunction and are not attributable to generalised cognitive impairment.

  17. Cognitive effects of atypical antipsychotic drugs in first-episode drug-na?ve schizophrenic patients

    Institute of Scientific and Technical Information of China (English)

    Juan Wang; Maorong Hu; Xiaofeng Guo; Renrong Wu; Lehua Li; Jingping Zhao

    2013-01-01

    Cognitive impairment is a core feature of schizophrenia. The present randomized open study enrolled antipsychotic-na?ve patients who were experiencing their first episode of schizophrenia. After baseline neurocognitive tests and clinical assessment, subjects were randomly assigned to olanzapine, risperidone and aripiprazole treatment groups. A battery of neurocognitive tests showed that risperidone produced cognitive benefits in all five cognitive domains, including verbal learning and memory, visual learning and memory, working memory, processing speed, and selective attention; olanzapine improved processing speed and selective attention; and aripiprazole improved visual learning and memory, and working memory. However, the three atypical antipsychotic drugs failed to reveal any significant differences in the composite cognitive scores at the study endpoint. In addition, the three drugs all significantly improved clinical measures without significant differences between the drugs after 6 months. These results suggest that the atypical antipsychotics, olanzapine, risperidone and aripiprazole may improve specific cognitive domains with similar global clinical efficacy. In clinical practice, it may be feasible to choose corresponding atypical antipsychotics according to impaired cognitive domains.

  18. CSF GABA is reduced in first-episode psychosis and associates to symptom severity.

    Science.gov (United States)

    Orhan, F; Fatouros-Bergman, H; Goiny, M; Malmqvist, A; Piehl, F; Cervenka, S; Collste, K; Victorsson, P; Sellgren, C M; Flyckt, L; Erhardt, S; Engberg, G

    2017-03-14

    Schizophrenia is characterized by a multiplicity of symptoms arising from almost all domains of mental function. γ-Aminobutyric acid (GABA) is the primary inhibitory neurotransmitter in the brain and is increasingly recognized to have a significant role in the pathophysiology of the disorder. In the present study, cerebrospinal fluid (CSF) concentrations of GABA were analyzed in 41 first-episode psychosis (FEP) patients and 21 age- and sex-matched healthy volunteers by high-performance liquid chromatography. We found lower CSF GABA concentration in FEP patients compared with that in the healthy volunteers, a condition that was unrelated to antipsychotic and/or anxiolytic medication. Moreover, lower CSF GABA levels were associated with total and general score of Positive and Negative Syndrome Scale, illness severity and probably with a poor performance in a test of attention. This study offers clinical in vivo evidence for a potential role of GABA in early-stage schizophrenia.Molecular Psychiatry advance online publication, 14 March 2017; doi:10.1038/mp.2017.25.

  19. [Challenge of social reintegration after a first-episode psychosis].

    Science.gov (United States)

    Pachoud, B

    2013-09-01

    One of the main issues of early intervention in first-episode psychosis is to prevent social exclusion, or at least to seek to reduce it as soon as possible. The aim is not only symptom remission and relapse prevention, it is also to optimize the social and functional outcome of the illness. Social exclusion is not only one the disabling consequences of the illness, it is also, due to a negative circularity, an aggravating factor. Therefore, alongside the healthcare strategy aiming at the remission and relapse prevention, it will be useful to set up, at an early stage, a strategy aiming at maintaining or restoring social inclusion, and more generally to support the social recovery. We will specify the factors conditioning such prospects for recovery, and the variety of measures to support this strategy.

  20. 10 year course of IQ in first-episode psychosis

    DEFF Research Database (Denmark)

    Barder, Helene Eidsmo; Sundet, Kjetil; Rund, Bjørn Rishovd

    2015-01-01

    are largely uninvestigated, but may identify subgroups with different intellectual trajectories. Eighty-nine first-episode psychosis patients were investigated on IQ at baseline and at 10-years follow-up. Total time in psychosis was defined as two separate variables; Duration of psychosis before start...... of treatment (i.e. duration of untreated psychosis: DUP), and duration of psychosis after start of treatment (DAT). The sample was divided in three equal groups based on DUP and DAT, respectively. To investigate if diagnosis could separate IQ-trajectories beyond that of psychotic duration, two diagnostic...... categories were defined: core versus non-core SSDs. No significant change in IQ was found for the total sample. Intellectual course was not related to DUP or stringency of diagnostic category. However, a subgroup with long DAT demonstrated a significant intellectual decline, mainly associated with a weaker...

  1. Spontaneous dyskinesia in first-episode psychosis in a Southeast Asian population.

    Science.gov (United States)

    Lee, Jimmy; Poon, Lye-Yin; Chong, Siow-Ann

    2008-10-01

    Spontaneous dyskinesia in first-episode psychosis was described previously with varying incidence rates ranging from zero to 53%. Dyskinesia was also found to be more common in siblings of patients with both schizophrenia and dyskinesia. This condition was linked with structural brain abnormalities and posited to be another subtype of schizophrenia with striatal pathology. Whether there are ethnic variations in the rates of spontaneous dyskinesia is unknown because of the paucity of studies in this area. This study aims to establish the rates of spontaneous dyskinesia in a Southeast Asian population of drug-naive patients experiencing their first psychotic episode and to examine the clinical correlates. A total of 908 patients were examined, of which, 76.1% were Chinese; 15.4%, Malays; 6.2%, Indians; and 2.3%, from other minor ethnic groups. Schizophrenia was diagnosed in 48.9% of the population. There were 3 patients of Chinese descent who had "minimal" or "mild" dyskinetic movements when rated with the Abnormal Involuntary Movement Scale, but none fulfilled the Schooler and Kane criteria for spontaneous dyskinesia. Their dyskinetic movements resolved when reassessed 3 and 6 months after treatment with antipsychotic medications. Of the 3 patients, 2 were treatment resistant and subsequently treated with clozapine. This is the largest study to date examining the prevalence of spontaneous dyskinesia. We hypothesize that there is an ethnically based difference in the rates of spontaneous dyskinesia that could reflect underlying genetic variations. Patients with dyskinetic movements at baseline could have a more treatment refractory course of illness.

  2. Mild Reinforcement Learning Deficits in Patients With First-Episode Psychosis.

    Science.gov (United States)

    Chang, Wing Chung; Waltz, James A; Gold, James M; Chan, Tracey Chi Wan; Chen, Eric Yu Hai

    2016-11-01

    Numerous studies have identified reinforcement learning (RL) deficits in schizophrenia. Most have focused on chronic patients with longstanding antipsychotic treatment, however, and studies of RL in early-illness patients have produced mixed results, particularly regarding gradual/procedural learning. No study has directly contrasted both rapid and gradual RL in first-episode psychosis (FEP) samples. We examined probabilistic RL in 34 FEP patients and 36 controls, using Go/NoGo (GNG) and Gain vs Loss-Avoidance (GLA) paradigms. Our results were mixed, with FEP patients exhibiting greater impairment in the ability to use positive, as opposed to negative, feedback to drive rapid RL on the GLA, but not the GNG. By contrast, patients and controls showed similar improvement across the acquisition. Finally, we found no significant between-group differences in the postacquisition expression of value-based preference in both tasks. Negative symptoms were modestly associated with RL measures, while the overall bias to engage in Go-responding correlated significantly with psychosis severity in FEP patients, consistent with striatal hyperdopaminergia. Taken together, FEP patients demonstrated more circumscribed RL impairments than previous studies have documented in chronic samples, possibly reflecting differential symptom profiles between first-episode and chronic samples. Our finding of relatively preserved gradual/procedural RL, in briefly medicated FEP patients, might suggest spared or restored basal ganglia function. Our findings of preserved abilities to use representations of expected value to guide decision making, and our mixed results regarding rapid RL, may reflect a lesser degree of prefrontal cortical functional impairment in FEP than in chronic samples. Further longitudinal research, in larger samples, is required.

  3. A systematic review of cognitive function in first-episode psychosis, including a discussion on childhood trauma, stress and inflammation

    Directory of Open Access Journals (Sweden)

    Monica eAas

    2014-01-01

    Full Text Available OBJECTIVE: To carry out a systematic review of the literature addressing cognitive functions in first-episode psychosis, divided into domains. Although this is not a full cognitive-genetics-in-schizophrenia review, we will also include putative ideas of mechanism(s behind these impairments, focusing on how early stress, and genetic vulnerability may moderate cognitive function in psychosis. METHOD: Relevant studies were identified via computer literature searches for research published up to and including January 2013, only case-control studies were included for the neurocognitive meta-analysis.RESULTS: Patients with first-episode psychosis present global cognitive impairment compared to healthy controls. The largest effect size was observed for verbal memory (Cohen’s d effect size=2.10, followed by executive function (effect size =1.86, and general IQ (effect size =1.71. However, effect sizes varied between studies. CONCLUSION: Cognitive impairment across domains, up to severe level based on Cohen’s effect size, is present already in first-episode psychosis studies. However, differences in levels of impairment are observed between studies, as well as within domains, indicating that further consolidation of cognitive impairment over the course of illness may be present. Cognitive abnormalities may be linked to a neurodevelopmental model including increased sensitivity to the negative effect of stress, as well as genetic vulnerability. More research on this field is needed.

  4. “Everyone Needs a Friend Sometimes” – Social Predictors of Long-term Remission In first Episode psychosis

    Directory of Open Access Journals (Sweden)

    Jone Bjornestad

    2016-10-01

    Full Text Available BackgroundPredictors of long-term symptomatic remission are crucial to the successful tailoring of treatment in first episode psychosis. There is lack of studies distinguishing the predictive effects of different social factors. This prevents a valid evaluating of their independent effects.ObjectivesTo test specific social baseline predictors of long-term remission. We hypothesized that first, satisfaction with social relations predicts remission; second, that frequency of social interaction predicts remission; and third, that the effect of friend relationship satisfaction and frequency will be greater than that of family relations satisfaction and frequency.Material and MethodsA sample of first episode psychosis (n=186 completed baseline measures of social functioning, as well as clinical assessments. We compared groups of remitted and non-remitted individuals using generalized estimating equations analyses.ResultsFrequency of social interaction with friends was a significant positive predictor of remission over a two-year period. Neither global perceived social satisfaction nor frequency of family interaction showed significant effects. ConclusionsThe study findings are of particular clinical importance since frequency of friendship interaction is a possibly malleable factor. Frequency of interaction could be affected through behavioral modification and therapy already from an early stage in the course, and thus increase remission rates.KeywordsFirst-Episode Psychosis, Schizophrenia, Social factors, Baseline predictors, Long-term remission.

  5. Schizophrenia

    Science.gov (United States)

    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 ...

  6. Predictors of engagement in first-episode psychosis.

    Science.gov (United States)

    Casey, Daniel; Brown, Luke; Gajwani, Ruchika; Islam, Zoebia; Jasani, Rubina; Parsons, Helen; Tah, Priya; Birchwood, Max; Singh, Swaran P

    2016-08-01

    Engagement with psychiatric services is critical for ensuring successful outcomes in patients experiencing a first episode of psychosis (FEP). However, it is not known how sociodemographic factors and patient beliefs about the causes of mental illness affect engagement. This study explored predictors of engagement in a cohort of 103 FEP patients presenting to an early-intervention service. Beliefs that mental illness is caused by social stress or thinking odd thoughts predicted higher engagement scores. Patients with no qualifications were found to have higher engagement scores than those educated to a higher level. Ethnicity, gender, age and socioeconomic factors were not significantly correlated with engagement scores. Duration of untreated illness (DUI) significantly predicted higher engagement scores, but only for values >1220days. Duration of untreated psychosis (DUP) was not a significant predictor of patient engagement scores. Patient beliefs about the causes of mental illness are an important factor to be taken into consideration and may represent a target of interventions to increase engagement in FEP.

  7. 六种非经典抗精神病药对首发精神分裂症患者代谢的影响%Influences of six atypical antipsychotics on metabolism in the treatment for patients with first-episode schizophrenia

    Institute of Scientific and Technical Information of China (English)

    亓高超

    2012-01-01

    Objective To explore the influences of 6 atypical antipsychotics on blood triglyceride (TG), high density lipoproteins (HDL), glucose, glycohemoglobin (HbAlC) and body weight in the treatment for patients with frist-episode schizophrenia. Methods A total of 210 patients with frist-episode schizophrenia were divided into clozapine group ( 38 cases) , olanzapine group (34 cases) , quetiapine group ( 32 cases ) , risperidone group ( 37 cases ) , amisulpride group (33 cases) and aripiprazole group (36 cases) for 8 weeks treatment. The blood TG, HDL, glucose, HbA1C and body weight were measured at baseline and at the end of the treatment. Results Compared with the baseline, there were no significant differences in blood level of TG, HDL, glucose, HbAlC and body weight of patients in aripiprazole group after the 8-week treatment. All the indexes mentioned above in clozapine group and olanzapine group increased significantly after the treatment (P <0. 05 or P <0. 01). Body weight increased significantly after the treatment in patients in quetiapine group, risperidone group and amisulpride group (P<0.01), however, no significant differences were found on TG, HDL, glucose and HbA1C in the 3 groups after the treatment compared with the baseline. Conclusion Aripiprazole has no effect on metabolic markers in patients with schizophrenia, but clozapine and olanzapine can heighten the blood TG, HDL, glucose, HbAlC and body weight. Quetiapine, risperidone, amisulpride only result in body weight gain in schizophrenic patients.%目的 探讨非经典抗精神病药对精神分裂症患者血甘油三酯(TG)、高密度脂蛋白(HDL)、血糖、糖化血红蛋白(HbA1C)和体质量的影响.方法 将210例精神分裂症患者分为氯氮平组38例、奥氮平组34例、喹硫平组32例、利培酮组37例、氨磺必利组33例、阿立哌唑组36例,治疗8周.于治疗前和治疗8周测量空腹血TG、HDL、血糖、HbA1C和体质量.结果 治疗前后

  8. A controlled study on effect of olanzapine and risperidone on quality of life in first-episode schizophrenia patients%奥氮平与利培酮治疗精神分裂症首次发病患者的疗效

    Institute of Scientific and Technical Information of China (English)

    徐彩; 李美银; 邓文

    2012-01-01

    目的:探讨奥氮平与利培酮治疗首发精神分裂症的疗效以及对生活质量的影响. 方法:68例首发精神分裂症患者随机分为奥氮平组和利培酮组各34例,分别给予奥氮平和利培酮治疗8周,随访6个月.于治疗前后采用阳性与阴性症状量表(PANSS)及治疗中出现的症状量表(TESS)评定疗效及不良反应;于治疗6个月前后,采用生活质量综合评定问卷(GQOLI)评定生活质量. 结果:两组PANSS评分治疗后均有显著下降(P<0.05或P<0.01).奥氮平组GQOLI总分及各维度与利培酮组GQOLI总分及躯体功能、心理功能维度治疗前后差异均有统计学意义(P均<0.01);两组间比较,治疗前两组GQOLI评分差异无统计学意义,6个月后随访,在躯体功能及社会功能差异有统计学意义(P均<0.01). 结论:奥氮平与利培酮治疗首发精神分裂症疗效相当,但奥氮平在提高生活质量方面略优于利培酮.%Objective: To study the curative powers and effect of olanzapine and risperidone on quality of life in the treatment of first onset schizophrenia patients. Method: 68 first onset schizophrenia patients were randomly divided into olanzapine group and risperidone group, each of which (n = 34 ) received the olanzapine or risperidone treatment respectively for 8 weeks and 6 months follow-up. The efficacy was assessed using positive and negative syndrome scales (PANSS) , and the adverse reaction using treatment emergent symptom scale (TESS). Generic quality of life inventory (GQOLI) was conducted before and 6 months after the treatment for assessmet of patients quality of life. Results: PANSS score of two groups decreased singnificanty after the treatment ( P < 0.05 or P < 0.01). The significant differences were found on GQOLI total score and each dimension score in olanzeoine group and GQOLI total score, physical function,psychological function in risperidone group between before and after treatment (all P<0.01). After 6

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

    Science.gov (United States)

    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

  10. Influence of medication self-management and symptom self-monitoring on the relapse in patients with first-episode ;schizophrenia%药物自我处置及症状自我监控与首发精神分裂症复发的相关性研究

    Institute of Scientific and Technical Information of China (English)

    葛茂宏; 孙红立; 王程辉

    2016-01-01

    Objective To investigate the effect of medication self-management and symptom self-monitoring on the relapse in patients with first-episode schizophrenics (FEP).Methods 120 FEP patients were randomized into study group treated with medication self-management training,symptom self-monitoring training plus routine medication therapy and control group treated with routine medication therapy.All patients in both groups were assessed with Positive and Negative Symptoms Scale (PANSS), Insight and Treatment Attitude Questionnaire (ITAQ ), Social Disability Screening Schedule (SDSS ) and Morningaide Rehabilitation Stats Scale (MRSS)at baseline,the end of the 8th week and the end of the one-year follow-up.Results (1)At the end of follow-up,there were significant differences in relapse rate,readmission rate and employment rate between the two groups (P<0.01).(2)Compared with baseline,scores of PANSS,SDSS and MRSS in study group decreased significantly and score of ITAQ in study group increased significantly at the end of the 8th week of treatment (P<0.01 );score of SDSS showed significant decrease till the end of the one-year follow-up (P<0.01).(3)Score of PANSS in control group was significantly higher at the end of the 8th week than baseline (P<0.01).At the end of one-year follow-up,score of ITAQ in control group was significantly lower than that at baseline (P<0.01),scores of PANSS and SDSS in control group were significantly higher than those at baseline (P<0.01),and score of SDSS in control group was significantly higher than that at the end of the 8th week (P<0.01).(4)At the end of the one-year follow-up,scores of PANSS and MRSS in both groups were significantly higher than those at the end of the 8th week (P<0.01),while scores of ITAQ were significantly lower than those at the end of the 8th week (P<0.01)and scores of MRSS in both groups increased significantly compared with baseline(P<0.01).Scores of PANSS, SDSS,MRSS in study group were significantly lower and score

  11. Functionally aberrant electrophysiological cortical connectivities in first episode medication-naive schizophrenics from three psychiatry centers

    Directory of Open Access Journals (Sweden)

    Dietrich eLehmann‡

    2014-08-01

    Full Text Available Functional dissociation between brain processes is widely hypothesized to account for aberrations of thought and emotions in schizophrenic patients. The typically small groups of analyzed schizophrenic patients yielded different neurophysiological findings, probably because small patient groups are likely to comprise different schizophrenia subtypes. We analyzed multichannel eyes-closed resting EEG from three small groups of acutely ill, first episode productive schizophrenic patients before start of medication (from three centers: Bern N=9; Osaka N=9; Berlin N=12 and their controls. Low resolution brain electromagnetic tomography (LORETA was used to compute intracortical source model-based lagged functional connectivity not biased by volume conduction effects between 19 cortical regions of interest (ROIs. The connectivities were compared between controls and patients of each group. Conjunction analysis determined six aberrant cortical functional connectivities that were the same in the three patient groups. Four of these six concerned the facilitating EEG alpha 1 frequency activity; they were decreased in the patients. Another two of these six connectivities concerned the inhibiting EEG delta frequency activity; they were increased in the patients. The principal orientation of the six aberrant cortical functional connectivities was sagittal; five of them involved both hemispheres. In sum, activity in the posterior brain areas of preprocessing functions and the anterior brain areas of evaluation and behavior control functions were compromised by either decreased coupled activation or increased coupled inhibition, common across schizophrenia subtypes in the three patient groups. These results of the analyzed three independent groups of schizophrenics support the concept of functional dissociation.

  12. The prevalence, diagnostic significance and demographic characteristics of Schneiderian first-rank symptoms in an epidemiological sample of first-episode psychoses.

    LENUS (Irish Health Repository)

    Ihara, Kazushige

    2009-01-01

    The diagnostic significance of first-rank symptoms (FRSs) remains uncertain. Ethnic differences in FRSs may account for high rates of schizophrenia in minority groups. This study aims to examine the prevalence of FRSs in an epidemiological sample of first-episode psychoses stratified by relevant demographic variables. SAMPLING AND METHOD: We identified everyone aged 16-64 presenting with their first psychosis over 2 years in 3 UK centres.

  13. Charateristics of First Episode Psychosis Patients with Reassessment after Eight Years

    Directory of Open Access Journals (Sweden)

    Susana Vaz Carreiro

    2014-06-01

    Full Text Available The first episode psychosis (FEP is now a widely investigated topic, given that early intervention in these cases can mean an improved prognostic. Thus, this study sought to evaluate and characterize the evolution of these early outbreaks that were admitted at the Acute Inpatient Unit of the Department of Psychiatry and Mental Health, Hospital São Francisco Xavier, as only knowledge of the needs of care can enhance the quality and appropriateness of provided health care and assistance and enable to create structures that meet real needs. The present study, naturalistic, retrospective, evaluated the first psychotic episodes in patients admitted to the inpatient unit. It documented socio-demographic and clinical variables and re-evaluated the outcomes of these patients 8 years after admission, through information in the clinical case notes. The initial sample was 25 patients. The main findings consisted of a high number of dropouts from the outpatient clinic (only 20% remaining in follow-up, large number of substance abuse (48% of patients, a large number of readmissions and a slight worsening of the socio-professional status. It should be noted also that 20% of patients evolved to a schizophrenia diagnosis. This study allows us to alert healthcare professionals to this reality and emphasize the need to develop secondary prevention strategies that promote a pro-active attitude of the technicians, in order to obtain a greater adherence to a therapeutic project.

  14. Bangkit: The Processes of Recovery from First Episode Psychosis in Java.

    Science.gov (United States)

    Subandi, M A

    2015-12-01

    There is a growing literature on recovery from schizophrenia. Most studies, however, focused on outcome, with insufficient attention paid to the process of recovery. The aim of this study was to explore the process of recovery from first episode psychotic illness in a Javanese cultural setting. An ethnographic method was applied where researcher conducted a field work and followed seven participants in their natural setting. This study identified three phases of recovery process in the context of Javanese culture: Bangkit, gaining insight; Usaha, struggling to achieve recovery; and Rukun, harmonious integration with family and community integration. Recovery entails regaining insight, followed by simultaneous inward and outward efforts that reconstitute one's inner and outer world, respectively. Participants also expressed their recovery in terms of a movement through physical space, from confinement in their own home to the wider spaces shared with family and community. Movements in physical space parallel movements in social space, where participants accomplish a social recovery. The Javanese phase of recovery found in this study is comparable to the phase of recovery identified by previous literatures in the Western context.

  15. Metacognitive functioning predicts positive and negative symptoms over 12 months in first episode psychosis.

    Science.gov (United States)

    McLeod, Hamish J; Gumley, Andrew I; Macbeth, Angus; Schwannauer, Matthias; Lysaker, Paul H

    2014-07-01

    The negative symptoms of schizophrenia are a major source of impairment and distress but both pharmacological and psychological treatment options provide only modest benefit. Developing more effective psychological treatments for negative symptoms will require a more sophisticated understanding of the psychological processes that are implicated in their development and maintenance. We extended previous work by demonstrating that metacognitive functioning is related to negative symptom expression across the first 12 months of first episode psychosis (FEP). Previous studies in this area have either been cross-sectional or have used much older participants with long-standing symptoms. In this study, forty-five FEP participants were assessed three times over 12 months and provided data on PANSS rated symptoms, premorbid adjustment, metacognitive functioning, and DUP. Step-wise linear regression showed that adding metacognition scores to known predictors of negative symptoms (baseline symptom severity, gender, DUP, and premorbid academic and social adjustment) accounted for 62% of the variance in PANSS negative symptom scores at six months and 38% at 12 months. The same predictors also explained 47% of the variance in positive symptoms at both six and 12 months. However, exploration of the simple correlations between PANSS symptom scores and metacognition suggests a stronger univariate relationship between metacognition and negative symptoms. Overall, the results indicate that problems with mental state processing may be important determinants of negative symptom expression from the very early stages of psychosis. These results provide further evidence that metacognitive functioning is a potentially relevant target for psychological interventions.

  16. Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008355 Efficacy and safety of aripiprazole in the treatment of schizophrenia: a randomized, double-blind, risperidone controlled, multicenter study. YAN Jun(闫俊), et al. Instit Mental Health, Peking Univ, Beijing 100083. Chin J Psychiat 2008;41(2):81-84.Objective To evaluate the efficacy and safety of aripiprazole in treating acute exacerbation of schizophrenia.

  17. Thalamic shape abnormalities in antipsychotic naïve schizophrenia

    Directory of Open Access Journals (Sweden)

    Vijay Danivas

    2013-01-01

    Full Text Available Background: Neurodevelopmental hypothesis of schizophrenia states abnormal pruning as one of the pathogenetic mechanism in schizophrenia. Though thalamic volume abnormalities have been documented, the shape differences of thalamus in antipsychotic-free schizophrenia in comparison with age- and sex-matched healthy volunteers need validation. Materials and Methods: We examined antipsychotic naïve schizophrenia patients ( n=60 and age- and sex-matched healthy volunteers ( n=44. The thalamic shape abnormalities were analyzed from their coded structural magnetic resonance imaging (MRI data using three-dimensional automated image analysis software, FMRIB′s (Oxford Center for the functional MRI of the brain tools-FIRST (FMRIB′s Integrated Registration and Segmentation Tool by creating deformable mesh model. Correlation with the psychopathology scores was carried out using F-statistics. Results: Patients with schizophrenia showed significant inward deformations in the regions corresponding to anterior, ventromedial, mediodorsal, and pulvinar nuclei. There was a direct correlation between negative syndrome score and the deformation in the right mediodorsal and right pulvinar nuclei. Conclusion: The inward deformations of thalamus in antipsychotic naive schizophrenia patients correspond to those nuclei which have reciprocal connections with frontal, superior temporal, and anterior cingulate regions and support the neurodevelopmental hypothesis of schizophrenia.

  18. Schizophrenia

    Science.gov (United States)

    ... have normal emotional responses, and act normally in social situations. ... therapy may be helpful for many people with schizophrenia. Behavioral techniques, such as social skills training, can help the person function better ...

  19. Risk of Recurrent Pancreatitis and Progression to Chronic Pancreatitis After a First Episode of Acute Pancreatitis

    NARCIS (Netherlands)

    Ahmed Ali, Usama; Issa, Yama; Hagenaars, Julia C.; Bakker, Olaf J.; van Goor, Harry; Nieuwenhuijs, Vincent B.; Bollen, Thomas L.; van Ramshorst, Bert; Witteman, Ben J.; Brink, Menno A.; Schaapherder, Alexander F.; Dejong, Cornelis H.; Spanier, B. W Marcel; Heisterkamp, Joos; van der Harst, Erwin; van Eijck, Casper H.; Besselink, Marc G.; Gooszen, Hein G.; van Santvoort, Hjalmar C.; Boermeester, Marja A.

    2016-01-01

    Background & Aims: Patients with a first episode of acute pancreatitis can develop recurrent or chronic pancreatitis (CP). However, little is known about the incidence or risk factors for these events. Methods: We performed a cross-sectional study of 669 patients with a first episode of acute pancre

  20. Two-Year Diagnostic Stability in Early-Onset First-Episode Psychosis

    Science.gov (United States)

    Castro-Fornieles, Josefina; Baeza, Immaculada; de la Serna, Elena; Gonzalez-Pinto, Ana; Parellada, Mara; Graell, Montserrat; Moreno, Dolores; Otero, Soraya; Arango, Celso

    2011-01-01

    Background: Only one study has used a prospective method to analyze the diagnostic stability of first psychotic episodes in children and adolescents. The Child and Adolescent First-Episode Psychosis Study (CAFEPS) is a 2-year, prospective longitudinal study of early-onset first episodes of psychosis (EO-FEP). Aim: To describe diagnostic stability…

  1. First-episode psychosis patients recruited into treatment via early detection teams versus ordinary pathways

    DEFF Research Database (Denmark)

    Johannessen, Jan Olav; Joa, Inge; Auestad, Bjørn;

    2011-01-01

    To compare the 5-year course and outcome of first-episode psychosis (FEP) patients recruited via active outreach detection teams (DTs) versus ordinary referral channels (not-DT).......To compare the 5-year course and outcome of first-episode psychosis (FEP) patients recruited via active outreach detection teams (DTs) versus ordinary referral channels (not-DT)....

  2. Integrated treatment of first-episode psychosis: effect of treatment on family burden: OPUS trial

    DEFF Research Database (Denmark)

    Jeppesen, Pia; Petersen, Lone; Thorup, Anne;

    2005-01-01

    The families of patients with first-episode psychosis often play a major role in care and often experience lack of support.......The families of patients with first-episode psychosis often play a major role in care and often experience lack of support....

  3. Neurocognition and Duration of Psychosis: A 10-year Follow-up of First-Episode Patients.

    Science.gov (United States)

    Rund, Bjørn Rishovd; Barder, Helene Eidsmo; Evensen, Julie; Haahr, Ulrik; ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan Olav; Langeveld, Johannes; Larsen, Tor Ketil; Melle, Ingrid; Opjordsmoen, Stein; Røssberg, Jan Ivar; Simonsen, Erik; Sundet, Kjetil; Vaglum, Per; McGlashan, Thomas; Friis, Svein

    2016-01-01

    A substantial proportion of schizophrenia-spectrum patients exhibit a cognitive impairment at illness onset. However, the long-term course of neurocognition and a possible neurotoxic effect of time spent in active psychosis, is a topic of controversy. Furthermore, it is of importance to find out what predicts the long-term course of neurocognition. Duration of untreated psychosis (DUP), accumulated time in psychosis the first year after start of treatment, relapse rates and symptoms are potential predictors of the long-term course. In this study, 261 first-episode psychosis patients were assessed neuropsychologically on one or more occasions. Patients were tested after remission of psychotic symptoms and reassessed 1, 2, 5, and 10 years after inclusion. The neurocognitive battery consisted of California Verbal Learning Test, Wisconsin Card Sorting Test, Controlled Oral Word Association Task, Trail Making A and B, and Finger Tapping. We calculated a composite score by adding the z-scores of 4 tests that were only moderately inter-correlated, not including Finger Tapping. Data were analyzed by a linear mixed model. The composite score was stable over 10 years. No significant relationship between psychosis before (DUP) or after start of treatment and the composite score was found, providing no support for the neurotoxicity hypothesis, and indicating that psychosis before start of treatment has no significant impact on the course and outcome in psychosis. We found no association between symptoms and the neurocognitive trajectory. Stable remission during the first year predicted neurocognitive functioning, suggesting that the early clinical course is a good predictor for the long-term course.

  4. Altered Default Network Resting State Functional Connectivity in Patients with a First Episode of Psychosis

    Science.gov (United States)

    Alonso-Solís, Anna; Corripio, Iluminada; de Castro-Manglano, Pilar; Duran-Sindreu, Santiago; Garcia-Garcia, Manuel; Proal, Erika; Nuñez-Marín, Fidel; Soutullo, Cesar; Alvarez, Enric; Gómez-Ansón, Beatriz; Kelly, Clare; Castellanos, F. Xavier

    2012-01-01

    Background Default network (DN) abnormalities have been identified in patients with chronic schizophrenia using “resting state” functional magnetic resonance imaging (R-fMRI). Here, we examined the integrity of the DN in patients experiencing their first episode of psychosis (FEP) compared with sex- and age-matched healthy controls. Methods We collected R-fMRI data from 19 FEP patients (mean age 24.9±4.8 yrs, 14 males) and 19 healthy controls (26.1±4.8 yrs, 14 males) at 3 Tesla. Following standard preprocessing, we examined the functional connectivity (FC) of two DN subsystems and the two DN hubs (P<0.0045, corrected). Results Patients with FEP exhibited abnormal FC that appeared largely restricted to the dorsomedial prefrontal cortex (dMPFC) DN subsystem. Relative to controls, FEP patients exhibited weaker positive FC between dMPFC and posterior cingulate cortex (PCC) and precuneus, extending laterally through the parietal lobe to the posterior angular gyrus. Patients with FEP exhibited weaker negative FC between the lateral temporal cortex and the intracalcarine cortex, bilaterally. The PCC and temporo-parietal junction also exhibited weaker negative FC with the right fusiform gyrus extending to the lingual gyrus and lateral occipital cortex, in FEP patients, compared to controls. By contrast, patients with FEP showed stronger negative FC between the temporal pole and medial motor cortex, anterior precuneus and posterior mid-cingulate cortex. Conclusions Abnormalities in the dMPFC DN subsystem in patients with a FEP suggest that FC patterns are altered even in the early stages of psychosis. PMID:22633527

  5. Substance abuse and first-episode schizophrenia-spectrum disorders. The Danish OPUS trial

    DEFF Research Database (Denmark)

    Petersen, Lone; Jeppesen, Pia; Thorup, Anne;

    2007-01-01

    To evaluate whether integrated treatment (given by OPUS), in comparison with standard treatment, significantly reduced the number of patients with substance abuse and improved clinical and social outcome in the group of substance abusers after 2 years.......To evaluate whether integrated treatment (given by OPUS), in comparison with standard treatment, significantly reduced the number of patients with substance abuse and improved clinical and social outcome in the group of substance abusers after 2 years....

  6. Course of intelligence deficits in early onset, first episode schizophrenia: a controlled, 5-year longitudinal study

    DEFF Research Database (Denmark)

    Jepsen, Jens Richardt Moellegaard; Fagerlund, Birgitte; Pagsberg, Anne Katrine

    2010-01-01

    ) from their first psychotic episode to 5 years of post onset with that of healthy controls (N = 35) and patients who at baseline had been diagnosed with other non-affective psychoses (N = 8). The same version of a Wechsler Intelligence Scale was administered at both baseline and follow-up assessments...... FSIQ change was observed between patients with EOS and patients with other non-affective psychoses, although this result must be interpreted with caution due to the small sample sizes. The results suggest abnormally slow acquisition of new intellectual information and skills in EOS patients during...

  7. Physical activity and anomalous bodily experiences in patients with first-episode schizophrenia

    DEFF Research Database (Denmark)

    Nyboe, Lene; Moeller, Marianne K; Vestergaard, Claus H

    2016-01-01

    were obtained from medical records of all patients. RESULTS: Physical activity and aerobic fitness was significantly lower in patients with FES compared with healthy controls (p fitness. Patients with more severe....... AIM: The purpose of the study was to compare physical activity in patients with FES with healthy controls; to investigate changes in physical activity over 1 year of follow-up; and to explore the correlations of physical activity and anomalous bodily experiences reported by patients with FES. METHODS......: Both physical activity and aerobic fitness were measured. Anomalous bodily experiences were measured by selected items from the Examination of Anomalous Self-Experience and The Body Awareness Scale. Psychopathological data comprising negative and positive symptoms and data on psychotropic medication...

  8. Using internet enabled mobile devices and social networking technologies to promote exercise as an intervention for young first episode psychosis patients

    Directory of Open Access Journals (Sweden)

    Sun Pamela

    2011-05-01

    Full Text Available Abstract Background Young people with first episode psychosis are at an increased risk for a range of poor health outcomes. In contrast to the growing body of evidence that suggests that exercise therapy may benefit the physical and mental health of people diagnosed with schizophrenia, there are no studies to date that have sought to extend the use of exercise therapy among patients with first episode psychosis. The aim of the study is to test the feasibility and acceptability of an exercise program that will be delivered via internet enabled mobile devices and social networking technologies among young people with first episode psychosis. Methods/Design This study is a qualitative pilot study being conducted at Orygen Youth Health Research Centre in Melbourne, Australia. Participants are young people aged 15-24 who are receiving clinical care at a specialist first episode psychosis treatment centre. Participants will also comprise young people from the general population. The exercise intervention is a 9-week running program, designed to gradually build a person's level of fitness to be able to run 5 kilometres (3 miles towards the end of the program. The program will be delivered via an internet enabled mobile device. Participants will be asked to post messages about their running experiences on the social networking website, and will also be asked to attend three face-to-face interviews. Discussion This paper describes the development of a qualitative study to pilot a running program coupled with the use of internet enabled mobile devices among young people with first episode psychosis. If the program is found to be feasible and acceptable to patients, it is hoped that further rigorous evaluations will ultimately lead to the introduction of exercise therapy as part of an evidence-based, multidisciplinary approach in routine clinical care.

  9. Cost-effectiveness of early intervention in first-episode psychosis

    DEFF Research Database (Denmark)

    Hastrup, Lene Halling; Kronborg, Christian; Bertelsen, Mette

    2013-01-01

    BACKGROUND: Information about the cost-effectiveness of early intervention programmes for first-episode psychosis is limited. AIMS: To evaluate the cost-effectiveness of an intensive early-intervention programme (called OPUS) (trial registration NCT00157313) consisting of enriched assertive...... community treatment, psychoeducational family treatment and social skills training for individuals with first-episode psychosis compared with standard treatment. METHOD: An incremental cost-effectiveness analysis of a randomised controlled trial, adopting a public sector perspective was undertaken. RESULTS...

  10. Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    2005280 Association between polymorphism in the dopamine D4 receptor gene and qualitative and quantitative characters of schizophrenia in Chinese. ZHAO Ai-ling(赵爱玲),et al. Dept Psych, 2nd Xi-angya Hosp,Central South Univ,Changsha 410011. Chin J Psychi,2005;38(1) :3-6. Objective: To investigate the relationship between 48 bp variant number tandem repeat polymorphism in the third exon of dopamine D4 receptor (DRD4) gene

  11. Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008489 Establishment of a schizophrenia mouse model of deficient sensorimotor gating by MK-801. SU Yunai(苏允爱), et al. Key Lab, Ment Health, Health Ministry, Instit Ment Health Peking Univ, Beijing 100083.Chin J Nerv Ment Dis 2008;34(5):283-286. Objective To investigate the effects of MK-801, a selective non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist, on

  12. A randomised multicentre trial of integrated versus standard treatment for patients with a first episode of psychotic illness

    DEFF Research Database (Denmark)

    Petersen, Lone Bente; Jeppesen, Pia; Thorup, Anne;

    2005-01-01

    To evaluate the effects of integrated treatment for patients with a first episode of psychotic illness.......To evaluate the effects of integrated treatment for patients with a first episode of psychotic illness....

  13. Tardive dyskinesia in a South Asian population with first episode psychosis treated with antipsychotics

    Directory of Open Access Journals (Sweden)

    Adam UU

    2014-10-01

    Full Text Available Usman Adam, Nusrat Husain, Peter M Haddad, Tariq Munshi, Fauzia Tariq, Farooq Naeem, Imran B ChaudhryBackground: Tardive dyskinesia (TD is a side effect of antipsychotic treatment that often only appears after months or years of treatment. A systematic review of randomized controlled trials lasting more than 1 year showed that second-generation antipsychotics (SGAs were associated with an approximately fivefold lower risk of TD compared to haloperidol in patients with chronic schizophrenia. In contrast, there is little research on the risk of TD with other first-generation antipsychotics (FGAs, and this applies especially to their use in the treatment of patients with first episode psychosis (FEP.Objectives: To determine the severity and point prevalence of TD in a naturalistic sample of patients with FEP in Pakistan treated with FGAs or SGAs.Methods: This was an observational study. TD was assessed by trained clinicians using the Abnormal Involuntary Movement Scale.Results: In the total sample (number =86 the mean age of patients was 26 years and the prevalence of TD (Schooler Kane criteria was 29% with no significant difference between those treated with FGAs and SGAs (31% FGAs versus 26% SGAs; P=0.805. The Abnormal Involuntary Movement Scale total score (items 1–7, a measure of the severity of TD, was significantly higher for patients treated with FGAs versus those treated with SGAs (P=0.033. Scores on specific items showed that this reflected higher scores for dyskinesia affecting the muscles of facial expression, as well as of the upper and lower limb, whereas scores did not differ significantly in other body areas. Conclusion: FGAs were associated with greater severity, though not prevalence, of TD than SGAs. The study highlights the relatively high rate of TD in Asian FEP patients and the need for clinicians to monitor for this and other potential antipsychotic side effects during treatment. Keywords: first-generation antipsychotic

  14. Risk factors for the first episode of peritonitis in Southern Chinese continuous ambulatory peritoneal dialysis patients.

    Directory of Open Access Journals (Sweden)

    Xiaoguang Fan

    Full Text Available The first episode of peritonitis affects survival of the peritoneal membrane as a medium for dialysis as well as survival of patients. The aim of this study is to investigate risk factors associated with the first episode of peritonitis in Southern Chinese continuous ambulatory peritoneal dialysis (CAPD patients.This is a single-center, retrospective, cohort study. All incident CAPD patients from 1 January 2006 to 31 December 2010 were recruited, and followed up until their first episode of peritonitis or 31 December, 2012. Baseline demographic, socioeconomic, clinical and laboratory data were collected. Cox proportional model was used to determine the factors associated with the first episode of peritonitis.In a cumulative 30756.5 patient-months follow-up (the median vintage 26.1 months of 1117 CAPD patients, 309(27.7% patients presented the first episodes of peritonitis. The cumulative peritonitis-free survival was 86.2%, 78.1%, 71.4% and 57.8% at 1, 2, 3 and 5 year, respectively. The multivariate analysis showed that factors associated with risk for the first episode of peritonitis were elderly patients (>65 years [hazard ratio (HR = 1.427, 95% confidence interval (CI = 1.051 to 1.938, P = 0.023], male(HR = 1.315, 95% CI = 1.028 to 1.684, P = 0.030, lower education level (HR = 1.446, 95% CI: 1.127 to 1.855, P = 0.004 and albumin <38g/L (HR = 1.425, 95% CI: 1.112 to 1.825, P = 0.005.Older age, male, lower educational level and hypoalbuminemia at the commencement of PD were the risk factors associated with the first episode of peritonitis in Southern Chinese CAPD patients.

  15. Visual Hallucinations in First-Episode Psychosis: Association with Childhood Trauma.

    Directory of Open Access Journals (Sweden)

    Martine Solesvik

    Full Text Available Hallucinations are a core diagnostic criterion for psychotic disorders and have been investigated with regard to its association with childhood trauma in first-episode psychosis samples. Research has largely focused on auditory hallucinations, while specific investigations of visual hallucinations in first-episode psychosis remain scarce.The aims of this study were to describe the prevalence of visual hallucinations, and to explore the association between visual hallucination and childhood trauma in a first-episode psychosis sample.Subjects were included from TIPS-2, a first episode psychosis study in south Rogaland, Norway. Based on the medical journal descriptions of the Positive and Negative Symptoms Scale (PANSS, a separate score for visual and auditory hallucinations was created (N = 204. Patients were grouped according to hallucination severity (none, mild, and psychotic hallucinations and multinomial logistic regression was performed to identify factors associated with visual hallucination group.Visual hallucinations of a psychotic nature were reported by 26.5% of patients. The experience of childhood interpersonal trauma increased the likelihood of having psychotic visual hallucinations.Visual hallucinations are common in first-episode psychosis, and are related to childhood interpersonal trauma.

  16. Negative association between a history of obstetric complications and the number of neurological soft signs in first-episode schizophrenic disorder.

    Science.gov (United States)

    Boks, Marco P M; Selten, Jean-Paul; Leask, Stuart; Castelein, Stynke; van den Bosch, Robert J

    2007-01-15

    We examined the relationship between a history of obstetric complications (OCs) and the number of neurological soft signs (NSS) in a group of 132 patients experiencing their first episode of psychosis. We measured NSS by means of a comprehensive standardized assessment and gained information on a selection of nine OCs from the patient's mother. Contrary to our expectations we found significantly more NSS in the group of patients without a history of OCs. This effect was independent of medication in the group of patients with a schizophrenic disorder, but not in the entire group. It is possible that the patients with a history of OCs carry fewer genes for schizophrenia (and NSS) and 'needed' the OCs to develop schizophrenia.

  17. Trajectories of suicidal ideation in patients with first-episode psychosis

    DEFF Research Database (Denmark)

    Madsen, Trine; Karstoft, Karen-Inge; Secher, Rikke Gry

    2016-01-01

    BACKGROUND: Heterogeneity in suicidal ideation over time in patients with first-episode psychosis is expected, but prototypical trajectories of this have not yet been established. We aimed to identify trajectories of suicidal ideation over a 3-year period and to examine how these trajectories...... relate to subsequent suicidality. METHODS: We used longitudinal data from the prospective 10-year follow-up OPUS trial of young Danish patients with first-episode psychosis. Participants were recruited between January, 1998, and December, 2000, from all inpatient and outpatient mental health services...

  18. Neurocognitive development in first episode psychosis 5 years follow-up

    DEFF Research Database (Denmark)

    Barder, Helene Eidsmo; Sundet, Kjetil; Rund, Bjørn Rishovd

    2013-01-01

    Cognitive deficits are documented in first-episode psychosis (FEP), but the continuing course is not fully understood. The present study examines the longitudinal development of neurocognitive function in a five year follow-up of FEP-patients, focusing on the relation to illness severity, as meas......Cognitive deficits are documented in first-episode psychosis (FEP), but the continuing course is not fully understood. The present study examines the longitudinal development of neurocognitive function in a five year follow-up of FEP-patients, focusing on the relation to illness severity...

  19. The promise of biological markers for treatment response in first-episode psychosis

    DEFF Research Database (Denmark)

    Fond, Guillaume; d'Albis, Marc-Antoine; Jamain, Stéphane

    2015-01-01

    of conventional treatments or the prescription of innovative treatments. Trials including first-episode psychoses are few in number. Most of the available data focused on pharmacogenetics markers with so far only preliminary results. To date, these studies yielded-beside markers for metabolism of antipsychotics......-no or only a few biomarkers for response or side effects, none of which have been implemented in daily clinical practice. Other biomarkers exploring immunoinflammatory, oxidative, and hormonal disturbances emerged as biomarkers of first-episode psychoses in the last decades, and some of them have been...

  20. Examination of anomalous self-experience in first-episode psychosis: interrater reliability

    DEFF Research Database (Denmark)

    Møller, Paul; Haug, Elisabeth; Raballo, Andrea

    2011-01-01

    Background: The growing research focus on early detection of schizophrenia has fostered an increasing interest in the nonpsychotic experiential anomalies that may antedate schizophrenia spectrum disorders and assist early differential diagnosis. The Examination of Anomalous Self-Experience (EASE)...

  1. Criminal offending and distinguishing features of offenders among persons experiencing a first episode of psychosis.

    LENUS (Irish Health Repository)

    Hodgins, Sheilagh

    2011-02-01

    Persons with severe mental illness (SMI) are at increased risk of criminal offending, particularly violent offending, as compared with the general population. Most offenders with SMI acquire convictions prior to contact with mental health services. This study examined offending among 301 individuals experiencing their first episode of psychosis.

  2. Influence of antipsychotic agents on neurological soft signs and dyskinesia in first episode psychosis.

    Science.gov (United States)

    Boks, Marco P M; Liddle, Peter F; Russo, Sascha; Knegtering, Rikus; van den Bosch, Robert Jan

    2003-07-15

    First episode psychosis patients treated with atypical antipsychotics had significantly fewer signs of dyskinesia than patients treated with classical antipsychotics, but there were no significant differences regarding the total number of neurological soft signs (NSS). This suggests that the type of antipsychotic medication does not influence NSS, but that atypical antipsychotics are associated with less dyskinesia in the early stages of treatment.

  3. Influence of antipsychotic agents on neurological soft signs and dyskinesia in first episode psychosis

    NARCIS (Netherlands)

    Boks, MPM; Liddle, PF; Russo, S; Knegtering, R; van den Bosch, RJ

    2003-01-01

    First episode psychosis patients treated with atypical antipsychotics had significantly fewer signs of dyskinesia than patients treated with classical antipsychotics, but there were no significant differences regarding the total number of neurological soft signs (NSS). This suggests that the type of

  4. Subjective quality of life in first-episode psychosis. A ten year follow-up study

    DEFF Research Database (Denmark)

    Gardsjord, Erlend Strand; Romm, Kristin Lie; Friis, Svein;

    2016-01-01

    patients with a first episode psychotic disorder was included from 1997 through 2000. At 10year follow-up 186 patients participated. QoL was measured by the Lehman's Quality of Life Interview. Linear mixed model analyses were performed to investigate longitudinal effects of baseline psychiatric symptoms...

  5. Multi-center MRI prediction models : Predicting sex and illness course in first episode psychosis patients

    NARCIS (Netherlands)

    Nieuwenhuis, Mireille; Schnack, Hugo G.; van Haren, Neeltje E.; Kahn, René S.; Lappin, Julia; Dazzan, Paola; Morgan, Craig; Reinders, Antje A.; Gutierrez-Tordesillas, Diana; Gutierrez-Tordesillas, Diana; Roiz-Santiañez, Roberto; Crespo-Facorro, Benedicto; Schaufelberger, Maristela S.; Rosa, Pedro G.; Zanetti, Marcus V.; Busatto, Geraldo F.; McGorry, Patrick D.; Velakoulis, Dennis; Pantelis, Christos; Wood, Stephen J.; Mourao-Miranda, Janaina; Mourao-Miranda, Janaina; Dazzan, Paola; Crespo-Facorro, Benedicto

    2017-01-01

    Structural Magnetic Resonance Imaging (MRI) studies have attempted to use brain measures obtained at the first-episode of psychosis to predict subsequent outcome, with inconsistent results. Thus, there is a real need to validate the utility of brain measures in the prediction of outcome using large

  6. Are multi family groups appropriate for patients with first episode psychosis?

    DEFF Research Database (Denmark)

    Rossberg, Jan Ivar; Johannessen, J O; Klungsoyr, O

    2010-01-01

    OBJECTIVE: To compare outcome over 5 years for patients who participated in multi family groups (MFGs) to those who refused or were not offered participation. METHOD: Of 301 first episode psychotic patients aged 15-65 years, 147 participated in MFGs. Outcome was measured by drop-out rates, positive...

  7. Regional Gray Matter Volume Deficits in Adolescents with First-Episode Psychosis

    Science.gov (United States)

    Janssen, Joost; Parellada, Mara; Moreno, Dolores; Graell, Montserrat; Fraguas, David; Zabala, Arantzazu; Vazquez, Veronica Garcia; Desco, Manuel; Arango, Celso

    2008-01-01

    The regional gray matter volumes of adolescents with first-episode psychosis are compared with those of a control group. Magnetic resonance imaging was conducted on 70 patients with early onset FEP and on 51 individuals without FEP. Findings revealed that volume deficits in the left medial frontal gray matter were common in individuals with…

  8. First-episode psychosis patients recruited into treatment via early detection teams versus ordinary pathways

    DEFF Research Database (Denmark)

    Johannessen, Jan O; Friis, Svein; Joa, Inge;

    2007-01-01

    Within an early detection sector, to compare the 1- and 2-year course and outcome of first-episode psychosis patients coming into the treatment system via active outreach detection teams (DTs) versus those achieving help via ordinary referral channels (not-DT)....

  9. The quality of life among first-episode psychotic patients in the OPUS trial

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia

    2010-01-01

    BACKGROUND: From an 'objective' perspective, treatment of first-episode psychosis has improved in many ways with the development of specialised early and intensive team-based treatment like e.g. the 'OPUS' treatment. However, the patients' perspective is also important and was investigated in the...... extent and more strongly with the affective balance and level of self-esteem....

  10. Grey matter morphological anomalies in the caudate head in first-episode psychosis patients with delusions of reference.

    Science.gov (United States)

    Tao, Haojuan; Wong, Gloria H Y; Zhang, Huiran; Zhou, Yuan; Xue, Zhimin; Shan, Baoci; Chen, Eric Y H; Liu, Zhening

    2015-07-30

    Delusions of reference (DOR) are theoretically linked with aberrant salience and associative learning. Previous studies have shown that the caudate nucleus plays a critical role in the cognitive circuits of coding prediction errors and associative learning. The current study aimed at testing the hypothesis that abnormalities in the caudate nucleus may be involved in the neuroanatomical substrate of DOR. Structural magnetic resonance imaging of the brain was performed in 44 first-episode psychosis patients (with diagnoses of schizophrenia or schizophreniform disorder) and 25 healthy controls. Patients were divided into three groups according to symptoms: patients with DOR as prominent positive symptom; patients with prominent positive symptoms other than DOR; and patients with minimal positive symptoms. All groups were age-, gender-, and education-matched, and patient groups were matched for diagnosis, duration of illness, and antipsychotic treatment. Voxel-based morphometric analysis was performed to identify group differences in grey matter density. Relationships were explored between grey matter density and DOR. Patients with DOR were found to have reduced grey matter density in the caudate compared with patients without DOR and healthy controls. Grey matter density values of the left and right caudate head were negatively correlated with DOR severity. Decreased grey matter density in the caudate nucleus may underlie DOR in early psychosis.

  11. The quality of life among first-episode psychotic patients in the OPUS trial

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia;

    2010-01-01

    BACKGROUND: From an 'objective' perspective, treatment of first-episode psychosis has improved in many ways with the development of specialised early and intensive team-based treatment like e.g. the 'OPUS' treatment. However, the patients' perspective is also important and was investigated...... in the 'OPUS' study by analysing data concerning quality of life. AIM: We aimed to investigate the 'quality of life from patients' perspective' among a cohort of young adults with a first-episode psychosis at the time of treatment initiation and after two years. Especially, we were interested in analysing...... if there were any significant effects on the subjective quality of life of receiving an intensive psychosocial assertive community treatment called 'OPUS' compared to standard treatment (ST). METHOD: This study is part of the Danish 'OPUS' trial, a randomised controlled trial (RCT) comparing 'treatment as usual...

  12. The influence of comorbid personality disorder and neuroticism on treatment outcome in first episode depression

    DEFF Research Database (Denmark)

    Bock, Camilla; Bukh, Jens Otto Drachmann; Vinberg, Maj

    2010-01-01

    BACKGROUND: It has never been investigated whether comorbid personality disorder or neuroticism predicts a poor treatment outcome in first episode depression. METHODS: Medically treated patients discharged with a diagnosis of a single depressive episode from a psychiatric in- or outpatient hospital...... of any kind. Comorbid personality disorder was associated with a 2.2-times (95% CI: 1.1-4.2) increased risk of non-remission following the first antidepressant trial, whereas no effect was found following the second antidepressant trial (OR: 1.6; 95% CI: 0.8-3.4). A high level of neuroticism...... was associated with non-remission in first as well as second trials. CONCLUSION: Comorbid personality disorder and high levels of neuroticism in first episode depression predict an increased risk of non-remission from depression....

  13. Long-term trajectories of positive and negative symptoms in first episode psychosis

    DEFF Research Database (Denmark)

    Austin, Stephen; Mors, Ole; Budtz-Jørgensen, Esben;

    2015-01-01

    OBJECTIVE: Knowledge about course of illness can help clinicians to develop effective interventions and improve treatment outcomes. The goal of this study was to construct positive and negative symptom trajectories based on structured clinical assessments collected over 10years within a cohort...... of people with first episode psychosis. METHOD: A cohort of 496 people with first episode psychosis (ICD-10, F20-28) originally recruited for the OPUS study (1998-2000) and treated in community psychiatric services were rated on clinical symptoms at 5 different occasions across ten years. Psychopathology...... was assessed using the Scales for Assessment of Positive and Negative Symptoms. Symptom trajectories were constructed using Latent Class Analysis. RESULTS: Five distinct trajectories were identified for positive symptoms (response - 47%, delayed response - 12%, relapse - 15%, non-response - 13% and episodic...

  14. The relationship between insight and neurological dysfunction in first-episode psychosis.

    LENUS (Irish Health Repository)

    Hill, M

    2012-04-01

    Impaired insight is commonly seen in psychosis and some studies have proposed that is a biologically based deficit. Support for this view comes from the excess of neurological soft signs (NSS) observed in patients with psychoses and their neural correlates which demonstrate a degree of overlap with the regions of interest implicated in neuroimaging studies of insight. The aim was to examine the relationship between NSS and insight in a sample of 241 first-episode psychosis patients.

  15. Genital self-mutilation in a case of first episode psychosis

    Directory of Open Access Journals (Sweden)

    Anuj Khandelwal

    2016-01-01

    Full Text Available Genital self-mutilation (GSM is a much rare finding and more commonly associated with psychosis when it comes to comparison with self-mutilation as a whole. There have been anecdotal case reports of GSM in psychotic disorders with most of them being in long standing psychoses. We describe herein a case of GSM during the first episode of psychosis where multiple phenomenological variables were seen responsible for the act.

  16. Genital Self-mutilation in a Case of First Episode Psychosis

    Science.gov (United States)

    Khandelwal, Anuj; Chauhan, Khushboo; De Sousa, Avinash; Sonavane, Sushma; Pawar, Alka

    2016-01-01

    Genital self-mutilation (GSM) is a much rare finding and more commonly associated with psychosis when it comes to comparison with self-mutilation as a whole. There have been anecdotal case reports of GSM in psychotic disorders with most of them being in long standing psychoses. We describe herein a case of GSM during the first episode of psychosis where multiple phenomenological variables were seen responsible for the act. PMID:27570352

  17. Association of Premorbid Adjustment with Symptom Profile and Quality of Life in First Episode Psychosis in a Tertiary Hospital in Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Vandad Sharifi

    2010-05-01

    Full Text Available "n Objective: Poor premorbid adjustment has been reported to be a predictor of more severe psychotic symptoms and poor quality of life in such psychotic disorders as schizophrenia. However, most studies were performed on chronic schizophrenic patients, and proposed the likelihood of recall biases and the effect of chronicity. The aim of this study was to investigate these factors in a sample of first episode psychotic patients, as a part of Roozbeh first episode psychosis project (RooF. "n "n "nMethod: Premorbid adjustment was assessed using Premorbid Adjustment Scale (PAS in 48 patients with the first psychotic episode who were admitted to Roozbeh Psychiatric Hospital. The severity of symptoms was measured using Positive and Negative Scale (PANSS in three subgroups of positive, negative and general subscales. Quality of life was measured using WHO QOL ,and Global Assessment of Functioning (GAF was also measured. "nResults: The mean age was 24 years. Poor Premorbid adjustment in late adolescence was significantly associated with more severe symptoms according to PANSS negative symptoms (p=0.019, r=0.44. Furthermore, sociability and peer relationship domains had a positive correlation with PANSS negative subscale scores (r=0.531, p=0.002 and r=0.385, p=0.03, respectively. There were no significant differences between males and females in premorbid adjustment. Furthermore, this study failed to show any differences between affective and non-affective psychosis in premorbid functioning . "nConclusion: Our study confirms poor premorbid adjustment association with more severe negative symptoms and poor quality of life in a sample of Iranian first episode psychotic patients.

  18. Opposite effective connectivity in the posterior cingulate and medial prefrontal cortex between first-episode schizophrenic patients with suicide risk and healthy controls.

    Directory of Open Access Journals (Sweden)

    Huiran Zhang

    Full Text Available OBJECTIVE: The schizophrenic patients with high suicide risk are characterized by depression, better cognitive function, and prominent positive symptoms. However, the neurobiological basis of suicide attempts in schizophrenia is not clear. The suicide in schizophrenia is implicated in the defects in emotional process and decision-making, which are associated with prefrontal-cingulate circuit. In order to explore the possible neurobiological basis of suicide in schizophrenia, we investigated the correlation of prefrontal-cingulate circuit with suicide risk in schizophrenia via dynamic casual modelling. METHOD: Participants were 33 first-episode schizophrenic patients comprising of a high suicide risk group (N = 14 and a low suicide risk group (N = 19. A comparison group of healthy controls (N = 15 were matched for age, gender and education. N-back tasking functional magnetic resonance imaging data was collected. RESULTS: Compared with healthy controls group, the two patients groups showed decreased task-related suppression during 2-back task state versus baseline state in the left posterior cingulate and medial prefrontal cortex; the hyper-connectivity from the left posterior cingulate cortex to the left medial prefrontal cortex existed in both schizophrenic patients groups, but hypo-connectivity in the opposite direction only existed in the schizophrenic patients group with high suicide risk. CONCLUSIONS: The hyper-connectivity from the left posterior cingulate cortex to the left medial prefrontal cortex may suggest that the abnormal effective connectivity was associated with risk for schizophrenia. The hypo-connectivity in the opposite direction may represent a possible correlate of increased vulnerability to suicide attempt.

  19. Improving 1-year outcome in first-episode psychosis: OPUS trial

    DEFF Research Database (Denmark)

    Petersen, Lone; Nordentoft, Merete; Jeppesen, Pia;

    2005-01-01

    Because early illness course and outcome may affect the long-term outcome of schizophrenia-spectrum disorders, it is especially important to address poor outcome in this early critical period.......Because early illness course and outcome may affect the long-term outcome of schizophrenia-spectrum disorders, it is especially important to address poor outcome in this early critical period....

  20. Association between DBH 19 bp insertion/deletion polymorphism and cognition in first-episode schizophrenic patients.

    Science.gov (United States)

    Hui, Li; Zhang, Xuan; Yu, Ya Qin; Han, Mei; Huang, Xu Feng; Chen, Da Chun; Wang, Zhi Ren; Du, Wei Li; Kou, Chang Gui; Yu, Qiong; Kosten, Thomas R; Zhang, Xiang Yang

    2013-07-01

    Many genes associated with dopamine (DA) and norepinephrine (NE) systems influence cognitive deficits of schizophrenia patients, but one key enzyme is dopamine beta-hydroxylase (DBH), which converts DA to NE and whose activity and levels are under strong genetic control. This study examines the association of the 19 bp insertion/deletion (Ins/Del) polymorphism in the 5' flank of the DBH gene with cognitive deficits in first-episode schizophrenic patients (FEP). We assessed the cognitive function in 195 FEP and 304 healthy controls using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The 19 bp Ins/Del polymorphism of DBH gene was genotyped. Our results showed that the allelic and genotypic frequencies of the 19 bp Ins/Del polymorphism significantly differed between FEP and healthy controls (both p 0.05). Immediate memory abilities significantly differed by genotype (p<0.05) but not genotype×diagnosis. Immediate memory score was lower in FEP with DBH5'-Del/Del genotype (61.3 ± 17.2) than those with DBH5'-Ins/Ins genotype (68.6 ± 16.2; p < 0.05). The 19 bp Del allele was associated with poorer immediate memory performance than the Ins allele in FEP (p < 0.05). However, healthy controls did not show any differences in cognitive function indices between the Ins and Del for either the allele or genotype of the 19 bp Ins/Del polymorphism. Our findings suggest that the DBH5'-Ins/Del polymorphism may play a role in susceptibility to FEP. The DBH5'-Ins/Del polymorphism may also influence immediate memory in FEP. Moreover, FEP had poorer cognitive function than healthy controls in all examined cognitive domains except for the visuospatial/constructional index.

  1. Family Functioning in First-Episode and Chronic Psychosis: The Role of Patient's Symptom Severity and Psychosocial Functioning.

    Science.gov (United States)

    Koutra, Katerina; Triliva, Sofia; Roumeliotaki, Theano; Basta, Maria; Lionis, Christos; Vgontzas, Alexandros N

    2016-08-01

    The aim of the present study was to assess the relationship between illness-related characteristics, such as symptom severity and psychosocial functioning, and specific aspects of family functioning both in patients experiencing their first episode of psychosis (FEP) and chronically ill patients. A total of 50 FEP and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) and their family caregivers participated in the study. Family functioning was evaluated in terms of cohesion and flexibility (FACES IV Package), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Patients' symptom severity (BPRS) and psychosocial functioning (GAS) were assessed by their treating psychiatrist within 2 weeks from the caregivers' assessment. Increased symptom severity was associated with greater dysfunction in terms of family cohesion and flexibility (β coefficient -0.13; 95 % CI -0.23, -0.03), increased caregivers' EE levels on the form of emotional overinvolvement (β coefficient 1.03; 95 % CI 0.02, 2.03), and psychological distress (β coefficient 3.37; 95 % CI 1.29, 5.45). Family burden was found to be significantly related to both symptom severity (β coefficient 3.01; 95 % CI 1.50, 4.51) and patient's functioning (β coefficient -2.04; 95 % CI -3.55, -0.53). No significant interaction effect of chronicity was observed in the afore-mentioned associations. These findings indicate that severe psychopathology and patient's low psychosocial functioning are associated with poor family functioning. It appears that the effect for family function is significant from the early stages of the illness. Thus, early psychoeducational interventions should focus on patients with severe symptomatology and impaired functioning and their families.

  2. Does bereavement-related first episode depression differ from other kinds of first depressions?

    DEFF Research Database (Denmark)

    Kessing, Lars Vedel; Bukh, Jens Drachmann; Bock, Camilla;

    2009-01-01

    (4.7%) had experienced death of a first degree relative (parent, sibling, child) or a near friend, 163 patients (54.2%) had experienced other moderate to severe stressful life events and 112 patients had not experienced stressful life events in a 6 months period prior to the onset of depression....... Patients who had experienced bereavement did not differ from patients with other stressful life events or from patients without stressful life events in socio-demographic variables or in the phenomenology of the depression, psychiatric comorbidity, family history or response to antidepressant treatment....... CONCLUSION: Bereavement-related first episode depression does not differ from other kinds of first depression....

  3. Neuroactive Steroids in First-Episode Psychosis: A Role for Progesterone?

    Directory of Open Access Journals (Sweden)

    Martino Belvederi Murri

    2016-01-01

    Full Text Available Neuroactive steroids may play a role in the pathophysiology of psychotic disorders, but few studies examined this issue. We compared serum levels of cortisol, testosterone, dehydroepiandrosterone, and progesterone between a representative sample of first-episode psychosis (FEP patients and age- and gender-matched healthy subjects. Furthermore, we analyzed the associations between neuroactive steroids levels and the severity of psychotic symptom dimensions. Male patients had lower levels of progesterone than controls (p=0.03. Progesterone levels were inversely associated with the severity of positive symptoms (p=0.007. Consistent with preclinical findings, results suggest that progesterone might have a role in the pathophysiology of psychotic disorders.

  4. Neuroactive Steroids in First-Episode Psychosis: A Role for Progesterone?

    Science.gov (United States)

    Pagotto, Uberto; Bonora, Elena; Triolo, Federico; Chiri, Luigi; Menchetti, Marco; Mondelli, Valeria; Pariante, Carmine; Berardi, Domenico

    2016-01-01

    Neuroactive steroids may play a role in the pathophysiology of psychotic disorders, but few studies examined this issue. We compared serum levels of cortisol, testosterone, dehydroepiandrosterone, and progesterone between a representative sample of first-episode psychosis (FEP) patients and age- and gender-matched healthy subjects. Furthermore, we analyzed the associations between neuroactive steroids levels and the severity of psychotic symptom dimensions. Male patients had lower levels of progesterone than controls (p = 0.03). Progesterone levels were inversely associated with the severity of positive symptoms (p = 0.007). Consistent with preclinical findings, results suggest that progesterone might have a role in the pathophysiology of psychotic disorders. PMID:27747103

  5. Suicidal behaviour and mortality in first-episode psychosis: the OPUS trial

    DEFF Research Database (Denmark)

    Bertelsen, Mette; Jeppesen, Pia; Petersen, Lone

    2007-01-01

    . standard treatment. All participants were followed in the Danish Cause of Death Register for 5 years. Suicidal behaviour and clinical and social status were assessed using validated interviews and rating scales at entry, and at 1- and 2-year follow-ups. RESULTS: Sixteen participants died during the follow......-up. We found a strong association between suicidal thoughts, plans and previous attempts, depressive and psychotic symptoms and young age, and with suicidal plans and attempts at 1- and 2-year follow-up. CONCLUSIONS: In this first-episode cohort depressive and psychotic symptoms, especially...

  6. Examination of anomalous self-experience in first-episode psychosis: interrater reliability

    DEFF Research Database (Denmark)

    Møller, Paul; Haug, Elisabeth; Raballo, Andrea

    2011-01-01

    Background: The growing research focus on early detection of schizophrenia has fostered an increasing interest in the nonpsychotic experiential anomalies that may antedate schizophrenia spectrum disorders and assist early differential diagnosis. The Examination of Anomalous Self-Experience (EASE...... consistent clinical tool for the assessment of subjective experience in FEP patients, suggesting that this instrument could usefully supplement standard clinical assessments during the onset phase of psychosis....

  7. Determinants of adherence to treatment in first-episode psychosis: a comprehensive review

    Directory of Open Access Journals (Sweden)

    Emilie Leclerc

    2015-06-01

    Full Text Available Objective:To conduct a comprehensive review of current evidence on factors for nonadherence to treatment in individuals with first-episode psychosis (FEP.Methods:MEDLINE, LILACS, PsycINFO, and SciELO databases were searched with the keywords first episode psychosis, factor, adherence, nonadherence, engagement, disengagement, compliance, and intervention. References of selected studies were consulted for relevant articles.Results:A total of 157 articles were screened, of which 33 articles were retained for full review. The factors related to nonadherence were: a patient-related (e.g., lower education level, persistent substance use, forensic history, unemployment, history of physical abuse; b environment-related (e.g., no family involved in treatment, social adjustment difficulties; c medication-related (e.g., rapid remission of negative symptoms when starting treatment, therapeutic alliance; and d illness-related (e.g., more positive symptoms, more relapses. Treatment factors that improve adherence include a good therapeutic alliance and a voluntary first admission when hospitalization occurs.Conclusion:The results of this review suggest that nonadherence to treatment in FEP is multifactorial. Many of these factors are modifiable and can be specifically targeted in early intervention programs. Very few studies have assessed strategies to raise adherence in FEP.

  8. Hippocampus, glucocorticoids and neurocognitive functions in patients with first-episode major depressive disorders.

    Science.gov (United States)

    Kaymak, Semra Ulusoy; Demir, Başaran; Sentürk, Senem; Tatar, Ilkan; Aldur, M Mustafa; Uluğ, Berna

    2010-04-01

    The aim of this study was to determine whether there was any relationship between hippocampal volume, and glucocorticoid regulation, and cognitive dysfunctions in drug-naïve major depressive disorder (MDD) patients during their first episode. Twenty drug-free female MDD patients in their first episode and 15 healthy females as control subjects were included in the study. All subjects underwent 3.0 Tesla (T) magnetic resonance imaging (MRI), comprehensive neuropsychological testing and dexamethasone suppression tests (DST). The volumes of the right and left hippocampus of the patients were found to be significantly smaller than those of the controls. Patients were found to have significantly lower scores on measures of attention, working memory, psychomotor speed, executive functions, and visual and verbal memory fields. The performance of the patients only in the recollection memory and memory of reward-associated rules were positively correlated with hippocampal volumes. The volumes of the left and right hippocampus did not correlate with basal or post-dexamethasone cortisol levels. Our findings indicate that depressed patients have smaller hippocampi even in the earlier phase of their illness. Further research efforts are needed to explain the mechanisms that are responsible for the small hippocampus in depressed patients.

  9. The diagnostic yield of the first episode of a periodic health evaluation: a descriptive epidemiology study

    Directory of Open Access Journals (Sweden)

    Kermott Cindy A

    2012-05-01

    Full Text Available Abstract Background The benefits of a periodic health evaluation remain debatable. The incremental value added by such evaluations beyond the delivery of age appropriate screening and preventive medicine recommendations is unclear. Methods We retrospectively collected data on a cohort of consecutive patients presenting for their first episode of a comprehensive periodic health evaluation. We abstracted data on new diagnoses that were identified during this single episode of care and that were not trivial (i.e., required additional testing or intervention. Results The cohort consisted of 491 patients. The rate of new diagnoses per this single episode of care was 0.9 diagnoses per patient. The majority of these diagnoses was not prompted by patients’ complaints (71% and would not have been identified by screening guidelines (51%. Men (odds ratio 2.67; 95% CI, 1.76, 4.03 and those with multiple complaints at presentation (odds ratio 1.12; 95% CI, 1.05, 1.19 were more likely to receive a clinically relevant diagnosis at the conclusion of the visit. Age was not a predictor of receiving a diagnosis in this cohort. Conclusion The first episode of a comprehensive periodic health evaluation may reveal numerous important diagnoses or risk factors that are not always identified through routine screening.

  10. Subclinical depressive symptoms and continued cannabis use: predictors of negative outcomes in first episode psychosis.

    Directory of Open Access Journals (Sweden)

    Itxaso González-Ortega

    Full Text Available Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use.64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a patients with subclinical depressive symptoms at least once during follow-up (DPG, and (b patients without subclinical depressive symptoms during follow-up (NDPG. Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS, depressive symptoms using the Hamilton Depression Rating Scale (HDRS-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF. A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome.Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001 and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009.Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients.

  11. The association between social anxiety and social functioning in first episode psychosis.

    Science.gov (United States)

    Voges, Marcia; Addington, Jean

    2005-07-15

    The purpose of the study was to examine the relationship between social anxiety and social functioning in first episode psychosis, and to determine whether those with psychosis have any maladaptive or irrational beliefs regarding social situations. A sample of 60 first episode patients (41 males, 19 females) participated in the study. The presence of social phobia was determined using the Structured Clinical Interview for DSM-IV (SCID-I). Measures included The Social Phobia and Anxiety Inventory (SPAI), the Social Functioning Scale (SFS), the Quality of Life Scale (QLS) and the Social Interaction Self-Statement Test. Thirty-two percent of the sample met SCID-I criteria for social phobia and approximately 60% of participants were experiencing elevated levels of social anxiety according to the SPAI (M=69.57, S.D.=27.42). Results were that negative symptoms and negative self-statements, but not social anxiety, were significant predictors of social functioning. This has implications for addressing these negative cognitions in early psychosis.

  12. Psychotic symptoms, cognition and affect as predictors of psychosocial problems and functional change in first-episode psychosis

    NARCIS (Netherlands)

    Stouten, Luyken H.; Veling, Wim; Laan, Winfried; van der Helm, Mischa; van der Gaag, Mark

    2014-01-01

    Objective: To enable further understanding of how cognitive deficits and psychopathology impact psychosocial functioning in first-episode psychosis patients, we investigated how psychopathology and cognitive deficits are associated with psychosocial problems at baseline, and how these predict psycho

  13. An examination of associations between the inability to taste phenylthiocarbamide (PTC) and clinical characteristics and trait markers in first-episode, nonaffective psychotic disorders.

    Science.gov (United States)

    Compton, Michael T; Ionescu, Dawn F; Broussard, Beth; Cristofaro, Sarah L; Johnson, Stephanie; Haggard, Patrick J; Potts, Amy A; Wan, Claire Ramsay; Walker, Elaine F

    2013-08-30

    Research findings are mixed as to whether or not the inability to taste phenylthiocarbamide (PTC) might represent an endophenotypic trait marker for schizophrenia. We hypothesized associations between PTC-tasting status and select clinical characteristics and trait markers in patients with psychotic disorders that, if present, would provide support for the inability to taste PTC as a trait marker. In a first-episode psychosis sample (n=93), we measured PTC tasting, family history of psychosis, age at onset of prodrome and psychosis, severity of positive and negative symptoms, global impairment in functioning, neurological soft signs, and four neurocognitive domains (verbal learning/memory, visual learning/memory, verbal working memory, and spatial working memory). Associations between PTC-non-tasting and clinical/neurocognitive variables were examined with χ(2) tests and independent samples t tests. Among participants, 67.7% tasted PTC in comparison to a strip of control paper, and 25.8% were non-tasters. Tasters and non-tasters did not show statistically significant differences with respect to family history, age at onset, severity of symptoms, neurological soft signs, or the four neurocognitive domains. In conjunction with other findings, it is unlikely that PTC-non-tasting is a trait marker of schizophrenia, though a conclusive study is warranted.

  14. Social functioning in Chinese college students with and without schizotypal personality traits: an exploratory study of the Chinese version of the First Episode Social Functioning Scale.

    Directory of Open Access Journals (Sweden)

    Yi Wang

    Full Text Available OBJECTIVES: The First Episode Social Functioning Scale (FESFS was designed to measure social functioning of young individuals with schizophrenia. The aim of this study was to validate a Chinese version of the FESFS in a sample of young Chinese adults. METHOD: The FESFS was translated to Chinese prior to being administered to 1576 college students. The factor structure, reliability, and validity of the scale were examined. RESULTS: Two items were deleted after item analysis and the internal consistency of the whole scale was .89. A six-factor structure was derived by exploratory factor analysis. The factors were interpersonal, family and friends, school, living skills, intimacy, and balance. Estimates of the structural equation model supported this structure, with Goodness of Fit Chi-Square χ(2 = 1097.53 (p<0.0001, the root mean square error of approximation (RMSEA = 0.058, and the comparative fit index (CFI = 0.93. Scale validity was supported by significant correlations between social functioning factors scores and schizophrenia personality questionnaire (SPQ scores. Individuals with schizotypal personality features presented poorer social functioning than those without schizotypal personality features. CONCLUSIONS: The Chinese revised version of the FESFS was found to have good psychometric properties and could be used in the future to examine social functioning in Chinese college students.

  15. Integrated Treatment to Achieve Functional Recovery for First-Episode Psychosis

    Directory of Open Access Journals (Sweden)

    Marcelo Valencia

    2012-01-01

    Full Text Available This study describes an integrated treatment approach that was implemented to enhance functional recovery in first-episode psychotic patients. Patients were randomized to two treatment conditions: either to an integrated treatment approach: pharmacotherapy, psychosocial treatment, and psychoeducation (experimental group: N=39 or to medication alone (control group: N=34. Patients were evaluated at baseline and after one year of treatment. Functional recovery was assessed according to symptomatic and functional remission. At the end of treatment, experimental patients showed a 94.9% of symptomatic remission compared to 58.8% of the control group. Functional remission was 56.4% for the experimental group and 3.6% for the control group, while 56.4% of the experimental group met both symptomatic and functional remission criteria and were considered recovered compared to 2.9% of the control group.

  16. Metacognition, symptoms and premorbid functioning in a first episode psychosis sample.

    Science.gov (United States)

    Macbeth, Angus; Gumley, Andrew; Schwannauer, Matthias; Carcione, Antonino; Fisher, Rebecca; McLeod, Hamish J; Dimaggio, Giancarlo

    2014-02-01

    Significant metacognitive impairments are observed in chronic psychosis samples but metacognition is less understood in first episode psychosis (FEP). The current study explored correlations between metacognition, symptoms and premorbid functioning in an FEP sample. In a cross-sectional cohort study, individuals in the first 12 months of treatment metacognition were assessed with the Metacognition Assessment Scale-Revised version (MAS-R). Psychotic symptomatology, premorbid adjustment, and clinician rated service engagement were also measured. Lower scores for metacognitive understanding of other's minds were significantly correlated with greater negative symptoms, poorer early adolescent social adjustment and poorer clinician rated help-seeking. Our findings suggest that FEP individuals with difficulties in understanding other's minds have more social deficits and may be less able to make effective use of treatment.

  17. Metacognition in first-episode psychosis and its association with positive and negative symptom profiles

    DEFF Research Database (Denmark)

    Trauelsen, Anne Marie; Gumley, Andrew; Jansen, Jens Einar

    2016-01-01

    There is growing evidence that metacognitive abilities which include the ability to synthesize knowledge regarding mental states in self and others and use this ability to solve problems are impaired in non-affective psychosis and associated with positive and negative symptom severity. We sought...... to (a) investigate the severity of metacognitive impairments in first-episode psychosis (FEP) compared to non-clinical controls and (b) explore associations with positive and negative symptom profiles. Ninety-seven people with FEP were compared to 101 control persons. Metacognition was assessed...... with interviews and the Metacognitive assessment scale-abbreviated. Four groups based on positive and negative symptoms were identified by cluster analysis and compared on metacognition, childhood adversities, duration of untreated psychosis and premorbid social and academic adjustment. Those with high levels...

  18. Urovirulence determinants in Escherichia coli isolates causing first-episode and recurrent cystitis in women.

    Science.gov (United States)

    Stapleton, A; Moseley, S; Stamm, W E

    1991-04-01

    To assess the prevalence of urovirulence determinants among Escherichia coli isolates from women with acute uncomplicated cystitis, 121 isolates from 87 women with first-episode or recurrent cystitis and 156 fecal isolates from 52 women without recent urinary tract infection were tested using DNA probes for P fimbriae, hemolysin, aerobactin, and diffuse adhesin and for expression of hemolysin and P and F adhesins. P fimbrial genotype (P = .002), hemolysin phenotype (P = .007), and the diffuse adhesin determinant (P = .03), but not aerobactin, were found more frequently in E. coli from women with acute cystitis, and expression of the F adhesin (41%) was more common than the P adhesin (24%; P = .001). E. coli isolates that caused cystitis in women using diaphragms had fewer virulence determinants than those from nonusers (P = .04), suggesting that diaphragm use may allow infection with less virulent E. coli.

  19. Pathways to Care for Patients With First-Episode Psychosis in Singapore.

    Science.gov (United States)

    Chesney, Edward; Abdin, Edimansyah; Poon, Lye Yin; Subramaniam, Mythily; Verma, Swapna

    2016-04-01

    In this study, we aim to describe the pathways to care for patients with first-episode psychosis in Singapore. We analyzed data from 900 individuals accepted by the Singapore Early Psychosis Intervention Programme between 2007 and 2012. The most common first contacts were specialist care (59%), primary care (27%), and the police (12%). Multivariate regression models showed that first contact with services varied according to demographic variables and diagnosis. The duration of untreated psychosis, total number of contacts before referral, and rate of referral to the Early Psychosis Intervention Programme varied according to demographic and clinical variables and first contact. We hope that this information will enable clinicians, managers, and other service providers to target interventions to streamline referrals, reduce distress, and improve the treatment of young people with psychotic illnesses.

  20. Early Predictors of Ten-Year Course in First-Episode Psychosis

    DEFF Research Database (Denmark)

    Friis, Svein; Melle, Ingrid; Johannessen, Jan Olav

    2016-01-01

    OBJECTIVE: Identifying patients at risk of poor outcome at an early stage of illness can aid in treatment planning. This study sought to create a best-fit statistical model of known baseline and early-course risk factors to predict time in psychosis during a ten-year follow-up period after a first...... psychotic episode. METHODS: Between 1997 and 2000, 301 patients with DSM-IV nonorganic, nonaffective first-episode psychosis were recruited consecutively from catchment area-based sectors in Norway and Denmark. Specialized mental health personnel evaluated patients at baseline, three months, and one, two......, five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores ≥4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years...

  1. Childhood adversity specificity and dose-response effect in non-affective first-episode psychosis

    DEFF Research Database (Denmark)

    Trauelsen, Anne Marie; Bendall, Sarah; Jansen, Jens Einar

    2015-01-01

    BACKGROUND: Reviews conclude that childhood and adolescence sexual, physical, emotional abuse and emotional and physical neglect are all risk factors for psychosis. However, studies suggest only some adversities are associated with psychosis. Dose-response effects of several adversities on risk...... of psychosis have not been consistently found. The current study aimed to explore adversity specificity and dose-response effects of adversities on risk of psychosis. METHOD: Participants were 101 persons with first-episode psychosis (FEP) diagnosed with ICD-10 F20 - F29 (except F21) and 101 non......% of the control group. Childhood and adolescent sexual, physical, emotional abuse, and physical and emotional neglect, separation and institutionalization were about four to 17 times higher for the FEP group (all ppsychosis increased two and a half times for each additional adversity. All...

  2. Assessment of posttraumatic symptoms in patients with first-episode psychosis.

    LENUS (Irish Health Repository)

    2011-11-01

    Posttraumatic stress disorder is common among patients with psychotic disorders. The present study examined the internal reliability and comparability of the Impact of Event Scale (IES) in a sample of 38 patients with first-episode psychosis and 47 controls exposed to severe physical and\\/or sexual abuse. The IES total score and both subscales showed high internal consistency in both groups (Cronbach\\'s alpha coefficients of approximately 0.9 or higher). Given their equivalent trauma reporting, the lack of differences in IES scores between patients and controls seems to indicate that patients are likely to report accurately and neither exaggerate nor minimize their posttraumatic symptoms. Overall, the findings suggest that the IES can be used to assess symptoms of posttraumatic stress in patients with psychotic disorders as in other populations.

  3. Change in cannabis use, clinical symptoms and social functioning among patients with first-episode psychosis

    DEFF Research Database (Denmark)

    Clausen, L; Hjorthøj, C R; Thorup, Anne A.E.

    2014-01-01

    BACKGROUND: Several studies indicate that cannabis use among patients with psychotic disorders is associated with worse outcome, but only a few studies have controlled for baseline condition and medication. METHOD: At 5-year follow-up, interviews were carried out with 314 first-episode psychosis.......26, 95% CI 2.13-14.39, p = 0.01). Those who stopped using cannabis between entry and 5-year follow-up had a significantly lower level of psychotic symptoms at 5-year follow-up even after controlling for baseline level of psychotic symptoms and for insufficient antipsychotic medication (adjusted...... difference in psychotic dimension -1.04, 95% CI -1.77 to -0.31, p = 0.006). CONCLUSIONS: Continuous cannabis use was associated with higher levels of psychotic symptoms after 5 years, and this association was only partly explained by insufficient antipsychotic medication....

  4. Abnormal resting-state brain activities in patients with first-episode obsessive-compulsive disorder

    Science.gov (United States)

    Niu, Qihui; Yang, Lei; Song, Xueqin; Chu, Congying; Liu, Hao; Zhang, Lifang; Li, Yan; Zhang, Xiang; Cheng, Jingliang; Li, Youhui

    2017-01-01

    Objective This paper attempts to explore the brain activity of patients with obsessive-compulsive disorder (OCD) and its correlation with the disease at resting duration in patients with first-episode OCD, providing a forceful imaging basis for clinic diagnosis and pathogenesis of OCD. Methods Twenty-six patients with first-episode OCD and 25 healthy controls (HC group; matched for age, sex, and education level) underwent functional magnetic resonance imaging (fMRI) scanning at resting state. Statistical parametric mapping 8, data processing assistant for resting-state fMRI analysis toolkit, and resting state fMRI data analysis toolkit packages were used to process the fMRI data on Matlab 2012a platform, and the difference of regional homogeneity (ReHo) values between the OCD group and HC group was detected with independent two-sample t-test. With age as a concomitant variable, the Pearson correlation analysis was adopted to study the correlation between the disease duration and ReHo value of whole brain. Results Compared with HC group, the ReHo values in OCD group were decreased in brain regions, including left thalamus, right thalamus, right paracentral lobule, right postcentral gyrus, and the ReHo value was increased in the left angular gyrus region. There was a negative correlation between disease duration and ReHo value in the bilateral orbitofrontal cortex (OFC). Conclusion OCD is a multifactorial disease generally caused by abnormal activities of many brain regions at resting state. Worse brain activity of the OFC is related to the OCD duration, which provides a new insight to the pathogenesis of OCD. PMID:28243104

  5. Contribution of ultrasound scans in the first episode of urinary tract infection in children.

    Science.gov (United States)

    Jellouli, Manel; Ben Mansour, Asma; Abidi, Kamel; Ferjani, Meriem; Naija, Ouns; Hammi, Yousra; Zarrouk, Chokri; Gargah, Tahar

    2016-06-01

    Background - Vesicoureteral reflux (VUR) is a common pediatric urologic disorder. After the first urinary tract infection (UTI), imaging studies are recommended, starting with a renal ultrasound (US) and voiding cystourethrography (VCUG). We propose to determine whether abnormalities found on US can help indicate the necessity of VCUG in children after the first urinary tract infection. Methods - A retrospective study included all children admitted with their first episode of urinary tract infection from January 2007 to December 2012. Results - A total of 311 children were included. The median age was 2.5 years, 72.3% were female. VUR Prevalence was 14%.  Forty-four patients were found to have VUR on VCUG, giving a prevalence of 14%. Of these 44 patients, 11 had grade I reflux, 6 had grade II reflux, 3 had grade III reflux, 15had grade IV reflux, and 9 had grade V reflux. Ultrasound findings were positive for VUR in 43 patients, 19 of them had RVU. Twenty five patients had a normal ultrasound but showed VUR on VCUG (11 had grade I reflux, six grade II reflux, three grade III reflux and five grade IV reflux).  The sensitivity and specificity of ultrasound in suggesting VUR were 43% and 91%, respectively. The positive predictive value of ultrasound in suggesting VUR was 44%; the negative predictive value was 91%. Conclusion - Renal ultrasound findings are specific for VUR in children with a first UTI, but no sensitive. Clinicians should consider renal ultrasound results to take decision on whether or not to proceed with a VCUG in the investigation of a first episode UTI in young children.

  6. The Treatment of Hallucinations in Schizophrenia Spectrum Disorders

    NARCIS (Netherlands)

    Sommer, Iris E. C.; Slotema, Christina W.; Daskalakis, Zafiris J.; Derks, Eske M.; Blom, Jan Dirk; van der Gaag, Mark

    2012-01-01

    This article reviews the treatment of hallucinations in schizophrenia. The first treatment option for hallucinations in schizophrenia is antipsychotic medication, which can induce a rapid decrease in severity. Only 8% of first-episode patients still experience mild to moderate hallucinations after c

  7. Depressive symptoms in first episode schizophrenic patients.%首发精神分裂症病人的抑郁症状

    Institute of Scientific and Technical Information of China (English)

    李献云; 费立鹏; 张培琰; 吉中孚

    2001-01-01

    Objective  To investigate the prevalence, characteristics and correlates of depressive symptoms in first episode schizophrenic patients. Methods To examine 164 first episode schizophrenic patients at the time of admission and at 3,6,9, and 12 months after starting treatment using the HAMD, BPRS, the Chinese version of SANS, CGI and GAF. Results 71% of the patients had depressive symptoms (mild or more) at damission, but the prevalence of depressive symptoms dropped to a mean of 12% during the recovery period. The most prominent depressive symptoms during the acute phase of schizophrenia were ‘cognitive disturbance’ and ‘retardation’ (the respective subscales constituted 35% and 29% of the total HAMD score on admission). Depressive symptoms improved in parallel with the schizophrenic illness. The severity of depressive symptoms was not related to gender, age of onset, educational level, duration of prodromal period or duration of illness. At admission the severity of depressive symptoms was only related to the BPRS anxiety and depression subscale score, but during the recovery period the HAMD total score was significantly correlated with all of the other clinical scales. The level of depressive symptoms at admission and at three months after starting treatment was not related to the subsequent course of positive or negative symptoms. Conclusions Depressive symptoms appeared to be a separate symptom cluster during the acute phase of first episode schizophrenia. The severity of depressive symptoms did not predict the clinical outcome of first episode schizophrenic patients.%目的探讨首发精神分裂症病人抑郁症状的发生率、特征及相关因素。方法于入院、治疗3、6、9、12月时用汉密尔顿抑郁量表(HAMD)、简明精神病评定量表(BPRS)、阴性症状量表中文版(SANS-CV)、临床总体印象量表(CGI)及功能总体评定量表(GAF)对164例首发精神分裂症患者进行评定。结果急性期首发精神

  8. Specific and generalized neuropsychological deficits: a comparison of patients with various first-episode psychosis presentations.

    LENUS (Irish Health Repository)

    Zanelli, Jolanta

    2010-01-01

    Overwhelming evidence suggests that compromised neuropsychological function is frequently observed in schizophrenia. Neurocognitive dysfunction has often been reported in other psychotic disorders, although there are inconsistencies in the literature. In the context of four distinct diagnostic groups, the authors compared neuropsychological performance among patients experiencing their first psychotic episode.

  9. Mismatch negativity and P3a amplitude in young adolescents with first-episode psychosis

    DEFF Research Database (Denmark)

    Rydkjær, J; Jepsen, Jens Richardt Møllegaard; Pagsberg, A K

    2017-01-01

    BACKGROUND: Deficient mismatch negativity (MMN) has been proposed as a candidate biomarker in schizophrenia and may therefore be potentially useful in early identification and intervention in early onset psychosis. In this study we explored whether deficits in the automatic orienting and reorient...

  10. Metacognition in first-episode psychosis and its association with positive and negative symptom profiles.

    Science.gov (United States)

    Trauelsen, Anne Marie; Gumley, Andrew; Jansen, Jens Einar; Pedersen, Marlene Buch; Nielsen, Hanne-Grethe Lyse; Trier, Christopher Høier; Haahr, Ulrik H; Simonsen, Erik

    2016-04-30

    There is growing evidence that metacognitive abilities which include the ability to synthesize knowledge regarding mental states in self and others and use this ability to solve problems are impaired in non-affective psychosis and associated with positive and negative symptom severity. We sought to (a) investigate the severity of metacognitive impairments in first-episode psychosis (FEP) compared to non-clinical controls and (b) explore associations with positive and negative symptom profiles. Ninety-seven people with FEP were compared to 101 control persons. Metacognition was assessed with interviews and the Metacognitive assessment scale-abbreviated. Four groups based on positive and negative symptoms were identified by cluster analysis and compared on metacognition, childhood adversities, duration of untreated psychosis and premorbid social and academic adjustment. Those with high levels of negative symptoms had poorer metacognitive abilities. Those with high positive and low negative symptoms did not have poorer metacognitive abilities than those with low positive and negative symptoms. None of the other predictors differed between the groups. The FEP group had poorer metacognitive abilities than the control group. Inclusion of metacognition in psychosis models may improve our understanding of negative symptoms, while previous findings of a relation with positive symptoms may have been confounded. Implications for current interventions are discussed.

  11. Effectiveness of antipsychotics used in first-episode psychosis: a naturalistic cohort study

    Science.gov (United States)

    Whale, Richard; Harris, Michael; Kavanagh, Gail; Wickramasinghe, Vijitha; Jones, Christopher I.; Marwaha, Steven; Jethwa, Ketan; Ayadurai, Nirmalan; Thompson, Andrew

    2016-01-01

    Background One year of antipsychotic treatment from symptom remission is recommended following a first episode of psychosis (FEP). Aims To investigate the effectiveness of commonly used antipsychotic medications in FEP. Method A retrospective cohort study of naturalistic treatment of patients (N=460) accepted by FEP services across seven UK sites. Treatment initiation to all-cause discontinuation determined from case files. Results Risk of treatment discontinuation is greatest within 3 months of treatment initiation. Risperidone had longest median survival time. No significant differences were observed in time to discontinuation between commonly used antipsychotics on multivariable Cox regression analysis. Poor adherence and efficacy failure were the most common reasons for discontinuation. Conclusions Effectiveness differences appear not to be a current reason for antipsychotic choice in FEP. Adherence strategies and weighing up likely adverse effects should be the clinical focus. Declaration of interest R.W., A.T. and S.M. have received research grant, speaker honoraria and conference attendance funding from all companies marketing antipsychotics. Copyright and usage © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) license. PMID:27733935

  12. Toward a model of cognitive insight in first-episode psychosis: verbal memory and hippocampal structure.

    Science.gov (United States)

    Buchy, L; Czechowska, Y; Chochol, C; Malla, A; Joober, R; Pruessner, J; Lepage, M

    2010-09-01

    Our previous work has linked verbal learning and memory with cognitive insight, but not clinical insight, in individuals with a first-episode psychosis (FEP). The current study reassessed the neurocognitive basis of cognitive and clinical insight and explored their neural basis in 61 FEP patients. Cognitive insight was measured with the Beck Cognitive Insight Scale (BCIS) and clinical insight with the Scale to assess Unawareness of Mental Disorder (SUMD). Global measures for 7 domains of cognition were examined. Hippocampi were manually segmented in to 3 parts: the body, head, and tail. Verbal learning and memory significantly correlated with the BCIS composite index. Composite index scores were significantly associated with total left hippocampal (HC) volume; partial correlations, however, revealed that this relationship was attributable largely to verbal memory performance. The BCIS self-certainty subscale significantly and inversely correlated with bilateral HC volumes, and these associations were independent of verbal learning and memory performance. The BCIS self-reflectiveness subscale significantly correlated with verbal learning and memory but not with HC volume. No significant correlations emerged between the SUMD and verbal memory or HC volume. These results strengthen our previous assertion that in individuals with an FEP cognitive insight may rely on memory whereby current experiences are appraised based on previous ones. The HC may be a viable location among others for the brain system that underlies aspects of cognitive insight in individuals with an FEP.

  13. A randomized controlled trial of bibliotherapy for carers of young people with first-episode psychosis.

    Science.gov (United States)

    McCann, Terence V; Lubman, Dan I; Cotton, Sue M; Murphy, Brendan; Crisp, Kingsley; Catania, Lisa; Marck, Claudia; Gleeson, John F M

    2013-11-01

    Caring for young people with first-episode psychosis (FEP) is challenging and can adversely affect carer well-being, with limited evidence-based support materials available. We aimed to examine whether completion of a self-directed problem-solving bibliotherapy among carers of young people with FEP led to a better experience of caring, less distress and expressed emotion, and better general health than carers who only received treatment as usual (TAU). A randomized controlled trial was conducted across two early-intervention psychosis services in Melbourne, Australia. A total of 124 carers were randomized to problem-solving bibliotherapy intervention (PSBI) or TAU and assessed at baseline, 6-week and 16-week follow-up. Intent-to-treat analyses were carried out and indicated that recipients of PSBI had a more favorable experience of caring than those receiving TAU, and these effects were sustained at both follow-up time points. Across the other measures, both groups demonstrated improvements by week 16, although the PBSI group tended to improve earlier. The PSBI group experienced a greater reduction in negative emotional evaluations of the need to provide additional support to young people with FEP than the TAU group by week 6, while the level of psychological distress decreased at a greater rate from baseline to 6 weeks in the PSBI compared with the TAU group. These findings support the use of problem-solving bibliotherapy for first-time carers, particularly as a cost-effective adjunct to TAU.

  14. Relationship of frontal D2/3 binding potentials to cognition

    DEFF Research Database (Denmark)

    Fagerlund, Birgitte; Pinborg, Lars H; Mortensen, Erik Lykke;

    2013-01-01

    Studies of in vivo dopamine receptors in schizophrenia have mostly focused on D2 receptors in striatal areas or on D1 receptors in cortex. No previous study has examined the correlation between cortical dopamine D2/3 receptor binding potentials and cognition in schizophrenia patients. The objective...... was to examine this relation in the frontal cortex in first-episode, drug-naive schizophrenia patients. Based on preclinical and pharmacological evidence, we specifically expected to find a relation between D2/3 receptor binding potentials and set shifting. This was a cross-sectional, case-control study using...... single-photon emission computerized tomography with the D2/3-receptor ligand [123I]epidepride, co-registered with structural magnetic resonance imaging and correlated to cognitive measures. Participants were 24 antipsychotic-naive, first-episode schizophrenia patients and 20 healthy controls matched...

  15. Cognitive deficits characterization using the CogState Research Battery in first-episode psychosis patients

    Directory of Open Access Journals (Sweden)

    Audrey Benoit

    2015-09-01

    Full Text Available The computer-based CogState Research Battery (CSRB proposes a test structure which follows MATRICS recommended cognitive domains but lacks direct comparison to pen and paper batteries in first-episode psychosis (FEP. The aim of this study was to compare performances obtained with the CSRB and a pen and paper battery in a historical cohort of FEP patients. Among patients entering an early intervention program between 2003 and 2014, separate cohorts completed the traditional pen and paper cognitive battery (n = 182 and the CSRB (n = 97. Composite z-scores were derived using normative data of matched controls (n = 64 pen and paper, n = 69 CSRB and were compared between the two batteries for the 7 cognitive domains. The cohort tested using the CSRB performed better on the domains of processing speed, attention, visual memory, and verbal memory than the cohort tested using the pen and paper battery (all p < 0.001. Performance did not differ between the two types of batteries for the working memory, executive functions, and social cognition domains. Cognitive profiles identified in the two patient cohorts were similar, with verbal memory being the most impaired domain. Better performances on the CSRB may be primarily due to the minimal demand of the computerized tests on graphomotor abilities and reading speed compared to the pen and paper tests. Our investigation offers a better understanding on how the results obtained with computerized batteries may compare to earlier work done with traditional tests.

  16. Role of environmental confounding in the association between FKBP5 and first-episode psychosis

    Directory of Open Access Journals (Sweden)

    Olesya eAjnakina

    2014-07-01

    Full Text Available Background: Failure to account for the etiological diversity that typically occurs in psychiatric cohorts may increase the potential for confounding, as a proportion of genetic variance will be specific to exposures that have variable distribution in cases. This study investigated whether minimizing the potential for such confounding strengthened the evidence for a genetic candidate currently unsupported at the genome-wide level.Methods: 291 first-episode psychosis cases from South London UK, and 218 unaffected controls were evaluated for a functional polymorphism at the rs1360780 locus in FKBP5. The relationship between FKBP5 and psychosis was modelled using logistic regression. Cannabis use (Cannabis Experiences Questionnaire and parental separation (Childhood Experience of Care and Abuse Questionnaire were modelled as confounders in the analysis.Results: Association at rs1360780 was not detected until the effects of the two environmental factors had been adjusted for in the model (OR=2.81, 95% CI 1.23-6.43, p=0.02. A statistical interaction between rs1360780 and parental separation was confirmed by stratified tests (OR=2.8, p=0.02 vs. OR=0.89, p=0.80. The genetic main effect was directionally-consistent with findings in other (stress-related clinical phenotypes. Moreover, the variation in effect magnitude was explained by the level of power associated with different cannabis constructs used in the model (r=0.95.Conclusions: Our results suggest that the extent to which genetic variants in FKBP5 can influence susceptibility to psychosis may depend on the other etiological factors involved. This finding requires further validation in other large independent cohorts. Potentially this work could have translational implications, as the ability to discriminate between genetic etiologies, based on a case-by-case understanding of exposure history would confer an important clinical advantage that would benefit the delivery of personalizable treatment

  17. Cognitive insight is associated with cortical thickness in first-episode psychosis.

    Science.gov (United States)

    Buchy, Lisa; Barbato, Mariapaola; MacMaster, Frank P; Bray, Signe; Clark, Darren; Deighton, Stephanie; Addington, Jean

    2016-04-01

    Compared to non-clinical subjects, people with psychosis show poor cognitive insight as reflected in low Self-Reflectiveness and high Self-Certainty. Neuroimaging studies have reported that 1) low Self-Reflectiveness is associated with volumetric reductions in ventrolateral prefrontal cortex (VLPFC), 2) higher Self-Certainty is associated with volumetric reductions in hippocampus, and 3) higher Self-Certainty is associated with fractional anisotropy in the fornix, in people with psychosis. The aims of the current study were to expand on this research by 1) performing an exploratory whole-brain cortical thickness analysis of the neural correlates of cognitive insight, to reveal whether regions outside the VLPFC are important for cognitive insight, and 2) to evaluate associations between cognitive insight and subfields of the hippocampus, which are distinct, interacting, and have different functions. We also aimed to replicate previous research documenting associations between cognitive insight and 3) total hippocampal volumes and 4) fornix fractional anisotropy. Fifteen people with a first-episode psychosis completed the Beck Cognitive Insight Scale and provided magnetic resonance and diffusion tensor imaging scans. Cortical thickness and hippocampal volumes were analyzed in FreeSurfer, and fornixfractional anisotropy was analyzed in Diffusion Toolkit/TrackVis. Higher Self-Reflectiveness and lower Self-Certainty significantly associated with thickness and thinness in VLPFC, respectively, as well as thickness and thinness in widespread frontal, parietal and temporal cortices. No associations emerged between Self-Reflectiveness or Self-Certainty and hippocampal total or sub-field volumes, or fornix fractional anisotropy. Results suggest that the neural correlates of cognitive insight involve a network of frontal, temporal and parietal brain regions.

  18. Diagnostic Stability of Comorbid Personality Disorders Among Patients Fully or Partially Remitted From First-Episode Depression

    DEFF Research Database (Denmark)

    Bukh, Jens Otto Drachmann; Bech, Per; Kessing, Lars Vedel

    2016-01-01

    The diagnostic stability of comorbid personality disorders among patients with depression remains unclear. A total of 262 patients suffering from first-episode depression were assessed using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and reassessed after 5...

  19. Role of respiratory pathogens in infants hospitalized for a first episode of wheezing and their impact on recurrences

    NARCIS (Netherlands)

    Bosis, S.; Esposito, S.; Niesters, H. G. M.; Zuccotti, G. V.; Marseglia, G.; Lanari, M.; Zuin, G.; Pelucchi, C.; Osterhaus, A. D. M. E.; Principi, N.

    2008-01-01

    In order to evaluate the infectious agents associated with the first episode of severe acute wheezing in otherwise healthy infants and to define the role of each of them in recurrences, 85 patients in Italy, aged <12 months, hospitalized because of a first acute episode of wheezing, were prospective

  20. Lower levels of the glial cell marker TSPO in drug-naive first-episode psychosis patients as measured using PET and [(11)C]PBR28.

    Science.gov (United States)

    Collste, K; Plavén-Sigray, P; Fatouros-Bergman, H; Victorsson, P; Schain, M; Forsberg, A; Amini, N; Aeinehband, S; Erhardt, S; Halldin, C; Flyckt, L; Farde, L; Cervenka, S

    2017-02-14

    Several lines of evidence are indicative of a role for immune activation in the pathophysiology of schizophrenia. Nevertheless, studies using positron emission tomography (PET) and radioligands for the translocator protein (TSPO), a marker for glial activation, have yielded inconsistent results. Whereas early studies using a radioligand with low signal-to-noise in small samples showed increases in patients, more recent studies with improved methodology have shown no differences or trend-level decreases. Importantly, all patients investigated thus far have been on antipsychotic medication, and as these compounds may dampen immune cell activity, this factor limits the conclusions that can be drawn. Here, we examined 16 drug-naive, first-episode psychosis patients and 16 healthy controls using PET and the TSPO radioligand [(11)C]PBR28. Gray matter (GM) volume of distribution (VT) derived from a two-tissue compartmental analysis with arterial input function was the main outcome measure. Statistical analyses were performed controlling for both TSPO genotype, which is known to affect [(11)C]PBR28 binding, and gender. There was a significant reduction of [(11)C]PBR28 VT in patients compared with healthy controls in GM as well as in secondary regions of interest. No correlation was observed between GM VT and clinical or cognitive measures after correction for multiple comparisons. The observed decrease in TSPO binding suggests reduced numbers or altered function of immune cells in brain in early-stage schizophrenia.Molecular Psychiatry advance online publication, 14 February 2017; doi:10.1038/mp.2016.247.

  1. Measuring trauma and stressful events in childhood and adolescence among patients with first-episode psychosis: initial factor structure, reliability, and validity of the Trauma Experiences Checklist.

    Science.gov (United States)

    Cristofaro, Sarah L; Cleary, Sean D; Ramsay Wan, Claire; Broussard, Beth; Chapman, Colby; Haggard, Patrick J; Jananeh, Sara; Myers, Neely L; Compton, Michael T

    2013-12-15

    Past trauma and stressful events, especially in childhood and adolescence, are common among individuals with serious mental illnesses like schizophrenia. Traumatic experiences are thought to be a socio-environmental risk factor not only for poorer outcomes, but also potentially for the onset of these disorders. Because improved measurement tools are needed, we developed and studied, among 205 first-episode psychosis patients, the factor structure, internal consistency reliability, and initial validity of the Trauma Experiences Checklist (TEC), our measure of trauma and stressful events during childhood/adolescence. We assessed validity of subscales using correlations with Childhood Trauma Questionnaire-Short Form, Parental Harsh Discipline, Violence Exposure, and TEC-Informant Version scores. Exploratory factor analysis resulted in two internally consistent subscales (Cronbach's α=0.79 and 0.80, respectively), interpersonal abuse and family stress, and violence, death, and legal involvement. Scores from the former subscale were substantially associated with CTQ-SF physical, emotional, and sexual abuse (r=0.42-0.57, all p<0.001) and Violence Exposure (r=0.49, p<0.001). On the other hand, violence, death, and legal involvement scores were most highly correlated with Violence Exposure (r=0.49, p<0.001), and not with most CTQ-SF subscales. The TEC is a potentially useful tool in assessing diverse traumatic life events across various social contexts during childhood and adolescence.

  2. Deficits of cognitive theory of mind and its relationship with functioning in individuals with an at-risk mental state and first-episode psychosis.

    Science.gov (United States)

    Ohmuro, Noriyuki; Katsura, Masahiro; Obara, Chika; Kikuchi, Tatsuo; Sakuma, Atsushi; Iizuka, Kunio; Hamaie, Yumiko; Ito, Fumiaki; Matsuoka, Hiroo; Matsumoto, Kazunori

    2016-09-30

    Disturbance of theory of mind (ToM) and its relationship with functioning in schizophrenia is well documented; however, this is unclear in spectrum disorders like at-risk mental state (ARMS) and first-episode psychosis (FEP). To assess mental state reasoning ability, the total score of the Theory of Mind Picture Stories Task questionnaire was compared among 36 Japanese individuals with ARMS, 40 with FEP, and 25 healthy controls (HC). Pearson's correlations between ToM performance and global and social functioning indices were examined. ToM performance for FEP and ARMS subjects was significantly lower than that for HC, though the significance of the difference between the ARMS and HC disappeared when controlling for premorbid IQ. ToM deficits in ARMS subjects were confirmed only in the comprehension of higher-order false belief. Only among FEP subjects were ToM performance and global functioning significantly correlated, though the significance disappeared when controlling for neurocognitive performance or dose of antipsychotics. No significant correlation between ToM performance and social functioning was observed in the FEP and ARMS groups. The current findings suggest that ToM deficits emerge in ARMS subjects confined within a higher-order domain, and that the relationship between ToM impairment and functional deterioration might be established after psychosis onset.

  3. 10 year course of IQ in first-episode psychosis: relationship between duration of psychosis and long-term intellectual trajectories.

    Science.gov (United States)

    Barder, Helene Eidsmo; Sundet, Kjetil; Rund, Bjørn Rishovd; Evensen, Julie; Haahr, Ulrik; ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan Olav; Langeveld, Johannes; Larsen, Tor Ketil; Melle, Ingrid; Opjordsmoen, Stein; Røssberg, Jan Ivar; Simonsen, Erik; Vaglum, Per; McGlashan, Thomas; Friis, Svein P I

    2015-02-28

    A substantial proportion of patients suffering from schizophrenia-spectrum disorders (SSDs) exhibit a general intellectual impairment at illness onset, but the subsequent intellectual course remains unclear. Relationships between accumulated time in psychosis and long-term intellectual functioning are largely uninvestigated, but may identify subgroups with different intellectual trajectories. Eighty-nine first-episode psychosis patients were investigated on IQ at baseline and at 10-years follow-up. Total time in psychosis was defined as two separate variables; Duration of psychosis before start of treatment (i.e. duration of untreated psychosis: DUP), and duration of psychosis after start of treatment (DAT). The sample was divided in three equal groups based on DUP and DAT, respectively. To investigate if diagnosis could separate IQ-trajectories beyond that of psychotic duration, two diagnostic categories were defined: core versus non-core SSDs. No significant change in IQ was found for the total sample. Intellectual course was not related to DUP or stringency of diagnostic category. However, a subgroup with long DAT demonstrated a significant intellectual decline, mainly associated with a weaker performance on test of immediate verbal recall/working memory (WAIS-R Digit Span). This indicates a relationship between accumulated duration of psychosis and long-term intellectual course, irrespective of diagnostic category, in a significant subgroup of patients.

  4. Acute variations of cytokine levels after antipsychotic treatment in drug-naïve subjects with a first-episode psychosis: A meta-analysis.

    Science.gov (United States)

    Capuzzi, Enrico; Bartoli, Francesco; Crocamo, Cristina; Clerici, Massimo; Carrà, Giuseppe

    2017-03-08

    Schizophrenia is likely to be associated with immunological abnormalities. However, antipsychotics may induce immunomodulatory effects, by influencing plasma cytokines. In order to distinguish these influences, we carried out a systematic review and meta-analysis exploring the acute effect of antipsychotics on candidate cytokines plasma levels (IL-1β, IL-2, IL-6, IL-17, IFN-γ, TNF-α) among drug-naïve subjects with first episode psychosis. We searched main Electronic Databases, identifying eight studies meeting our inclusion criteria. Pre and post-treatment plasma cytokines values were used to estimate standardized mean differences. Heterogeneity was estimated using the I(2) index. Heterogeneity-based sensitivity analyses were performed. IL-2 (p=0.023) and IL-6 (p=0.012) levels showed a significant decrease after four weeks of antipsychotic treatment. Relevant sensitivity analysis confirmed these findings. IL-1β had high between-study heterogeneity. However, leaving out one study, significant after treatment decrease was found. IL-6 and IL-2, and possibly IL-1β, could be considered state markers, decreasing after antipsychotic treatment, whilst TNF-α, IL-17, and IFN-γ might be considered trait markers. Options for novel treatments in FEP, involving cytokine-modulating agents, should be further studied.

  5. Finding meaning in first episode psychosis: experience, agency, and the cultural repertoire.

    Science.gov (United States)

    Larsen, John Aggergaard

    2004-12-01

    The article examines individuals' attempts to generate meaning following their experiences with psychosis. The inquiry is based on a person-centered ethnographic study of a Danish mental health community program for early intervention in schizophrenia and involves longitudinal interviews with 15 of its participants. The article takes an existential anthropological perspective emphasizing agency and cultural phenomenology to investigate how individuals draw on resources from the cultural repertoire to make sense of personally disturbing experiences during their psychosis. It is suggested that the concept of "system of explanation" has advantages over, for example, "illness narrative" and "explanatory model" when demonstrating how some individuals engage in the creative analytic and theory-building work of bricolage, selecting, adding, and combining various systems of explanation. Delusions are equally derived from the cultural repertoire but are constructed as dogmatic explanations that are idiosyncratic to the individual who holds them.

  6. Agreeableness and neuroticism as predictors of relapse after first-episode psychosis: a prospective follow-up study.

    Science.gov (United States)

    Gleeson, John F; Rawlings, David; Jackson, Henry J; McGorry, Patrick D

    2005-03-01

    Cross-sectional investigations, using the five-factor model of personality have evinced relationships among neuroticism, agreeableness, and psychotic symptoms. The current study examined these relationships via a prospective follow-up study with remitted first-episode psychosis patients. Baseline five-factor model personality profiles, diagnoses, symptom ratings, and premorbid adjustment ratings were followed by nine monthly ratings on Brief Psychiatric Rating Scale psychosis items in 60 first-episode patients. Valid baseline personality profiles were completed by 40 patients. Patients who had a return of symptoms scored higher on baseline neuroticism and agreeableness than those who remained in remission. Premorbid adjustment also predicted return of symptoms. After premorbid adjustment was controlled for, the agreeableness differences remained significant, but the neuroticism scores were no longer significantly different. It is concluded that lower agreeableness acts as a mediating variable in relapse. Further studies should clarify whether agreeableness is associated with specific biases in processing interpersonal information, and interpersonal behaviors.

  7. Emotion regulation in first episode adolescent non-suicidal self-injury: what difference does a year make?

    Science.gov (United States)

    Voon, David; Hasking, Penelope; Martin, Graham

    2014-10-01

    We examined the roles of cognitive reappraisal, expressive suppression, and rumination in first episode non-suicidal self-injury (NSSI) among adolescents, and the impact of age-related differences in emotion regulation use. Adverse life events and psychological distress played a significant role in NSSI onset. Being male and less use of cognitive reappraisal contributed to NSSI risk but only in regard to 12-month incidence; this effect was not observed when predicting 24-month incidence. Neither expressive suppression nor rumination was related to NSSI onset in our sample. Age-related differences in emotion regulation were found, but did not modify the above relationships. Findings hint at the possible impact of developmental changes in adolescents' cognitive-emotional processing and their subsequent risk of NSSI. Results support further investigation into prevention and early intervention initiatives aimed at assisting adolescents cope with acute life stressors to prevent/delay first episode NSSI.

  8. Brain activation before and after cognitivebehavior therapy in first-episode patients with mildto-moderate major depressive disorder

    Institute of Scientific and Technical Information of China (English)

    谭雅容

    2014-01-01

    Objective To explore the neurobiological mechanisms underlying cognitive-behavior therapy(CBT)for major depressive disorder(MDD)by detecting the neural changes of patients following CBT.Methods Thirteen first-episode treatment-naive patients with MDD and 13 matched healthy volunteers underwent fM RI scan.All the patients were treated with 6-week CBT only and scanned again after treatment.A gender recognition task

  9. A systematic review of ethnic variations in hospital admission and compulsory detention in first-episode psychosis

    OpenAIRE

    Mann, Farhana; Fisher, Helen L.; Johnson, Sonia

    2014-01-01

    Background Marked ethnic variations in incidence, pathways to care and outcomes have been demonstrated in psychosis. Less research has focused specifically on first-episode psychosis (FEP), particularly adverse contacts such as compulsory detention and hospitalization. This is despite international initiatives to promote equity of care and active early intervention. Aim Systematically review current evidence for ethnic variations in rates of compulsory admission and hospitalization in FEP. Me...

  10. Preferences of Young Adults With First-Episode Psychosis for Receiving Specialized Mental Health Services Using Technology: A Survey Study

    OpenAIRE

    2015-01-01

    Background Despite the potential and interest of using technology for delivering specialized psychiatric services to young adults, surprisingly limited attention has been paid to systematically assess their perspectives in this regard. For example, limited knowledge exists on the extent to which young people receiving specialized services for a first-episode psychosis (FEP) are receptive to using new technologies as part of mental health care, and to which types of technology-enabled mental h...

  11. Prevalence of metabolic syndrome among patients with major depressive disorder--differences between newly diagnosed first episode and recurrent disease.

    Science.gov (United States)

    Ljubicic, Rudolf; Jakovac, Hrvoje; Bistrović, Ivana Ljubicić; Franceski, Tanja; Mufić, Ana Kovak; Karlović, Dalibor

    2013-12-01

    The objective of the present study was to assess differences in prevalence of the metabolic syndrome among depressed patients in regard to the duration of the illness (first episode versus recurrent episodes). A total of 190 patients suffering from major depressive disorder were included in the study, diagnosed according to International classification of disorders, 10th revision. The same criteria were used to divide participants into two groups: first episode major depressive disorder and major depressive disorder with recurrent episodes. The metabolic syndrome was defined according to the criteria of the American National Cholesterol Education Program-Treatment Panel III. Results showed that metabolic syndrome is significantly more prevalent in patients with recurrent major depressive disorder (45.2%) compared to patients with first episode of major depressive disorder (27.3%), mainly due to differences in plasma glucose, triglycerides and HDL-cholesterol levels. These findings indicate the importance of the duration of depression and the number of recurring episodes as factors involved in etiopathogenesis of the associated metabolic syndrome.

  12. Service User Perspectives on the Experience of Illness and Pathway to Care in First-Episode Psychosis

    DEFF Research Database (Denmark)

    Jansen, Jens Einar; Wøldike, Peter Michael; Haahr, Ulrik Helt

    2015-01-01

    to include psychological factors such as normalisation of symptoms and fear of stigma when attempting to reduce DUP in early psychosis, in addition to initiatives to reduce service delays. Also, a greater use of the potentials inherent in Internet and social media platforms seems important in this regard....... service users (median age 20, range 15-24, 6 males, 5 females) diagnosed with a first-episode psychosis and currently enrolled in treatment for this disorder. Fear of stigma, lack of knowledge about mental illness and normalisation of symptoms were barriers to accessing appropriate treatment, while...

  13. Differing patterns of brain structural abnormalities between black and white patients with their first episode of psychosis.

    LENUS (Irish Health Repository)

    Morgan, K D

    2010-07-01

    African-Caribbean and black African people living in the UK are reported to have a higher incidence of diagnosed psychosis compared with white British people. It has been argued that this may be a consequence of misdiagnosis. If this is true they might be less likely to show the patterns of structural brain abnormalities reported in white British patients. The aim of this study therefore was to investigate whether there are differences in the prevalence of structural brain abnormalities in white and black first-episode psychosis patients.

  14. First-episode medication-naive major depressive disorder is associated with altered resting brain function in the affective network.

    Directory of Open Access Journals (Sweden)

    Xiaocui Zhang

    Full Text Available BACKGROUND: Major depressive disorder (MDD has been associated with abnormal structure and function of the brain's affective network, including the amygdala and orbitofrontal cortex (OFC. However, it is unclear if alterations of resting-state function in this affective network are present at the initial onset of MDD. AIMS: To examine resting-state function of the brain's affective network in first-episode, medication-naive patients with MDD compared to healthy controls (HCs. METHODS: Resting-state functional magnetic resonance imaging (rs-fMRI was performed on 32 first-episode, medication-naive young adult patients with MDD and 35 matched HCs. The amplitude of low-frequency fluctuations (ALFF of the blood oxygen level-dependent (BOLD signal and amygdala-seeded functional connectivity (FC were investigated. RESULTS: Compared to HC, MDD patients showed reduced ALFF in the bilateral OFC and increased ALFF in the bilateral temporal lobe extending to the insular and left fusiform cortices. Enhanced anti-correlation of activity between the left amygdala seed and the left OFC was found in MDD patients but not in HCs. CONCLUSIONS: Reduced ALFF in the OFC suggests hypo-functioning of emotion regulation in the affective network. Enhanced anti-correlation of activity between the amygdala and OFC may reflect dysfunction of the amygdala-OFC network and additionally represent a pathological process of MDD.

  15. Altered functional connectivity of the dorsolateral prefrontal cortex in first-episode patients with major depressive disorder

    Energy Technology Data Exchange (ETDEWEB)

    Ye, Ting, E-mail: yeting@ihep.ac.cn [Key Laboratory of Nuclear Analytical Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Graduate School of Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Peng, Jing, E-mail: ppengjjing@sina.com.cn [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); Nie, Binbin, E-mail: niebb@ihep.ac.cn [Key Laboratory of Nuclear Analytical Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Gao, Juan, E-mail: gaojuan@ihep.ac.cn [Key Laboratory of Nuclear Analytical Techniques, Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Graduate School of Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Liu, Jiangtao, E-mail: Liujiangtao813@sina.com [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); Li, Yang, E-mail: Liyang2007428@hotmail.com [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Wang, Gang, E-mail: gangwang@gmail.com [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Ma, Xin, E-mail: lijianshe@medmail.com.cn [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Li, Kuncheng [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); and others

    2012-12-15

    Background: The aim of this study was to investigate resting-state functional connectivity alteration of the right dorsolateral prefrontal cortex (DLPFC) in patients with first-episode major depressive disorder (MDD). Methods: Twenty-two first-episode MDD patients and thirty age-, gender- and education-matched healthy control subjects were enrolled. Rest state functional magnetic resonance images and structure magnetic resonance images were scanned. The functional connectivity analysis was done based on the result of voxel-based morphometry (VBM). And the right DLPFC was chosen as the seed region of interests (ROI), as its gray matter density (GMD) decreased in the MDD patients compared with controls and its GMD values were negative correlation with the Hamilton Depression Rating Scale (HDRS) scores. Results: Compared to healthy controls, the MDD patients showed increased functional connectivity with right the DLPFC in the left dorsal anterior cingulate cortex (ACC), left parahippocampal gyrus (PHG), thalamus and precentral gyrus. In contrast, there were decreased functional connectivity between the right DLPFC and right parietal lobe. Conclusions: By applying the VBM results to the functional connectivity analysis, the study suggested that abnormality of GMD in right DLPFC might be related to the functional connectivity alteration in the pathophysiology of MDD, which might be useful in further characterizing structure–function relations in this disorder.

  16. “Everyone Needs a Friend Sometimes” – Social Predictors of Long-Term Remission In First Episode Psychosis

    Science.gov (United States)

    Bjornestad, Jone; Joa, Inge; Larsen, Tor K.; Langeveld, Johannes; Davidson, Larry; ten Velden Hegelstad, Wenche; Anda, Liss G.; Veseth, Marius; Melle, Ingrid; Johannessen, Jan O.; Bronnick, Kolbjorn

    2016-01-01

    Background: Predictors of long-term symptomatic remission are crucial to the successful tailoring of treatment in first episode psychosis. There is lack of studies distinguishing the predictive effects of different social factors. This prevents a valid evaluating of their independent effects. Objectives: To test specific social baseline predictors of long-term remission. We hypothesized that first, satisfaction with social relations predicts remission; second, that frequency of social interaction predicts remission; and third, that the effect of friend relationship satisfaction and frequency will be greater than that of family relations satisfaction and frequency. Material and Methods: A sample of first episode psychosis (n = 186) completed baseline measures of social functioning, as well as clinical assessments. We compared groups of remitted and non-remitted individuals using generalized estimating equations analyses. Results: Frequency of social interaction with friends was a significant positive predictor of remission over a two-year period. Neither global perceived social satisfaction nor frequency of family interaction showed significant effects. Conclusions: The study findings are of particular clinical importance since frequency of friendship interaction is a possibly malleable factor. Frequency of interaction could be affected through behavioral modification and therapy already from an early stage in the course, and thus increase remission rates. PMID:27757090

  17. Schizophrenia Basics

    Science.gov (United States)

    ... I know with schizophrenia? For More Information Share Schizophrenia Basics Download PDF Download ePub Order a free hardcopy What is schizophrenia? Schizophrenia is a serious mental disorder that affects ...

  18. Attributional style in fist episode of schizophrenia and schizophrenia spectrum disorders with and without paranoid ideation.

    Science.gov (United States)

    Zaytseva, Yulia; Burova, Vitalina; Garakh, Zanna; Gurovich, Isaac Ya

    2013-09-01

    In the present study we evaluated attributional style which refers to how individuals explain the causes for positive and negative events in their lives in patients with first episode of schizophrenia with and without paranoid ideation. 43 patients with first episode of psychosis and 37 matched normal controls completed Ambiguous Intentions Hostility Questionnaire (AIHQ) (Combs et al. 2007). Between group comparison of AIHQ scores showed a notable tendency to show aggressive response in overall patients group. We obtained significant elevation of hostility and blame biases scores in intentional and accidental situations in patients with paranoid ideation while the patients with non-paranoid ideation showed greater hostility and blame biases only in accidental situations as compared to controls. Correlations with positive and negative symptoms were obtained. Our findings suggest that patients with first episode of psychosis exhibit difficulties of the attribution biases which are interconnected with symptoms and thus indicate a trait-deficit of attributional style.

  19. Five years of specialised early intervention versus two years of specialised early intervention followed by three years of standard treatment for patients with a first episode psychosis: randomised, superiority, parallel group trial in Denmark (OPUS II)

    Science.gov (United States)

    Melau, Marianne; Jensen, Heidi; Emborg, Charlotte; Jepsen, Jens Richardt Mollegaard; Fagerlund, Birgitte; Gluud, Christian; Mors, Ole; Hjorthøj, Carsten; Nordentoft, Merete

    2017-01-01

    Objective To compare the effects of five years of specialised early intervention (SEI) treatment for first episode schizophrenia spectrum disorder with the standard two years of SEI plus three years of treatment as usual. Design Randomised, superiority, parallel group trial with blinded outcome assessment. Randomisation was centralised and computerised with concealed randomisation sequence carried out at an external site. Setting Participants were recruited from six OPUS teams in Denmark between 2009 and 2012. OPUS teams provide SEI treatment to all patients diagnosed with a schizophrenia spectrum disorder in Denmark. Participants 400 participants (51% women) with a mean age of 25.6 (standard deviation 4.3) were randomised to five years of SEI (experimental intervention; n=197) or to two years of SEI plus three years of treatment as usual (control; n=203). Interventions OPUS treatment consists of three core elements—modified assertive community treatment, family involvement, and social skill training—with a patient-case manager ratio of no more than 12:1. For participants randomised to five years of OPUS treatment, the treatment was largely unchanged. Participants randomised to the control group were mostly referred to community health centres after two years of SEI treatment. Main outcomes Follow-up assessments were conducted five years after start of OPUS treatment. Primary outcome was negative symptoms measured on the scale for assessment of negative symptoms (avolition-apathy, anhedonia, alogia, and affective blunting). Secondary outcomes were remission of both negative and psychotic symptoms, psychotic symptoms, suicidal ideation, substance abuse, compliance with medical treatment, adherence with treatment, client satisfaction, days in hospital care, and labour market affiliation. Results Levels of negative symptoms did not differ between the intervention group and control group (1.72 v 1.81 points; estimated mean difference −0.10 (95% confidence

  20. Association Between Genetic Polymorphisms in the Serotonergic System and Comorbid Personality Disorders Among Patients with First-Episode Depression

    DEFF Research Database (Denmark)

    Bukh, Jens D; Bock, Camilla; Kessing, Lars V

    2014-01-01

    the serotonin transporter, serotonin receptors 1A, 2A, 2C, and tryptophan hydroxylase 1 were genotyped. The authors found a significant effect of the length polymorphism in the serotonin transporter gene (5-HTTLPR) on cluster B personality disorder (mainly borderline disorder), but no influence on cluster C......Studies on the association between genetic polymorphisms and personality disorders have provided inconsistent results. Using the "enriched sample method," the authors of the present study aimed to assess the association between polymorphisms in the serotonergic transmitter system and comorbid...... personality disorders in patients recently diagnosed with first-episode depression. A total of 290 participants were systematically recruited via the Danish Psychiatric Central Research Register. Diagnoses of personality disorders were assessed by a SCID-II interview, and polymorphisms in the genes encoding...

  1. Relation between premorbid adjustment, duration of untreated psychosis and close interpersonal trauma in first-episode psychosis

    DEFF Research Database (Denmark)

    Haahr, Ulrik Helt; Larsen, Tor Ketil; Simonsen, Erik

    2016-01-01

    different types of trauma, in particular close interpersonal traumas experienced before the age of 18, premorbid factors and baseline clinical characteristics in a sample of first-episode psychosis patients. METHODS: A total of 191 patients from the 'TIPS' cohort completed assessment with the Brief Betrayal...... and physical maltreatment than men. There were significant associations between early interpersonal trauma and premorbid adjustment and duration of untreated psychosis, but no significant associations with length of education, comorbid substance use or baseline clinical symptomatology. CONCLUSIONS: Close...... interpersonal trauma before the age of 18 is associated with poorer premorbid adjustment and a longer duration of untreated psychosis. This may indicate that traumatic experiences delay help-seeking behaviour....

  2. A 2-year follow-up of involuntary admission's influence upon adherence and outcome in first-episode psychosis

    DEFF Research Database (Denmark)

    Opjordsmoen, S; Friis, S; Melle, I;

    2010-01-01

    (n = 126) group as to psychopathology and functioning using Positive and Negative Syndrome Scale and Global Assessment of Functioning Scales at baseline, after 3 months and at 2 year follow-up. Moreover, duration of supportive psychotherapy, medication and number of hospitalisations during the 2......OBJECTIVE: To see, if voluntary admission for treatment in first-episode psychosis results in better adherence to treatment and more favourable outcome than involuntary admission. METHOD: We compared consecutively first-admitted, hospitalised patients from a voluntary (n = 91) with an involuntary...... years were measured. RESULTS: More women than men were admitted involuntarily. Voluntary patients had less psychopathology and better functioning than involuntary patients at baseline. No significant difference as to duration of psychotherapy and medication between groups was found. No significant...

  3. Association between genetic polymorphisms in the serotonergic system and comorbid personality disorders among patients with first-episode depression.

    Science.gov (United States)

    Bukh, Jens D; Bock, Camilla; Kessing, Lars V

    2014-06-01

    Studies on the association between genetic polymorphisms and personality disorders have provided inconsistent results. Using the "enriched sample method," the authors of the present study aimed to assess the association between polymorphisms in the serotonergic transmitter system and comorbid personality disorders in patients recently diagnosed with first-episode depression. A total of 290 participants were systematically recruited via the Danish Psychiatric Central Research Register. Diagnoses of personality disorders were assessed by a SCID-II interview, and polymorphisms in the genes encoding the serotonin transporter, serotonin receptors 1A, 2A, 2C, and tryptophan hydroxylase 1 were genotyped. The authors found a significant effect of the length polymorphism in the serotonin transporter gene (5-HTTLPR) on cluster B personality disorder (mainly borderline disorder), but no influence on cluster C personality disorder, and no associations between other polymorphisms and personality disorders. The study adds evidence to the effect of the serotonin transporter gene specifically on cluster B personality disorders.

  4. The impact a first episode of major depression has on marital dissatisfaction: Is remission associated with improvement in dissatisfaction?

    Directory of Open Access Journals (Sweden)

    Jaime Moyá

    2010-03-01

    Full Text Available Background and Objectives: Prior research suggests that marital dissatisfaction is associated with Major Depression (MD. The purpose of this study was to investigate whether remission from a first episode of MD is associated with improvement in marital dissatisfaction and whether the degree of marital dissatisfaction at the time of diagnosis has an influence on the outcome of MD. Methods: The Hamilton Rating Scale for Depression, the Dyadic Adjustment Scale and the Areas of Change Questionnaire were administered to 59 married couples in which one member fulfilled DSM-IV criteria for a first Episode of MD, but her husband (or his wife did not suffer any mental disorder, and to 53 control couples at 6 outpatient clinics, at baseline and after a 6-months follow-up. Results: The level of marital dissatisfaction in couples with a persistent depressed participant decreased in comparison to couples without a depressed subject (p < 0.05 CI: -10.6 and -0.2, but there were no significant differences between couples in which the depressed spouse recovered from MD and comparison couples. Regardless of MD´s severity, high levels of satisfaction were associated with a higher probability to recover. Limitations: The follow-up period was short and we assessed the level of marital dissatisfaction using self-report measures. Conclusion: This study shows that MD has an influence on Marital Satisfaction even at a very early stage of the Depressive Disorder. What is more, changes in any of the two factors (MD or marital dissatisfaction influenced the other factor´s course; thus an effective intervention on MD may have a positive impact on marital dissatisfaction as well.

  5. Is there an optimal factor structure of the Positive and Negative Syndrome Scale in patients with first-episode psychosis?

    DEFF Research Database (Denmark)

    Langeveld, J.; Andreassen, O.A.; Auestad, B.

    2013-01-01

    The Positive and Negative Syndrome Scale (PANSS) is the most widely used scale to assess a variety of symptoms in patients with schizophrenia and other psychoses. The factor structure of the PANSS has been examined with confirmatory factor analyses in several studies, but not in a well-defined fi......The Positive and Negative Syndrome Scale (PANSS) is the most widely used scale to assess a variety of symptoms in patients with schizophrenia and other psychoses. The factor structure of the PANSS has been examined with confirmatory factor analyses in several studies, but not in a well...

  6. First-episode psychosis

    DEFF Research Database (Denmark)

    Haahr, Ulrik; Friis, Svein; Larsen, Tor K

    2008-01-01

    Diagnostic stability is important for daily clinical work and planning of treatment. The aims of this study were to measure diagnostic stability in a clinical epidemiologic sample and to identify markers of change in diagnosis....

  7. The experience of childhood trauma and its influence on the course of illness in first-episode psychosis

    DEFF Research Database (Denmark)

    Jansen, Jens Einar; Pedersen, Marlene Buch; Trauelsen, Anne Marie;

    2016-01-01

    Persons with schizophrenia spectrum disorders often report high levels of childhood trauma, which often exacerbates symptoms and impede the process of recovery. However, little is known about how these traumas are experienced by service users and how they are integrated in their life stories...

  8. The association between pre-morbid adjustment, duration of untreated psychosis and outcome in first-episode psychosis

    DEFF Research Database (Denmark)

    Jeppesen, P; Petersen, L; Thorup, A

    2008-01-01

    The association between the duration of untreated psychosis (DUP) and outcome of schizophrenia may be confounded by other factors such as poor pre-morbid adjustment. The aim of the present study was to examine the independent contributions of DUP and of pre-morbid adjustment to the clinical...

  9. Childhood Schizophrenia

    Science.gov (United States)

    Childhood schizophrenia Overview By Mayo Clinic Staff Childhood schizophrenia is an uncommon but severe mental disorder in which children interpret reality abnormally. Schizophrenia involves a range of problems with thinking (cognitive), ...

  10. The influence of impaired processing speed on cognition in first-episode antipsychotic-naïve schizophrenic patients

    DEFF Research Database (Denmark)

    Andersen, Rune; Fagerlund, B; Rasmussen, Hans

    2013-01-01

    BACKGROUND: Impaired cognition is a prominent feature of schizophrenia. To what extent the heterogeneous cognitive impairments can be accounted for by considering only a single underlying impairment or a small number of core impairments remains elusive. This study examined whether cognitive...... of neuropsychological tests to assess domains of cognitive impairments in schizophrenia. Composite scores were calculated, grouping tests into cognitive domains. RESULTS: There were significant differences between patients and healthy controls on global cognition and all cognitive domains, including verbal intelligence......, processing speed, sustained attention, working memory, reasoning and problem solving, verbal learning and memory, visual learning and memory, and reaction time. All these significant differences, except for verbal intelligence and global cognition, disappeared when processing speed was included...

  11. A nutrition intervention is effective in improving dietary components linked to cardiometabolic risk in youth with first-episode psychosis.

    Science.gov (United States)

    Teasdale, Scott B; Ward, Philip B; Rosenbaum, Simon; Watkins, Andrew; Curtis, Jackie; Kalucy, Megan; Samaras, Katherine

    2016-06-01

    Severe mental illness is characterised by a 20-year mortality gap due to cardiometabolic disease. Poor diet in those with severe mental illness is an important and modifiable risk factor. The present study aimed to (i) examine baseline nutritional intake in youth with first-episode psychosis (FEP), (ii) evaluate the feasibility and acceptability of nutritional intervention early in FEP and (iii) to evaluate the effectiveness of early dietary intervention on key nutritional end points. Participants were recruited over a 12-month period from a community-based programme specifically targeting young people aged 15-25 years with newly diagnosed FEP. Individual dietetic consultations and practical group sessions were offered as part of a broader lifestyle programme. Dietary assessments were conducted before and at the end of the 12-week intervention. Participants exceeded recommended energy and Na intakes at baseline. Retention within the nutrition intervention was 67 %, consistent with other interventions offered to FEP clients. There was a 47 % reduction in discretionary food intake (-94 g/d, PNutrition intervention delivered shortly after initiation of antipsychotic medication is feasible, acceptable and effective in youth with FEP. Strategies to prevent weight gain and metabolic decline will contribute to prevent premature cardiometabolic disease in this vulnerable population.

  12. The volumetric and shape changes of the putamen and thalamus in first episode, untreated major depressive disorder.

    Science.gov (United States)

    Lu, Yi; Liang, Hongmin; Han, Dan; Mo, Yin; Li, Zongfang; Cheng, Yuqi; Xu, Xiufeng; Shen, Zonglin; Tan, Chunyan; Zhao, Wei; Zhu, Yun; Sun, Xuejin

    2016-01-01

    Previous MRI studies confirmed abnormalities in the limbic-cortical-striatal-pallidal-thalamic (LCSPT) network or limbic-cortico-striatal-thalamic-cortical (LCSTC) circuits in patients with major depressive disorder (MDD), but few studies have investigated the subcortical structural abnormalities. Therefore, we sought to determine whether focal subcortical grey matter (GM) changes might be present in MDD at an early stage. We recruited 30 first episode, untreated patients with major depressive disorder (MDD) and 26 healthy control subjects. Voxel-based morphometry was used to evaluate cortical grey matter changes, and automated volumetric and shape analyses were used to assess volume and shape changes of the subcortical GM structures, respectively. In addition, probabilistic tractography methods were used to demonstrate the relationship between the subcortical and the cortical GM. Compared to healthy controls, MDD patients had significant volume reductions in the bilateral putamen and left thalamus (FWE-corrected, p putamen, and on the dorsal and ventral aspects of left thalamus in MDD patients (FWE-corrected, p putamen and left thalamus have connections with the frontal and temporal lobes, which were found to be related to major depression. Our results suggested that structural abnormalities in the putamen and thalamus might be present in the early stages of MDD, which support the role of subcortical structure in the pathophysiology of MDD. Meanwhile, the present study showed that these subcortical structural abnormalities might be the potential trait markers of MDD.

  13. Reduced white matter integrity and its correlation with clinical symptom in first-episode, treatment-naive generalized anxiety disorder.

    Science.gov (United States)

    Wang, Wei; Qian, Shaowen; Liu, Kai; Li, Bo; Li, Min; Xin, Kuolin; Sun, Gang

    2016-11-01

    The purpose of this study was to explore white matter microstructural alterations in the patients with generalized anxiety disorder (GAD) using diffusion tensor imaging (DTI) technique, and to assess neural associations with the symptom severity. Twenty-eight first-episode, treatment-naive GAD patients without co-morbidities and 28 matched healthy controls underwent DTI acquisition and clinical symptom assessments. Tract-based spatial statistics (TBSS) was used to analyze white matter microstructural abnormalities in patients with GAD, as well as their associations with clinical symptom scores in a voxel-wise manner. Compared to controls, patients showed decreased fractional anisotropy (FA) values in 7 clusters of white matter in bilateral uncinate fasciculus, body of corpus callosum, left middle cingulum (cingulate gyrus), bilateral anterior thalamic radiation and corona radiate, right anterior limb of internal capsule, bilateral inferior frontal-occipital fasciculus, bilateral superior and inferior longitudinal fasciculus, and increased mean diffusivity and radial diffusivity in widespread white matter regions. Reduced FA values in right uncinate fasciculus, left cingulum bundle showed significantly negative correlations with clinical symptom severity for Hamilton anxiety Rating Scale scores. Our findings suggest microstructural abnormalities in uncinate fasciculus and cingulum bundle play key roles in the underlying neural basis of GAD.

  14. Overgeneral autobiographical memory at baseline predicts depressive symptoms at follow-up in patients with first-episode depression.

    Science.gov (United States)

    Liu, Yansong; Zhang, Fuquan; Wang, Zhiqiang; Cao, Leiming; Wang, Jun; Na, Aiguo; Sun, Yujun; Zhao, Xudong

    2016-09-30

    Previous studies have shown that overgeneral autobiographical memory (OGM) is a characteristic of depression. However, there are no studies to explore the association between baseline OGM and depressive symptoms at follow-up in patients with first-episode depression (FE). This study investigated whether baseline OGM predicts depressive symptoms at follow-up in patients with FE. We recruited 125 patients with FE. The participants were divided into remitted group and non-remitted group according to the severity of their depression at 12 months follow-up. The measures consisted of the 17-item Hamilton Depression Rating Scale, Ruminative Response Scale, and Autobiographical Memory Test. Hierarchical linear regression analyses and bootstrap mediation analyses were conducted. The results showed that non-remitted patients had more OGM at baseline. Baseline OGM predicted depressive symptoms at follow-up in patients with FE. Rumination mediated the relationship between baseline OGM and depressive symptoms at follow-up. Our findings highlight OGM as a vulnerability factor involved in the maintenance of depression in patients with FE.

  15. Initial diagnosis and treatment in first-episode psychosis: can an operationalized diagnostic classification system enhance treating clinicians' diagnosis and the treatment chosen?

    LENUS (Irish Health Repository)

    Coentre, Ricardo

    2011-05-01

    Diagnosis during the initial stages of first-episode psychosis is particularly challenging but crucial in deciding on treatment. This is compounded by important differences in the two major classification systems, International Classification of Diseases, 10th revision (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). We aimed to compare the concordance between an operationalized diagnosis using Operational Criteria Checklist (OPCRIT) and treating clinician-generated diagnosis in first episode psychosis diagnosis and its correlation with treatment prescribed.

  16. Association of variants in DRD2 and GRM3 with motor and cognitive function in first-episode psychosis.

    Science.gov (United States)

    Lencer, Rebekka; Bishop, Jeffrey R; Harris, Margret S H; Reilly, James L; Patel, Shitalben; Kittles, Rick; Prasad, Konasale M; Nimgaonkar, Vishwajit L; Keshavan, Matcheri S; Sweeney, John A

    2014-06-01

    Similar smooth pursuit eye tracking dysfunctions are present across psychotic disorders. They include pursuit initiation and maintenance deficits that implicate different functional brain systems. This candidate gene study examined psychosis-related genotypes regulating dopamine and glutamate neurotransmission in relation to these pursuit deficits. One hundred and thirty-eight untreated first-episode patients with a psychotic disorder were genotyped for four markers in DRD2 and four markers in GRM3. The magnitude of eye movement abnormality in patients was defined in relation to performance of matched healthy controls (N = 130). Eighty three patients were followed after 6 weeks of antipsychotic treatment. At baseline, patients with a -141C deletion in DRD2 rs1799732 had slower initiation eye velocity and longer pursuit latency than CC insertion carriers. Further, GRM3 rs274622_CC carriers had poorer pursuit maintenance than T-carriers. Antipsychotic treatment resulted in prolonged pursuit latency in DRD2 rs1799732_CC insertion carriers and a decline in pursuit maintenance in GRM3 rs6465084_GG carriers. The present study demonstrates for the first time that neurophysiological measures of motor and neurocognitive deficits in patients with psychotic disorders have different associations with genes regulating dopamine and glutamate systems, respectively. Alterations in striatal D2 receptor activity through the -141C Ins/Del polymorphism could contribute to pursuit initiation deficits in psychotic disorders. Alterations in GRM3 coding for the mGluR3 protein may impair pursuit maintenance by compromising higher perceptual and cognitive processes that depend on optimal glutamate signaling in corticocortical circuits. DRD2 and GRM3 genotypes also selectively modulated the severity of adverse motor and neurocognitive changes resulting from antipsychotic treatment.

  17. The volumetric and shape changes of the putamen and thalamus in first episode, untreated major depressive disorder

    Directory of Open Access Journals (Sweden)

    Yi Lu

    2016-01-01

    Full Text Available Previous MRI studies confirmed abnormalities in the limbic-cortical-striatal-pallidal-thalamic (LCSPT network or limbic-cortico-striatal-thalamic-cortical (LCSTC circuits in patients with major depressive disorder (MDD, but few studies have investigated the subcortical structural abnormalities. Therefore, we sought to determine whether focal subcortical grey matter (GM changes might be present in MDD at an early stage. We recruited 30 first episode, untreated patients with major depressive disorder (MDD and 26 healthy control subjects. Voxel-based morphometry was used to evaluate cortical grey matter changes, and automated volumetric and shape analyses were used to assess volume and shape changes of the subcortical GM structures, respectively. In addition, probabilistic tractography methods were used to demonstrate the relationship between the subcortical and the cortical GM. Compared to healthy controls, MDD patients had significant volume reductions in the bilateral putamen and left thalamus (FWE-corrected, p < 0.05. Meanwhile, the vertex-based shape analysis showed regionally contracted areas on the dorsolateral and ventromedial aspects of the bilateral putamen, and on the dorsal and ventral aspects of left thalamus in MDD patients (FWE-corrected, p < 0.05. Additionally, a negative correlation was found between local atrophy in the dorsal aspects of the left thalamus and clinical variables representing severity. Furthermore, probabilistic tractography demonstrated that the area of shape deformation of the bilateral putamen and left thalamus have connections with the frontal and temporal lobes, which were found to be related to major depression. Our results suggested that structural abnormalities in the putamen and thalamus might be present in the early stages of MDD, which support the role of subcortical structure in the pathophysiology of MDD. Meanwhile, the present study showed that these subcortical structural abnormalities might be

  18. Hemispheric language asymmetry in first episode psychosis and schizotypy: the role of cannabis consumption and cognitive disorganization.

    Science.gov (United States)

    Herzig, Daniela A; Sullivan, Sarah; Lewis, Glyn; Corcoran, Rhiannon; Drake, Richard; Evans, Jonathan; Nutt, David; Mohr, Christine

    2015-03-01

    Cannabis use has been related to an elevated psychosis risk and attenuated cognitive functioning. Cannabis-related cognitive impairments are also observed in populations along the psychosis dimension. We here investigated whether a potential behavioral marker of the psychosis dimension (attenuated functional hemispheric asymmetry) is even further attenuated in individuals using cannabis (CU) vs those not using cannabis (nCU). We tested 29 patients with first-episode psychosis (FEP; 11 CU) and 90 healthy controls (38 CU) on lateralized lexical decisions assessing left-hemisphere language dominance. In patients, psychotic symptoms were assessed by Positive & Negative Symptom Scale (PANSS). In controls, self-reported schizotypy was assessed (The Oxford-Liverpool Inventory of Feelings and Experiences: O-LIFE). Results indicated that nCU FEP patients had a relative reduced hemispheric asymmetry, as did controls with increasing cognitive disorganization (CogDis) scores, in particular when belonging to the group of nCU controls. Positive, disorganized and negative PANSS scores in patients and negative and positive schizotypy in controls were unrelated to hemispheric asymmetry. These findings suggest that cannabis use potentially balances rather than exacerbates uncommon hemispheric laterality patterns. Moreover, in healthy populations, the potential stabilization of typical hemispheric asymmetry in CU might be most relevant to individuals with elevated CogDis. We discuss the potential beneficial and harmful effects of cannabis use along the psychosis dimension together with propositions for future studies that should account for the mediating role of additional substances (eg nicotine), cannabis composition (eg cannabidiol content), and individual differences (eg physical health, or absence of significant polysubstance use).

  19. Neurocognitive development in first episode psychosis 5 years follow-up: associations between illness severity and cognitive course.

    Science.gov (United States)

    Barder, Helene Eidsmo; Sundet, Kjetil; Rund, Bjørn Rishovd; Evensen, Julie; Haahr, Ulrik; Ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan Olav; Langeveld, Hans; Larsen, T K; Melle, Ingrid; Opjordsmoen, Stein; Røssberg, Jan Ivar; Simonsen, Erik; Vaglum, Per; McGlashan, Thomas; Friis, Svein

    2013-09-01

    Cognitive deficits are documented in first-episode psychosis (FEP), but the continuing course is not fully understood. The present study examines the longitudinal development of neurocognitive function in a five year follow-up of FEP-patients, focusing on the relation to illness severity, as measured by relapses and diagnostic subgroups. The study is an extension of previous findings from the TIPS-project, reporting stability over the first two years. Sixty-two FEP patients (53% male, age 28 ± 9 years) were neuropsychologically examined at baseline and at 1, 2, and 5 year follow-ups. The test battery was divided into five indices; Verbal Learning, Executive Function, Impulsivity, Motor Speed, and Working Memory. To investigate the effect of illness severity, the sample was divided in groups based on number of relapses, and diagnostic subgroups, respectively. Impulsivity and Working Memory improved significantly in the first two years, followed by no change over the next three years. Motor Speed decreased significantly from 2 to 5 years. Number of relapses was significantly related to Verbal Learning and Working Memory, showing a small decrease and less improvement, respectively, in patients with two or more episodes. No significant association was found with diagnostic group. Neurocognitive stability as well as change was found in a sample of FEP-patients examined repeatedly over 5 years. Of potential greater importance for understanding how psychotic illnesses progress, is the finding of significant associations between neurocognition and number of relapses but not diagnostic group, indicating that neurocognition is more related to recurring psychotic episodes than to the descriptive diagnosis per se.

  20. Predictors of remission and recovery in a first-episode schizophrenia spectrum disorder sample: 2-year follow-up of the OPUS trial

    DEFF Research Database (Denmark)

    2008-01-01

    % remitted and 17% were considered fully recovered. Full recovery was associated with shorter DUP, better premorbid adjustment, fewer negative symptoms at baseline, no substance abuse at baseline, and adherence to medication and OPUS treatment. CONCLUSIONS: Several predictive factors were identified...

  1. Effectiveness of antipsychotics in first-episode schizophrenia and schizophreniform disorder on response and remission : An open randomized clinical trial (EUFEST)

    NARCIS (Netherlands)

    Boter, Han; Peuskens, Joseph; Libiger, Jan; Fleischhacker, W. Wolfgang; Davidson, Michael; Galderisi, Silvana; Kahn, Rene S.

    2009-01-01

    Background: Predefined response and remission criteria may hold more clinical relevance than mean scores on rating scales. We compared the effectiveness of low doses of haloperidol and regular doses of second generation antipsychotics (SGAs) on >= 50% response and remission. Methods: In an open rand

  2. Basal ganglia volumes in drug-naive first-episode schizophrenia patients before and after short-term treatment with either a typical or an atypical antipsychotic drug

    DEFF Research Database (Denmark)

    Glenthoj, Andreas; Glenthøj, Birte Yding; Mackeprang, Torben

    2007-01-01

    and 19 matched controls participated. Patients were randomly assigned to treatment with either low doses of the typical antipsychotic drug, zuclopenthixol, or the atypical compound, risperidone. High-resolution magnetic resonance imaging (MRI) scans were obtained in patients before and after 12 weeks...... medication groups did not differ significantly with respect to volume changes after 3 months of low dose treatment in any of the VOIs. Nevertheless, when medication groups were examined separately, a significant volume increase in the putamen was evidenced in the risperidone group. The altered asymmetry...

  3. Global Micro- and Macro-structural White Matter Alterations and the reward circuit in First-episode Antipsychotic-naïve Schizophrenia Patients. Preliminary Results

    DEFF Research Database (Denmark)

    Raghava, Jayachandra Mitta; Ebdrup, Bjørn Hylsebeck; Nielsen, Mette Ødegaard

    Achieva MR scanner. Whole brain DTI images were acquired using single shot spin-echo echo-planar imaging. Images were corrected for head movement, eddy current distortion and susceptibility artifacts. After the baseline data acquisition, the patients were treated for 6 weeks with amisulpride. 28 patients...

  4. Basal ganglia volumes in drug-naive first-episode schizophrenia patients before and after short-term treatment with either a typical or an atypical antipsychotic drug

    DEFF Research Database (Denmark)

    Glenthoj, Andreas; Glenthoj, Birte Y; Mackeprang, Torben

    2007-01-01

    of exposure to medication and in controls at baseline. Caudate nucleus, nucleus accumbens, and putamen volumes were measured. Compared with controls, absolute volumes of interest (VOIs) were smaller in patients at baseline and increased after treatment. However, with controls for age, gender and whole brain...... medication groups did not differ significantly with respect to volume changes after 3 months of low dose treatment in any of the VOIs. Nevertheless, when medication groups were examined separately, a significant volume increase in the putamen was evidenced in the risperidone group. The altered asymmetry...

  5. Cognitive training plus a comprehensive psychosocial programme (OPUS) versus the comprehensive psychosocial programme alone for patients with first-episode schizophrenia (the NEUROCOM trial)

    DEFF Research Database (Denmark)

    Vesterager, Lone; Christensen, Torben Ø; Olsen, Birthe B

    2011-01-01

    long-term effects of cognitive training. We conduct blinded assessments of cognition, everyday functional capacity and associations with the labour market, symptom severity, and self-esteem. Discussion: Results from four-month and ten-month follow-ups have the potential of reliably providing...

  6. Effect of goal attainment theory based education program on cardiovascular risks, behavioral modification, and quality of life among patients with first episode of acute myocardial infarction: Randomized study.

    Science.gov (United States)

    Park, Moonkyoung; Song, Rhayun; Jeong, Jin-Ok

    2017-02-24

    Effect of goal-attainment-theory-based education program on cardiovascular risks, behavioral modification, and quality of life among patients with first episode of acute myocardial infarction: randomized study BACKGROUND: The behavioral modification strategies should be explored at the time of admission to lead the maximum effect of cardiovascular risk management.

  7. Course of illness in a sample of 265 patients with first-episode psychosis--five-year follow-up of the Danish OPUS trial

    DEFF Research Database (Denmark)

    Bertelsen, Mette; Jeppesen, Pia; Petersen, Lone;

    2009-01-01

    -sample of the OPUS trial of 265 first-episode psychotic patients after five years. Recovery, defined as no psychotic or negative symptoms, living independently, GAF (f)>59, working or studying, was reached for 18% after five years, whereas 13% were institutionalized either at hospital or supported housing after five...

  8. Negative association between a history of obstetric complications and the number of neurological soft signs in first-episode schizophrenic disorder

    NARCIS (Netherlands)

    Boks, Marco P. M.; Selten, Jean-Paul; Leask, Stuart; Castelein, Stynke; van den Bosch, Robert J.

    2007-01-01

    We examined the relationship between a history of obstetric complications (OCs) and the number of neurological soft signs (NSS) in a group of 132 patients experiencing their first episode of psychosis. We measured NSS by means of a comprehensive standardized assessment and gained information on a se

  9. The course of neurocognitive functioning in first-episode psychosis and its relation to premorbid adjustment, duration of untreated psychosis, and relapse

    DEFF Research Database (Denmark)

    Rund, Bjørn Rishovd; Melle, Ingrid; Friis, Svein

    2007-01-01

    The aim was to determine the post-onset longitudinal course of cognitive functioning in first-episode psychoses and to examine how premorbid adjustment, duration of untreated psychosis (DUP), and clinical variables such as relapse are associated with that course. Consecutive patients with a DSM...

  10. Differential effects of olanzapine and risperidone on cognition in schizophrenia? A saccadic eye movement study

    NARCIS (Netherlands)

    Broerse, A; Crawford, TJ; den Boer, JA

    2002-01-01

    Recent studies suggest that novel antipsychotics have positive effects on certain cognitive functions in schizophrenia. The present study investigated this claim by means of saccadic paradigms, which provide a selective index of cognitive function. Thirty-three first-episode schizophrenic patients w

  11. Study of Attention Deficit in Patients with Schizophrenia and Bipolar Disorder

    Directory of Open Access Journals (Sweden)

    SM Kafi

    2013-05-01

    Full Text Available Abstract Background & aim: Attention deficit has significant effect on the life of patients suffering from schizophrenia and bipolar disorder. The aim of this study was to assess the attention deficit in patients with schizophrenia. Methods: In the present post-hoc study, 132 patients with schizophrenia and bipolar disorder were selected via non-randomized sampling at Shafa Hospital (Rasht, Iran and then divided into four equal groups: chronic schizophrenia patients, first-episode patients, chronic bipolar patients, and first-episode bipolar patients. Thirty-three healthy individuals were selected as the control group. Subjects were evaluated by Stroop color-word test. The gathered Data were analyzed by one-way ANOVA. Results: Attention deficit among chronic schizophrenics and patients suffering from bipolar disease was higher than the control group (p <1. Chronic schizophrenic patients compared with schizophrenia bipolar disease and first round schizophrenia showed more attention deficit. There was no significant difference among the first bipolar disease and schizophrenia, bipolar disorder, as well as the first round schizophrenia (p<0.05. Conclusion: Attention deficit is more severe in schizophrenic patients than bipolar disorder, and chronicity is more effective in schizophrenic patients. Key words: Attention, Schizophrenia, Chronicity

  12. Dyslipidaemia and Medical Outcome (Health Related Quality of Life) in Patients with Schizophrenia Taking Antipsychotics in Enugu, Nigeria

    Science.gov (United States)

    Edet, John; Igwe, Monday Nwite; Chukwujekwu, Donald Chidozie; Aguocha, Miriam Chinyere

    2017-01-01

    Aim. Determine association between use (and type) of antipsychotics and dyslipidaemia in newly diagnosed schizophrenia patients attending Federal Neuropsychiatric Hospital, Enugu. Methods. From sixty antipsychotic naive patients with schizophrenia and sixty first-degree relatives matched for gender and age, fasting blood lipid profiles were measured at baseline and after twelve weeks. Medical Outcome Study Short Form General Health Survey was administered to patients on both occasions. Fasting lipid profile changes of both groups were compared. Results. Mean endpoint of total cholesterol (TC), low density lipoprotein (LD), and triglycerides (TG) in mmol/l for cases was significantly higher than initial values (TC 4.5 versus 4.3, t = 4.3, p < 0.0001), (LDL 2.8 versus 2.6, t = 14.3, p < 0.0001), and (TG 1.3 versus 1.0, t = 12.1, p < 0.0001). Mean endpoint of high density lipoprotein (HDL) in mmol/l for cases was significantly lower than initial values (1.1 versus 1.2, t = 12.1, p < 0.0001). Prevalence of dyslipidaemia for cases was 13%. Mean endpoint of TC, LDL, TG, and HDL in mmol/l for controls was not significantly different from initial values (TC 4.30 versus 4.27, t = 1.09, p = 0.279), (LDL 2.49 versus 2.46, t = 1.28, p = 0.205), (TG 0.96 versus 0.94, t = 1.27, p = 0.207), and (HDL 1.37 versus 1.38, t = 1.61, p = 0.113). Subjects on atypical antipsychotics had higher risk for dyslipidaemia. Conclusion. Use of antipsychotics was significantly associated with dyslipidaemia.

  13. Cerebral and cerebellar gray matter reduction in first-episode patients with major depressive disorder: A voxel-based morphometry study

    Energy Technology Data Exchange (ETDEWEB)

    Peng Jing, E-mail: ppengjjing@sina.com.cn [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); Liu Jiangtao, E-mail: Liujiangtao813@sina.com [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China); Nie Binbin, E-mail: niebb@ihep.ac.cn [Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Li Yang, E-mail: Liyang2007428@hotmail.com [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Shan Baoci, E-mail: shanbc@ihep.ac.cn [Institute of High Energy Physics, Chinese Academy of Sciences, PO Box 918, Yu-Quan St, Shijingshan District, Beijing 100049 (China); Wang Gang, E-mail: gangwang@gmail.com [Department of Psychiatry, Anding Hospital of Capital Medical University, No. 5, An Kang Hutong, Deshengmen wai, Xicheng District, Beijing 100088 (China); Li Kuncheng, E-mail: likuncheng1955@yahoo.com.cn [Department of Radiology, Xuanwu Hospital of Capital Medical University, No. 45, Chang-Chun St, Xuanwu District, Beijing 100053 (China)

    2011-11-15

    Purpose: To investigate cerebral and cerebellar gray matter abnormalities in patients with first-episode major depressive disorder (MDD). Materials and methods: We examined the structural difference in regional gray matter density (GMD) between 22 first-episode MDD patients and 30 age-, gender- and education-matched healthy controls by optimized voxel-based morphometry (VBM) based on magnetic resonance imaging. Results: Compared with healthy controls, MDD patients showed decreased GMD in the right medial and left lateral orbitofrontal cortex, right dorsolateral prefrontal cortex (DLPFC), bilateral temporal pole, right superior temporal gyrus, bilateral anterior insular cortex, left parahippocampal gyrus, and left cerebellum. In addition, in MDD patients, there was a negative correlation between GMD values of the right DLPFC and the score of the depression rating scale. Conclusions: Our findings provided additional support for the involvement of limbic-cortical circuits in the pathophysiology of MDD and preliminary evidence that a defect involving the cerebellum may also be implicated.

  14. [OPUS: a randomised multicenter trial of integrated versus standard treatment for patients with a first-episode psychosis--secondary publication].

    Science.gov (United States)

    Nordentoft, Merete; Petersen, Lone; Jeppesen, Pia; Thorup, Anne A Elgaard; Abel, Maj-Britt Helle; Ohlenschlaeger, Johan; Christensen, Torben Østergaard; Krarup, Gertrud; Jørgensen, Per

    2006-01-23

    A total of 547 patients with first-episode psychosis were included in a randomised clinical trial comparing integrated treatment with standard treatment. The integrated treatment consisted of assertive community treatment with programmes for family involvement and social skills training. Patients in integrated treatment had significantly fewer psychotic and negative symptoms, less comorbid substance abuse, better adherence to treatment and more satisfaction with treatment at one-year and two-year follow-ups.

  15. Ten-Year Follow-up of the OPUS Specialized Early Intervention Trial for Patients With a First Episode of Psychosis

    DEFF Research Database (Denmark)

    Secher, Rikke Gry; Hjorthøj, Carsten; Austin, Stephen F;

    2015-01-01

    INTRODUCTION: Specialized early intervention programs such as The Danish OPUS treatment are efficient in treating patients with a first episode of psychosis (FEP) at least after 2 and 5 years. Few studies have examined long-term outcomes of these interventions. AIM: To examine the effect of 2 years....... There is a need for further studies investigating if extending the intervention will improve outcomes more markedly at long-term follow-ups....

  16. Evidence for Trait Related Theory of Mind Impairment in First Episode Psychosis Patients and Its Relationship with Processing Speed: A 3 Year Follow-up Study.

    Science.gov (United States)

    Ayesa-Arriola, Rosa; Setién-Suero, Esther; Neergaard, Karl D; Ferro, Adele; Fatjó-Vilas, Mar; Ríos-Lago, Marcos; Otero, Soraya; Rodríguez-Sánchez, Jose M; Crespo-Facorro, Benedicto

    2016-01-01

    This study aimed to confirm whether first-episode psychosis patients present a stable trait impairment in theory of mind (ToM) and to examine the potential relationship between ToM and clinical symptomatology and neurocognition. Patients with a first episode of psychosis (N = 160) and healthy controls (N = 159) were assessed with an extensive neuropsychological test battery, which included a mental state decoding task known as "The Reading the Mind in the Eyes" (Eyes test), at baseline and reassessed after 1 and 3 years. The clinical group performed below healthy controls on the Eyes test while not showing test-retest differences between baseline and follow-up administrations. Analyses revealed age, education and premorbid IQ as potential moderators. Poorer performance on the Eyes test was not linked to clinical symptomatology but was associated with greater neurocognitive deficit, particularly related to processing speed. The persistence of ToM deficits in patients suggests that there are trait related metalizing impairments in first episode psychosis. This study shows the influence of processing speed and moderator variables on efficient ToM.

  17. Evidence for trait related theory of mind impairment in first episode psychosis patients and its relationship with processing speed: a three year follow-up study.

    Directory of Open Access Journals (Sweden)

    Rosa eAyesa-Arriola

    2016-05-01

    Full Text Available This study aimed to confirm whether first-episode psychosis patients present a stable trait impairment in theory of mind (ToM and to examine the potential relationship between ToM and clinical symptomatology and neurocognition. Patients with a first episode of psychosis (N = 160 and healthy controls (N = 159 were assessed with an extensive neuropsychological test battery, which included a mental state decoding task known as The Reading the Mind in the Eyes (Eyes test, at baseline and reassessed after 1 and 3 years. The clinical group performed below healthy controls on the Eyes test while not showing test-retest differences between baseline and follow-up administrations. Analyses revealed age, education and premorbid IQ as potential moderators. Poorer performance on the Eyes test was not linked to clinical symptomatology but was associated with greater neurocognitive deficit, particularly related to processing speed. The persistence of ToM deficits in patients suggests that there are trait related mentalising impairments in first episode psychosis. This study shows the influence of processing speed and moderator variables on efficient ToM.

  18. Community-acquired urinary tract infection in hospitalized children: etiology and antimicrobial resistance. A comparison between first episode and recurrent infection.

    Science.gov (United States)

    Sakran, Waheeb; Smolkin, Vladislav; Odetalla, Ahmad; Halevy, Raphael; Koren, Ariel

    2015-05-01

    Urinary tract infection (UTI) is common in infants and children, and Escherichia coli is the leading pathogen. The aims of this study were to compare first episode of UTI with recurrent infection, reveal organisms that cause UTI, uropathogen resistance, and presence of bacteria producing extended-spectrum β-lactamase (ESBL). The first-UTI group included 456 children. E coli was the leading pathogen (80.5%), and Pseudomonas aeruginosa was found in 1.5%. The uropathogens were resistant to gentamicin (3.41%) and cefuroxime (5.71%), and highly resistant to cefamezin (37.39%). The recurrent-infection group included 106 children. E coli was also the leading pathogen, but 7.5% of the isolates were P aeruginosa (P = .002 compared with first-episode group); 6.6% were ESBL-producing bacteria compared with 1.1% in the first-episode group (P = .002). E coli is the leading pathogen in both groups. P aeruginosa and ESBL-producing bacteria were more common in the recurrent infection group.

  19. Evidence for Trait Related Theory of Mind Impairment in First Episode Psychosis Patients and Its Relationship with Processing Speed: A 3 Year Follow-up Study

    Science.gov (United States)

    Ayesa-Arriola, Rosa; Setién-Suero, Esther; Neergaard, Karl D.; Ferro, Adele; Fatjó-Vilas, Mar; Ríos-Lago, Marcos; Otero, Soraya; Rodríguez-Sánchez, Jose M.; Crespo-Facorro, Benedicto

    2016-01-01

    This study aimed to confirm whether first-episode psychosis patients present a stable trait impairment in theory of mind (ToM) and to examine the potential relationship between ToM and clinical symptomatology and neurocognition. Patients with a first episode of psychosis (N = 160) and healthy controls (N = 159) were assessed with an extensive neuropsychological test battery, which included a mental state decoding task known as “The Reading the Mind in the Eyes” (Eyes test), at baseline and reassessed after 1 and 3 years. The clinical group performed below healthy controls on the Eyes test while not showing test-retest differences between baseline and follow-up administrations. Analyses revealed age, education and premorbid IQ as potential moderators. Poorer performance on the Eyes test was not linked to clinical symptomatology but was associated with greater neurocognitive deficit, particularly related to processing speed. The persistence of ToM deficits in patients suggests that there are trait related metalizing impairments in first episode psychosis. This study shows the influence of processing speed and moderator variables on efficient ToM. PMID:27199826

  20. Effects of antipsychotics on bone mineral density and prolactin levels \\ud in patients with schizophrenia: a 12-month prospective study

    OpenAIRE

    2014-01-01

    Objective: Effects of conventional and atypical antipsychotics on bone mineral density (BMD) and serum prolactin levels (PRL) were examined in patients with schizophrenia.\\ud \\ud Methods: One hundred and sixty-three first-episode inpatients with schizophrenia were recruited, to whom one of three conventional antipsychotics (perphenazine, sulpiride, and chlorpromazine) or one of three atypical antipsychotics (clozapine, quetiapine, and aripiprazole)\\ud was prescribed for 12 months as appropria...

  1. Five-year follow-up of a randomized multicenter trial of intensive early intervention vs standard treatment for patients with a first episode of psychotic illness: the OPUS trial

    DEFF Research Database (Denmark)

    Bertelsen, Mette; Jeppesen, Pia; Petersen, Lone;

    2008-01-01

    Intensive early treatment for first-episode psychosis has been shown to be effective. It is unknown if the positive effects are sustained for 5 years.......Intensive early treatment for first-episode psychosis has been shown to be effective. It is unknown if the positive effects are sustained for 5 years....

  2. Surface-Based Regional Homogeneity in First-Episode, Drug-Naïve Major Depression: A Resting-State fMRI Study

    Directory of Open Access Journals (Sweden)

    Hui-Jie Li

    2014-01-01

    Full Text Available Background. Previous volume-based regional homogeneity (ReHo studies neglected the intersubject variability in cortical folding patterns. Recently, surface-based ReHo was developed to reduce the intersubject variability and to increase statistical power. The present study used this novel surface-based ReHo approach to explore the brain functional activity differences between first-episode, drug-naïve MDD patients and healthy controls. Methods. Thirty-three first-episode, drug-naïve MDD patients and 32 healthy controls participated in structural and resting-state fMRI scans. MDD patients were rated with a 17-item Hamilton Rating Scale for Depression prior to the scan. Results. In comparison with the healthy controls, MDD patients showed reduced surface-based ReHo in the left insula. There was no increase in surface-based ReHo in MDD patients. The surface-based ReHo value in the left insula was not significantly correlated with the clinical information or the depressive scores in the MDD group. Conclusions. The decreased surface-based ReHo in the left insula in MDD may lead to the abnormal top-down cortical-limbic regulation of emotional and cognitive information. The surface-based ReHo may be a useful index to explore the pathophysiological mechanism of MDD.

  3. High-field magnetic resonance imaging of structural alterations in first-episode, drug-naive patients with major depressive disorder.

    Science.gov (United States)

    Chen, Z; Peng, W; Sun, H; Kuang, W; Li, W; Jia, Z; Gong, Q

    2016-11-08

    Previous structural imaging studies have found evidence of brain morphometric changes in patients with major depressive disorder (MDD), but these studies rarely excluded compounding effects of certain important factors, such as medications and long duration of illnesses. Furthermore, the neurobiological mechanism of the macroscopic findings of structural alterations in MDD patients remains unclear. In this study, we utilized magnetization transfer imaging, a quantitative measure of the macromolecular structural integrity of brain tissue, to identify biophysical alterations, which are represented by a magnetization transfer ratio (MTR), in MDD patients. To ascertain whether MTR changes occur independent of volume loss, we also conduct voxel-based morphometry (VBM) analysis. The participants included 27 first-episode, drug-naive MDD patients and 28 healthy controls matched for age and gender. Whole-brain voxel-based analysis was used to compare MTR and gray matter volume across groups and to analyse correlations between MTR and age, symptom severity, and illness duration. The patients exhibited significantly lower MTR in the left superior parietal lobule and left middle occipital gyrus compared with healthy controls, which may be related to the attentional and cognitive dysfunction in MDD patients. The VBM analysis revealed significantly increased gray matter volume in right postcentral gyrus in MDD patients. These findings in first-episode, drug-naive MDD patients may reflect microstructural gray matter changes in the parietal and occipital cortices close to illness onset that existed before volume loss, and thus potentially provide important new insight into the early neurobiology of depression.

  4. The relationship between the first episode of wheezing and matrix metalloproteinases-9 and MMP-2 and tissue inhibitors of MMP-1 levels in preterm infants

    Directory of Open Access Journals (Sweden)

    Rabia Gonul Sezer

    2013-01-01

    Full Text Available Aims: Matrix metalloproteinases (MMP have been associated with neonatal lung morbidity and MMP dysregulation contributes to the pathology of chronic and acute lung disorders. Most of the previous studies were performed in the 1 st weeks of life of the preterm newborns. There are no data on the serum levels of MMP-2, MMP-9 or tissue inhibitors of matrix metalloproteinases (TIMP-1 from preterm infants recovering from lung morbidities. We aimed to compare MMP-2, MMP-9 and TIMP-1 levels in preterm and term infants hospitalized with their first episode of wheezing. Methods: We prospectively evaluated 18 preterm infants with a history of chronic lung disease, respiratory distress syndrome or oxygen therapy and 14 age- and sex-matched term infants who were admitted for a first episode of wheezing. We quantified total serum concentrations of MMP-2, MMP-9 and TIMP-1 to assess whether these serum markers levels were associated with the first episode of wheezing in infants with a history of oxygen therapy during the neonatal period. Results: Upon hospitalization, MMP-2 and TIMP-1 levels were higher in preterm infants than in term infants. In contrast, there was no significant relationship between MMP-9 levels or the MMP-9/TIMP-1 ratio between preterm and term infants. The area under the receiver operating characteristic curve for MMP-2 was 0.70 (95% confidence interval [CI] 0.51-0.89. The area under the curve for TIMP-1 was 0.78 (95% CI 0.61-0.94. MMP-9, MMP-2 and TIMP-1 levels did not correlate with gestational age, gender or severity of wheezing. Conclusion: The negative proportion of MMP-9 to TIMP-1 that we detected in term infants was not present in preterm infants. The balance of MMP-9 to TIMP-1 may have been disrupted by lung damage in the premature infants. Overproduction of MMP-2 and TIMP-1 in the serum may be associated with the pathogenesis of wheezing in preterm infants.

  5. [The Spatial-Frequency Characteristics of the Visual System in Schizophrenia].

    Science.gov (United States)

    Shoshina, I I; Shelepin, Y E; Vershinina, E A; Novikova, K O

    2015-01-01

    In order to determine the spatial-frequancy characteristics of the visual system of healthy subjects and patients with schizophrenia, we used the contrast comparison of two Gabor gratings with sinusoidal distribution of brightness. The Gabor gratings have low, medium or high spatial frequencies; the neurons of magnocellular and parvocellular channels are sensitive to these frequencies to different extents. We found an increase in sensitivity to the contrast when comparing the gratings with low frequencies (to which magnocellular channels are most sensitive) in the patients with first-episode schizophrenia who had not receive long-term antipsychotic treatment, as compared with the control group. On the contrary, the sensitivity to the gratings with medium and high spatial frequencies in this group of patients was lower, as well as in patients with first-episode schizophrenia who had received long-term treatment. The patients with chronic schizophrenia showed a decrease in contrast sensitivity in all tested ranges of frequencies. We obtained supplementary evidence of the enhancement of internal noise in the visual system of the patients with schizophrenia. The results help us to explain the clinical data on the development of visual perceptual diorders at different stages of schizophrenia.

  6. The association between working alliance and clinical and functional outcome in a cohort of 400 patients with first-episode psychosis

    DEFF Research Database (Denmark)

    Melau, Marianne; Harder, Susanne; Jeppesen, Pia

    2015-01-01

    Self-Efficacy (GSE). Linear regression analyses were adjusted for age, sex, cognition, and self-efficacy. RESULTS: Results revealed significant associations between working alliance and fewer negative (β = -0.12; 95% CI, -0.19 to -0.04) and disorganized symptoms (β = -0.06; 95% CI, -0.11 to -0.......01), and between working alliance and better social functioning (β = 1.45; 95% CI, 0.55 to 2.36). General self-efficacy mediated the effect of working alliance, explaining 14%-18% of the variance in associated outcomes. Global level of cognitive functioning, compliance, and self-efficacy influenced clinical......OBJECTIVE: Working alliance between patients with a first-episode psychosis and their case manager is regarded as a key element in specialized early intervention services. The impact of this patient-case manager dyad on functional and clinical outcome is unknown. We aimed to investigate if a strong...

  7. Are variations in whole blood BDNF level associated with the BDNF Val66Met polymorphism in patients with first episode depression?

    DEFF Research Database (Denmark)

    Vinberg, Maj; Bukh, Jens Otto Drachmann; Bennike, Bente;

    2013-01-01

    Brain derived neurotrophic factor (BDNF) seems to play an important role in the pathophysiology of affective disorders. The current study investigated whether blood level BDNF is correlated with the severity of depressive symptoms and recent (six months prior to onset of depression) experience......). Symptomatology was rated using Hamilton Rating Scale for Depression (HAMD-17) and Becks Depression Inventory (BDI 21). No differences in whole blood BDNF was seen in relation to the BDNF Val66Met polymorphism and no significant correlations between whole blood BDNF and HAMD-17 or BDI 21 scores were found....... No significant associations between the experiences of SLE before onset of depression and BDNF level were observed. Finally, peripheral BDNF differentiated between patients and healthy control persons. In the current sample of first episode depressed patients, the Val66Met polymorphism was not associated...

  8. Comprehensive early intervention for patients with first-episode psychosis in Japan (J-CAP: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Harima Hirohiko

    2011-06-01

    Full Text Available Abstract Introduction Comprehensive approaches for patients with psychotic symptoms play essential roles in the symptomatic and functional outcomes of patients, especially during disease onset. In Japan, the shortage of mental health services, particularly for outpatients, and community-based supports has been a major problem. The purpose of this trial is to investigate the effectiveness and affordability of 18-month comprehensive early intervention services for patients with first-episode psychosis compared with typical treatment. Methods This interventional, parallel, single-blinded (open but blinded raters trial was effectively designed. The participants are patients with a diagnosis of F2 or F3 (International Classification of Disease, 10 th revision, with psychotic symptoms. The inclusion criteria were an age of 15-35 years, onset of psychotic symptoms within 5 years, first-episode psychosis, and residence in the catchment area of each site. Allocation will be conducted equally between case management and standard care groups. After enrollment, standard care will be provided for both groups, and community-based care to promote recovery for 18 months will be provided for the comprehensive approach group. The primary outcome will be the function domain of the global assessment of functioning scores at 18 months after enrollment. Data assessment will be performed at enrollment and 18, 36, and 60 months after enrollment. The target sample size will be 150, and registration will occur from March 1, 2011, to September 30, 2012. Discussion This trial will provide promising results about the effectiveness and cost-effectiveness of early intervention services in Japan to improve the quality and quantity of community mental health services. Trial registration This trial was registered in The University Hospital Medical Information Network Clinical Trials Registry (No. UMIN000005092.

  9. 首发和慢性精神分裂症脑白质的弥散张量成像%Diffusion tensor imaging findings in first-episode and chronic schizophrenics

    Institute of Scientific and Technical Information of China (English)

    魏钦令; 康庄; 吴小立; 张晋碚; 李雷俊; 郑俩荣; 国效峰; 赵靖平

    2011-01-01

    Objective To investigate the integrity of white matters in first-episode and chronic schizophrenics. Methods For this study, 39 first-episode and 38 chronic schizophrenics, 69 healthy controls (age, gender and years of received education no significantly different from those of the patients)underwent diffusion weighted images with a single-shot echo planar imaging (EPI) sequence aligned to the straight axial plane. The fractional anisotropy (FA) images of three groups underwent one-way ANOVA with the methods of voxel-based morphometric (VBM) analysis. Results ( 1 ) There were three brain regions where the FA values of white matter were different among three groups: right caudate nucleus ( MNI:20, 12,14; cluster = 432 voxels; FA value :0. 36 ± 0. 18 vs 0. 35 ± 0. 24 vs 0. 38 ± 0. 17 ), left insula ( MNI: - 32,18, 2; cluster =204 voxels; FA value:0. 35 ±0.31 vs 0.33 ±0.24 vs 0.36 ±0.21) and right anterior cingulated( MNI: 16, 36, 12; cluster = 132 voxels;FA value:0. 35 ±0. 29 vs 0. 34 ±0. 31 vs 0. 37 ±0. 25).(2)The mean FA values of the three brain regions of two patients groups decreased versus those of healthy controls (P <0. 05 ). (3)The mean FA values of left insular region in chronic patients decreased versus those of the first-episode patients ( P < 0. 05 ). Conclusion The reduced integrity of white matter may play an etiological role in schizophrenia and the changes are probably progressive.%目的 分析首发精神分裂症和慢性精神分裂症脑白质完整性变化.方法 2009年8月至2011年2月在中山大学附属第三医院精神科住院部或门诊部就诊的39例首发精神分裂症患者、38例慢性精神分裂症患者和广告招募的69名健康对照进行脑磁共振弥散张量成像,3组图像以基于体素的分析方法进行单因素方差分析,提取阳性结果区平均FA值再进行多重比较.结果 (1)首发精神分裂症、慢性精神分裂症和健康对照在以下脑区的白质FA值存在

  10. Social cognition in schizophrenia, Part 1: performance across phase of illness.

    Science.gov (United States)

    Green, Michael F; Bearden, Carrie E; Cannon, Tyrone D; Fiske, Alan P; Hellemann, Gerhard S; Horan, William P; Kee, Kimmy; Kern, Robert S; Lee, Junghee; Sergi, Mark J; Subotnik, Kenneth L; Sugar, Catherine A; Ventura, Joseph; Yee, Cindy M; Nuechterlein, Keith H

    2012-06-01

    Social cognitive impairments are consistently reported in schizophrenia and are associated with functional outcome. We currently know very little about whether these impairments are stable over the course of illness. In the current study, 3 different aspects of social cognition were assessed (emotion processing, Theory of Mind [ToM], and social relationship perception) at 3 distinct developmental phases of illness: prodromal, first episode, and chronic. In this cross-sectional study, participants included 50 individuals with the prodromal risk syndrome for psychosis and 34 demographically comparable controls, 81 first-episode schizophrenia patients and 46 demographically comparable controls, and 53 chronic schizophrenia patients and 47 demographically comparable controls. Outcome measures included total and subtest scores on 3 specialized measures of social cognition: (1) emotion processing assessed with the Mayer-Salovey-Caruso Emotional Intelligence Test, (2) ToM assessed with The Awareness of Social Inference Test, and (3) social relationship perception assessed the Relationships Across Domains Test. Social cognitive performance was impaired across all domains of social cognition and in all clinical samples. Group differences in performance were comparable across phase of illness, with no evidence of progression or improvement. Age had no significant effect on performance for either the clinical or the comparison groups. The findings suggest that social cognition in these 3 domains fits a stable pattern that has outcome and treatment implications. An accompanying article prospectively examines the longitudinal stability of social cognition and prediction of functional outcome in the first-episode sample.

  11. The optimization of treatment and management of schizophrenia in Europe (OPTiMiSE) trial

    DEFF Research Database (Denmark)

    Leucht, Stefan; Winter-van Rossum, Inge; Heres, Stephan;

    2015-01-01

    gap leaves important questions unanswered. For example, when a first antipsychotic failed, is switching to another drug effective? And when should we use clozapine? The aim of this article is to review the efficacy of switching antipsychotics in case of nonresponse. We also present the European...... Commission sponsored "Optimization of Treatment and Management of Schizophrenia in Europe" (OPTiMiSE) trial which aims to provide a treatment algorithm for patients with a first episode of schizophrenia. METHODS: We searched Pubmed (October 29, 2014) for randomized controlled trials (RCTs) that examined...

  12. Cognitive deficits and levels of IQ in adolescent onset schizophrenia and other psychotic disorders

    DEFF Research Database (Denmark)

    Fagerlund, Birgitte; Pagsberg, A Katrine; Hemmingsen, Ralf

    2006-01-01

    of intelligence, executive functions, memory, attention and processing speed was global or specific. First-episode psychotic adolescents (N = 39) between the ages 11 and 17 years were included, 18 of whom were diagnosed with schizophrenia, and 21 with other non-organic, non-affective psychoses, using ICD-10...... of attention, executive functions, reaction time, and memory in the schizophrenic and psychotic adolescent groups. However, analyses of WISC-III factor profiles suggested that early onset schizophrenia patients may have more global IQ deficits than non-organic, non-affective psychoses when examined recently...

  13. Psilocybin induces schizophrenia-like psychosis in humans via a serotonin-2 agonist action.

    Science.gov (United States)

    Vollenweider, F X; Vollenweider-Scherpenhuyzen, M F; Bäbler, A; Vogel, H; Hell, D

    1998-12-01

    Psilocybin, an indoleamine hallucinogen, produces a psychosis-like syndrome in humans that resembles first episodes of schizophrenia. In healthy human volunteers, the psychotomimetic effects of psilocybin were blocked dose-dependently by the serotonin-2A antagonist ketanserin or the atypical antipsychotic risperidone, but were increased by the dopamine antagonist and typical antipsychotic haloperidol. These data are consistent with animal studies and provide the first evidence in humans that psilocybin-induced psychosis is due to serotonin-2A receptor activation, independently of dopamine stimulation. Thus, serotonin-2A overactivity may be involved in the pathophysiology of schizophrenia and serotonin-2A antagonism may contribute to therapeutic effects of antipsychotics.

  14. A study of theory of mind deficit in first-episode schizophrenic patients%首发精神分裂症患者心灵理论损伤的研究

    Institute of Scientific and Technical Information of China (English)

    汪永光; 汪凯; 朱春燕; 汪辉

    2006-01-01

    成绩呈显著正相关.结论 首发、未服药的精神分裂症患者存在心灵理论能力的损害,并且这种损害可能与其额叶功能的障碍有关.两种不同亚型的精神分裂症患者可能存在着不同形式的心灵理论的损害.%Background The disability of theory of mind (ToM) has been confirmed in chronic or acute medicated schizophrenic patients.The role of ToM ability in first-episode, drug-naive schizophrenic patients was investigated in this study.Methods ToM was assessed with the Eyes task and Faux pas task in first-episode, drug-naive schizophrenic patients( n =52)compared with healthy controls ( n =64). Verbal Fluency Test (VFT) and Digit Span Test (DST) were also examined in two groups. Psychiatric symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS).Results The tests that involved the ToM ability (I. E. Mind reading and Faux pas questions) were impaired in the schizophrenic group. The schizophrenia performed worse than the normal controls on the VFT. The schizophrenic negative subgroup performed worse than the positive subgroup in Mind reading and VFT. There was a significantly positive correlation between the performances of the tests that involved the ToM ability and the scores of VFT in schizophrenic patients. There was a significantly negative correlation between the performances of the tests that involved the ToM ability and negative symptom scores in the patients.Conclusions The patients with schizophrenia exhibit ToM deficit that is probably associated with the frontal lobe dysfunction.The performance of ToM dysfunction might be different between negative subjects and positive ones.

  15. Course of illness in a sample of 265 patients with first-episode psychosis--five-year follow-up of the Danish OPUS trial.

    Science.gov (United States)

    Bertelsen, Mette; Jeppesen, Pia; Petersen, Lone; Thorup, Anne; Øhlenschlaeger, Johan; Le Quach, Phuong; Østergaard Christensen, Torben; Krarup, Gertrud; Jørgensen, Per; Nordentoft, Merete

    2009-02-01

    There is an ongoing debate as to whether psychosis is a progressively deteriorating illness or one of progressive amelioration. This paper aims at investigating the rate of recovery and institutionalization and predicting a continuous illness course in a descriptive prospective study of a sub-sample of the OPUS trial of 265 first-episode psychotic patients after five years. Recovery, defined as no psychotic or negative symptoms, living independently, GAF (f)>59, working or studying, was reached for 18% after five years, whereas 13% were institutionalized either at hospital or supported housing after five years. Male gender (OR 1.9, 95% CI 1.06 to 3.23), premorbid social functioning (OR 1.2, 95% CI 1.01 to 1.33), psychotic symptoms (OR 1.3, 95% CI 1.07 to 1.66), and negative symptoms (OR 1.3, 95% CI 1.01 to 1.67) were found to predict a continuous illness course at five-year follow-up. Rates of recovery and institutionalization contradict the assumption that the illness deteriorates progressively, since no changes in the rates are seen from two to five years.

  16. Neuroprotection after a first episode of mania: a randomized controlled maintenance trial comparing the effects of lithium and quetiapine on grey and white matter volume.

    Science.gov (United States)

    Berk, M; Dandash, O; Daglas, R; Cotton, S M; Allott, K; Fornito, A; Suo, C; Klauser, P; Liberg, B; Henry, L; Macneil, C; Hasty, M; McGorry, P; Pantelis, Cs; Yücel, M

    2017-01-24

    Lithium and quetiapine are effective treatments for bipolar disorder, but their potential neuroprotective effects in humans remain unclear. A single blinded equivalence randomized controlled maintenance trial was conducted in a prospective cohort of first-episode mania (FEM) patients (n=26) to longitudinally compare the putative protective effects of lithium and quetapine on grey and white matter volume. A healthy control sample was also collected (n=20). Using structural MRI scans, voxel-wise grey and white matter volumes at baseline and changes over time in response to treatment were investigated. Patients were assessed at three time points (baseline, 3 and 12-month follow-up), whereas healthy controls were assessed at two time points (baseline and 12-month follow-up). Patients were randomized to lithium (serum level 0.6 mmol l(-1), n=20) or quetiapine (flexibly dosed up to 800 mg per day, n=19) monotherapy. At baseline, compared with healthy control subjects, patients with FEM showed reduced grey matter in the orbitofrontal cortex, anterior cingulate, inferior frontal gyrus and cerebellum. In addition, patients had reduced internal capsule white matter volume bilaterally (t1,66>3.20, Pmatter of the left internal capsule (F2,112=8.54, Pmatter volume reduction after 12 months (t1,24=3.76, Pmatter reduction early in the illness course after FEM.

  17. Aberrant functioning of the putamen links delusions, antipsychotic drug dose, and compromised connectivity in first episode psychosis--Preliminary fMRI findings.

    Science.gov (United States)

    Raij, Tuukka T; Mäntylä, Teemu; Kieseppä, Tuula; Suvisaari, Jaana

    2015-08-30

    The dopamine theory proposes the relationship of delusions to aberrant signaling in striatal circuitries that can be normalized with dopamine D2 receptor-blocking drugs. Localization of such circuitries, as well as their upstream and downstream signaling, remains poorly known. We collected functional magnetic resonance images from first-episode psychosis patients and controls during an audiovisual movie. Final analyses included 20 patients and 20 controls; another sample of 10 patients and 10 controls was used to calculate a comparison signal-time course. We identified putamen circuitry in which the signal aberrance (poor correlation with the comparison signal time course) was predicted by the dopamine theory, being greater in patients than controls; correlating positively with delusion scores; and correlating negatively with antipsychotic-equivalent dosage. In Granger causality analysis, patients showed a compromised contribution of the cortical salience network to the putamen and compromised contribution of the putamen to the default mode network. Results were corrected for multiple comparisons at the cluster level with primary voxel-wise threshold p < 0.005 for the salience network contribution, but liberal primary threshold p < 0.05 was used in other group comparisons. If replicated in larger studies, these findings may help unify and extend current hypotheses on dopaminergic dysfunction, salience processing and pathogenesis of delusions.

  18. Neural correlates of aberrant emotional salience predict psychotic symptoms and global functioning in high-risk and first-episode psychosis.

    Science.gov (United States)

    Modinos, Gemma; Tseng, Huai-Hsuan; Falkenberg, Irina; Samson, Carly; McGuire, Philip; Allen, Paul

    2015-10-01

    Neurobiological and behavioral findings suggest that psychosis is associated with corticolimbic hyperactivity during the processing of emotional salience. This has not been widely studied in the early stages of psychosis, and the impact of these abnormalities on psychotic symptoms and global functioning is unknown. We sought to address this issue in 18 patients with first-episode psychosis (FEP), 18 individuals at ultra high risk of psychosis (UHR) and 22 healthy controls (HCs). Corticolimbic response and subjective ratings to emotional and neutral scenes were measured using functional magnetic resonance imaging. The clinical and functional impact of corticolimbic abnormalities was assessed with regression analyses. The FEP and UHR groups reported increased subjective emotional arousal to neutral scenes compared with HCs. Across groups, emotional vs neutral scenes elicited activation in the dorsomedial prefrontal cortex, inferior frontal gyrus/anterior insula and amygdala. Although FEP and UHR participants showed reduced activation in these regions when viewing emotional scenes compared with controls, this was driven by increased activation to neutral scenes. Corticolimbic hyperactivity to neutral scenes predicted higher levels of positive symptoms and poorer levels of functioning. These results indicate that disruption of emotional brain systems may represent an important biological substrate for the pathophysiology of early psychosis and UHR states.

  19. Satisfaction with inpatient treatment for first-episode psychosis among different ethnic groups: A report from the UK AeSOP study.

    LENUS (Irish Health Repository)

    Boydell, Jane

    2010-09-17

    BACKGROUND: There is concern about the level of satisfaction with mental healthcare among minority ethnic patients in the UK, particularly as black patients have more compulsory admissions to hospital. AIMS: To determine and compare levels of satisfaction with mental healthcare between patients from different ethnic groups in a three-centre study of first-onset psychosis. METHOD: Data were collected from 216 patients with first-episode psychosis and 101 caregivers from South London, Nottingham and Bristol, using the Acute Services Study Questionnaire (Patient and Relative Version) and measures of sociodemographic variables and insight. RESULTS: No differences were found between ethnic groups in most domains of satisfaction tested individually, including items relating to treatment by ward staff and number of domains rated as satisfactory. However, logistic regression modelling (adjusting for age, gender, social class, diagnostic category and compulsion) showed that black Caribbean patients did not believe that they were receiving the right treatment and were less satisfied with medication than white patients. Black African patients were less satisfied with non-pharmacological treatments than white patients. These findings were not explained by lack of insight or compulsory treatment. CONCLUSIONS: The study found that black patients were less satisfied with specific aspects of treatment, particularly medication, but were equally satisfied with nursing and social care. Understanding the reasons behind this may improve the acceptability of psychiatric care to black minority ethnic groups.

  20. Social functioning trajectories of young first-episode psychosis patients with and without cannabis misuse: a 30-month follow-up study.

    Science.gov (United States)

    González-Blanch, César; Gleeson, John F; Koval, Peter; Cotton, Sue M; McGorry, Patrick D; Alvarez-Jimenez, Mario

    2015-01-01

    The aim of the study was to investigate trajectories of social functioning in young people with first-episode psychosis (FEP) with and without cannabis misuse using a secondary analysis of data from the Episode-II trial. Forty-two young people with FEP and comorbid cannabis use disorder were compared with 39 young people with FEP but without a cannabis use disorder. Social functioning was assessed every 6 months during a 30-month follow-up. Multilevel linear growth curve modeling was used to compare the social functioning trajectories over time for those with and without cannabis misuse. Cannabis misuse was not associated with social functioning at baseline assessment. Over a 30-month follow-up, FEP patients without cannabis disorder showed significant improvements in their social functioning, whereas patients with cannabis misuse at baseline displayed no such improvement. Patients with and without cannabis misuse differed significantly in their levels of social functioning after 24 months. Similar results were obtained after adjusting for potential confounders (i.e., age, gender, negative symptoms, premorbid functioning, DSM-IV diagnoses, baseline social functioning and other substance use). In the context of a specialized early intervention service, patients with cannabis misuse at baseline did not attain the improvements in social outcomes observed in their counterparts without cannabis misuse. There is a need to develop effective interventions to reduce cannabis misuse to ultimately improve social outcomes in young people with psychosis.

  1. A Randomized Controlled Trial of Clinician-Supported Problem-Solving Bibliotherapy for Family Caregivers of People With First-Episode Psychosis.

    Science.gov (United States)

    Chien, Wai Tong; Thompson, David R; Lubman, Dan I; McCann, Terence V

    2016-11-01

    Family interventions for first-episode psychosis (FEP) are an integral component of treatment, with positive effects mainly on patients' mental state and relapse rate. However, comparatively little attention has been paid to the effects of family interventions on caregivers' stress coping and well-being, especially in non-Western countries. We aimed to test the effects of a 5-month clinician-supported problem-solving bibliotherapy (CSPSB) for Chinese family caregivers of people with FEP in improving family burden and carers' problem-solving and caregiving experience, and in reducing psychotic symptoms and duration of re-hospitalizations, compared with those only received usual outpatient family support (UOFS). A randomized controlled trial was conducted across 2 early psychosis clinics in Hong Kong, where there might be inadequate usual family support services for FEP patients. A total of 116 caregivers were randomly selected, and after baseline measurement, randomly assigned to the CSPSB or UOFS. They were also assessed at 1-week and 6- and 12-month post-intervention. Intention-to-treat analyses were applied and indicated that the CSPSB group reported significantly greater improvements in family burden and caregiving experience, and reductions in severity of psychotic symptoms and duration of re-hospitalizations, than the UOFS group at 6- and 12-month follow-up. CSPSB produces moderate long-term benefits to caregivers and FEP patients, and is a low-cost adjunct to UOFS.

  2. A Randomized Controlled Trial of Clinician-Supported Problem-Solving Bibliotherapy for Family Caregivers of People With First-Episode Psychosis

    Science.gov (United States)

    Chien, Wai Tong; Thompson, David R.; Lubman, Dan I.; McCann, Terence V.

    2016-01-01

    Family interventions for first-episode psychosis (FEP) are an integral component of treatment, with positive effects mainly on patients’ mental state and relapse rate. However, comparatively little attention has been paid to the effects of family interventions on caregivers’ stress coping and well-being, especially in non-Western countries. We aimed to test the effects of a 5-month clinician-supported problem-solving bibliotherapy (CSPSB) for Chinese family caregivers of people with FEP in improving family burden and carers’ problem-solving and caregiving experience, and in reducing psychotic symptoms and duration of re-hospitalizations, compared with those only received usual outpatient family support (UOFS). A randomized controlled trial was conducted across 2 early psychosis clinics in Hong Kong, where there might be inadequate usual family support services for FEP patients. A total of 116 caregivers were randomly selected, and after baseline measurement, randomly assigned to the CSPSB or UOFS. They were also assessed at 1-week and 6- and 12-month post-intervention. Intention-to-treat analyses were applied and indicated that the CSPSB group reported significantly greater improvements in family burden and caregiving experience, and reductions in severity of psychotic symptoms and duration of re-hospitalizations, than the UOFS group at 6- and 12-month follow-up. CSPSB produces moderate long-term benefits to caregivers and FEP patients, and is a low-cost adjunct to UOFS. PMID:27147450

  3. Social functioning trajectories of young first-episode psychosis patients with and without cannabis misuse: a 30-month follow-up study.

    Directory of Open Access Journals (Sweden)

    César González-Blanch

    Full Text Available The aim of the study was to investigate trajectories of social functioning in young people with first-episode psychosis (FEP with and without cannabis misuse using a secondary analysis of data from the Episode-II trial. Forty-two young people with FEP and comorbid cannabis use disorder were compared with 39 young people with FEP but without a cannabis use disorder. Social functioning was assessed every 6 months during a 30-month follow-up. Multilevel linear growth curve modeling was used to compare the social functioning trajectories over time for those with and without cannabis misuse. Cannabis misuse was not associated with social functioning at baseline assessment. Over a 30-month follow-up, FEP patients without cannabis disorder showed significant improvements in their social functioning, whereas patients with cannabis misuse at baseline displayed no such improvement. Patients with and without cannabis misuse differed significantly in their levels of social functioning after 24 months. Similar results were obtained after adjusting for potential confounders (i.e., age, gender, negative symptoms, premorbid functioning, DSM-IV diagnoses, baseline social functioning and other substance use. In the context of a specialized early intervention service, patients with cannabis misuse at baseline did not attain the improvements in social outcomes observed in their counterparts without cannabis misuse. There is a need to develop effective interventions to reduce cannabis misuse to ultimately improve social outcomes in young people with psychosis.

  4. The course of neurocognitive functioning in first-episode psychosis and its relation to premorbid adjustment, duration of untreated psychosis, and relapse.

    Science.gov (United States)

    Rund, Bjørn Rishovd; Melle, Ingrid; Friis, Svein; Johannessen, Jan Olav; Larsen, Tor K; Midbøe, Liv Jaeger; Opjordsmoen, Stein; Simonsen, Erik; Vaglum, Per; McGlashan, Thomas

    2007-03-01

    The aim was to determine the post-onset longitudinal course of cognitive functioning in first-episode psychoses and to examine how premorbid adjustment, duration of untreated psychosis (DUP), and clinical variables such as relapse are associated with that course. Consecutive patients with a DSM-IV diagnosis of non-organic psychosis coming to their first treatment in the health care areas under study were included. Ultimately, 207 patients were assessed neuropsychologically at baseline, 138 were reassessed one year later, and 111 two years later. Five dimensions were identified through principal component analysis of eight neuropsychological (NP) test results: Working Memory (WM), Executive Function (EF), Verbal Learning (VL), Impulsivity (Im), and Motor Speed (MS). No major changes were found in the level of neurocognitive functioning from baseline to the 1-year and 2-year follow-ups. Patients with good initial levels of premorbid academic functioning had consistently better scores on WM at all three time points. No association was found between DUP and the longitudinal course of neurocognitive function. Significant associations occurred between better WM and VL at 1 and 2 years and fewer relapses during the first year, but not the second. Most NP deficits are in place by onset of psychosis and are stable over two years. Milder WM deficits are associated with higher premorbid academic functioning. More severe deficits in WM and VL are associated with more relapses during the first year. It is unclear whether NP deficits cause relapse, relapse causes NP deficits, or both are manifestations of a third deteriorative process.

  5. The effect of five years versus two years of specialised assertive intervention for first episode psychosis - OPUS II: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Gluud Christian

    2011-03-01

    Full Text Available Abstract Background The Danish OPUS I trial randomized 547 patients with first-episode psychosis to a two-year early-specialised assertive treatment programme (OPUS versus standard treatment. The two years OPUS treatment had significant positive effects on psychotic and negative symptoms, secondary substance abuse, treatment adherence, lower dosage of antipsychotic medication, and a higher treatment satisfaction. However, three years after end of the OPUS treatment, the positive clinical effects were not sustained, except that OPUS-treated patients were significantly less likely to be institutionalised compared with standard-treated patients. The major objective of the OPUS II trial is to evaluate the effects of five years of OPUS treatment versus two years of OPUS treatment. Methods The OPUS II trial is designed as a randomized, open label, parallel group trial with blinded outcome assessment. Based on our sample size estimation, 400 patients treated in OPUS for two years will be randomized to further three years of OPUS treatment versus standard treatment. The specialized assertive OPUS treatment consists of three core elements: assertive community treatment, psycho-educational family treatment, and social skills training. Discussion It has been hypothesized that there is a critical period from onset up to five years, which represents a window of opportunity where a long-term course can be influenced. Extending the specialized assertive OPUS treatment up to five years may allow the beneficial effects to continue beyond the high-risk period, through consolidation of improved social and functional outcome. Trial registration Clinical Trial.gov NCT00914238

  6. Free thyroxine levels are associated with cognitive changes in individuals with a first episode of psychosis: A prospective 1-year follow-up study.

    Science.gov (United States)

    Labad, J; Barbero, J D; Gutiérrez-Zotes, A; Montalvo, I; Creus, M; Cabezas, Á; Solé, M; Algora, M J; Garcia-Parés, G; Vilella, E

    2016-03-01

    The results of previous cross-sectional studies suggest that free thyroxine (FT4) levels are associated with cognitive abilities (particularly attention/vigilance) during the early stages of psychosis. We aimed to explore whether hypothalamic-pituitary-thyroid hormones predict cognitive changes in a 1-year longitudinal study following first episodes of psychosis (FEP). We studied 36 FEP patients and a control group of 50 healthy subjects (HS). Plasma levels of thyroid-stimulating hormone (TSH) and FT4 were measured. Cognitive assessment was performed with the MATRICS Cognitive Consensus Cognitive Battery (MCCB). FEP patients were assessed twice (baseline and after 1year), whereas HS were assessed only once. We compared cognitive changes at 1year between three groups based on baseline FT4 levels: 1) lowest quartile (Q1, FT41.54ng/dL). No differences in TSH or FT4 levels were found between HS and FEP patients. All participants had FT4 levels within the normal range. HS outperformed FEP patients in all cognitive tasks. In relation to the relationship between FT4 levels and cognitive changes, a U-shaped pattern was observed: FEP patients from the middle quartiles (Q2-Q3) improved in attention/vigilance, whereas both extreme quartiles (Q1 and Q4) showed a worsening in this cognitive domain over time. Patients with lower FT4 (Q1) showed poorer baseline attention; therefore, lower baseline FT4 levels predicted a poorer prognosis in terms of attention performance. Our study suggests that baseline FT4 levels are associated with changes in attention and vigilance performance over one year in FEP patients.

  7. Frontal dopamine D(2/3) receptor binding in drug-naive first-episode schizophrenic patients correlates with positive psychotic symptoms and gender

    DEFF Research Database (Denmark)

    Glenthoj, Birte Y; Mackeprang, Torben; Svarer, Claus

    2006-01-01

    ; the patients, however, had significantly higher BP in the right compared to the left thalamus, whereas no significant hemispheric imbalances were observed in the healthy subjects. CONCLUSIONS: The present data are the first to confirm a significant correlation between frontal D(2/3) receptor BP values...... and positive symptoms in male schizophrenic patients. They are in agreement with the hypothesis that frontal D(2/3) receptor activity is significant for positive psychotic symptoms. Additionally, the data support a thalamic hemispheric imbalance in schizophrenia...

  8. Genetics Home Reference: schizophrenia

    Science.gov (United States)

    ... Help Me Understand Genetics Home Health Conditions schizophrenia schizophrenia Enable Javascript to view the expand/collapse boxes. Download PDF Open All Close All Description Schizophrenia is a mental health disorder classified as a ...

  9. Using deep belief network modelling to characterize differences in brain morphometry in schizophrenia

    Science.gov (United States)

    Pinaya, Walter H. L.; Gadelha, Ary; Doyle, Orla M.; Noto, Cristiano; Zugman, André; Cordeiro, Quirino; Jackowski, Andrea P.; Bressan, Rodrigo A.; Sato, João R.

    2016-12-01

    Neuroimaging-based models contribute to increasing our understanding of schizophrenia pathophysiology and can reveal the underlying characteristics of this and other clinical conditions. However, the considerable variability in reported neuroimaging results mirrors the heterogeneity of the disorder. Machine learning methods capable of representing invariant features could circumvent this problem. In this structural MRI study, we trained a deep learning model known as deep belief network (DBN) to extract features from brain morphometry data and investigated its performance in discriminating between healthy controls (N = 83) and patients with schizophrenia (N = 143). We further analysed performance in classifying patients with a first-episode psychosis (N = 32). The DBN highlighted differences between classes, especially in the frontal, temporal, parietal, and insular cortices, and in some subcortical regions, including the corpus callosum, putamen, and cerebellum. The DBN was slightly more accurate as a classifier (accuracy = 73.6%) than the support vector machine (accuracy = 68.1%). Finally, the error rate of the DBN in classifying first-episode patients was 56.3%, indicating that the representations learned from patients with schizophrenia and healthy controls were not suitable to define these patients. Our data suggest that deep learning could improve our understanding of psychiatric disorders such as schizophrenia by improving neuromorphometric analyses.

  10. Integrating schizophrenia.

    Science.gov (United States)

    Gray, J A

    1998-01-01

    A neuropsychological theory of the positive symptoms of schizophrenia proposed by J.A. Gray et al. is reviewed in light of subsequent evidence from studies of latent inhibition in clinical populations, healthy volunteers, and rats. It is clear that disrupted latent inhibition is associated with psychosis, but it is uncertain whether this is a state or a trait marker. Much evidence indicates that a similar disruption in latent inhibition can be provoked in rats by excess release of dopamine in the nucleus accumbens, and conversely, that potentiation of latent inhibition occurs when dopaminergic transmission is blocked in this structure. The projection from the hippocampal system to the nucleus accumbens also plays a role in latent inhibition. The theory, therefore, is broadly supported by recent findings. The resulting model of schizophrenia is discussed in relation to the contents of consciousness, positive psychotic symptoms, and alternative theories.

  11. A patient with a long history of relapsing psychosis and mania presenting with anti-NMDA receptor encephalitis ten years after first episode

    Directory of Open Access Journals (Sweden)

    Mateus Mistieri Simabukuro

    Full Text Available Anti-N-methyl- D-aspartate receptor (NMDAR encephalitis is a recently discovered autoimmune disorder, in which antibodies target NMDARs in the brain, leading to their removal from synapses. Early in the disease course, patients often present with marked psychosis and mood disturbances (i.e. mania, depression, explaining why most of these patients are first seen by psychiatrists. Hence, autoimmune encephalitis is receiving growing attention from psychiatry, mainly owing to concerns over misdiagnosing immunomediated and potentially curable disorders as primary psychiatric disorders, such as schizophrenia or major depressive disorder. Although anti-NMDAR encephalitis occurs in the context of new-onset psychiatric symptoms, there is a lack of information on differential diagnosis and treatment of this disorder after a long-term diagnostic history of functional psychiatric disorders. We report a case of a patient with a long history of bipolar affective disorder evolving with anti-NMDAR encephalitis, initially misdiagnosed as non-organic psychosis.

  12. Abnormal pathways in the genu of the corpus callosum in schizophrenia pathogenesis: a proteome study.

    Science.gov (United States)

    Sivagnanasundaram, Sinthuja; Crossett, Ben; Dedova, Irina; Cordwell, Stuart; Matsumoto, Izuru

    2007-10-01

    Abnormalities within the corpus callosum (CC) have been identified in schizophrenia brains and are thought to affect inter-hemispheric communication, which in-turn is postulated to underlie some schizophrenia symptoms. Furthermore, hemisphere asymmetry of fractional anisotropy, detected by diffusion tensor imaging, left-higher-than-right- has been observed in normal individuals in the CC genu. This asymmetry is significantly reduced in the left CC genu of first-episode and chronic schizophrenia subjects. We examined the protein expression profile of the CC genu, including the profiles from the left and right hemisphere, in schizophrenia brains compared to controls using two-dimensional gel electrophoresis and mass spectrometry techniques. Proteins involved in cytoskeletal structure and function, neuroprotective function and energy metabolism were identified as differentially expressed, suggesting these proteins may underlie abnormal CC genu structure and function. Proteins in these functional categories also displayed different expression levels in the left CC genu compared to the right in both control and schizophrenia brains and therefore may be involved in normal CC asymmetry and reduced asymmetry in schizophrenia individuals. This initial pool of protein candidates and abnormal functional pathways opens up avenues for further investigation of molecular mechanisms involving the CC in schizophrenia pathogenesis and symptoms.

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

    Science.gov (United States)

    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 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.

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

    Directory of Open Access Journals (Sweden)

    Forough Riahi

    2016-01-01

    Full Text Available 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.

  15. Prolactin and estradiol serum levels in unmedicated male paranoid schizophrenia patients.

    Science.gov (United States)

    Segal, Michael; Avital, Avi; Berstein, Severina; Derevenski, Andrei; Sandbank, Sergio; Weizman, Abraham

    2007-03-30

    There is evidence for the involvement of the endocrine system in schizophrenia. This involment was widely investigated in female patients. In the current study, we examined prolactin and estradiol serum levels in hospitalized unmedicated men with first-episode and recurrent schizophrenia and then tested possible correlation with various subtypes of the disease. In addition, the estradiol and prolactin levels were compared with a healthy control group. The serum samples were assessed the morning following admission in fifty-seven schizophrenia male patients. There was a significant difference in prolactin serum levels between the paranoid and "nonparanoid" schizophrenia subgroups. However, no significant differences were found in estradiol serum levels between schizophrenia subtypes or between the patients and their healthy counterparts. Finally, a significant and positive correlation was found between the prolactin and estradiol levels in the paranoid subgroup alone. Thus, it appears that low estradiol levels are associated with low prolactin levels, alleged hyperdopaminergic tone and psychotic breakdown in paranoid schizophrenia. The results of the present study further support our previous report of the association between prolactin serum levels and the schizophrenia cluster subtypes, indicating a different dopaminergic activity for the various forms of the disease.

  16. Unravelling genes and pathways implicated in working memory of schizophrenia in Han Chinese.

    Science.gov (United States)

    Ren, Hongyan; Zhang, Chengcheng; Huang, Chaohua; Li, Na; Li, Mingli; Li, Yinfei; Deng, Wei; Ma, Xiaohong; Xiang, Bo; Wang, Qiang; Li, Tao

    2015-01-20

    Working memory deficit is the core neurocognitive disorder in schizophrenia patients. To identify the factors underlying working memory deficit in schizophrenia patients and to explore the implication of possible genes in the working memory using genome-wide association study (GWAS) of schizophrenia, computerized delay-matching-to-sample (DMS) and whole genome genotyping data were obtained from 100 first-episode, treatment-naïve patients with schizophrenia and 140 healthy controls from the Mental Health Centre of the West China Hospital, Sichuan University. A composite score, delay-matching-to-sample total correct numbers (DMS-TC), was found to be significantly different between the patients and control. On associating quantitative DMS-TC with interactive variables of groups × genotype, one SNP (rs1411832), located downstream of YWHAZP5 in chromosome 10, was found to be associated with the working memory deficit in schizophrenia patients with lowest p-value (p = 2.02 × 10(-7)). ConsensusPathDB identified that genes with SNPs for which p values below the threshold of 5 × 10(-5) were significantly enriched in GO:0007155 (cell adhesion, p schizophrenia, could improve the efficacy of GWAS in schizophrenia. However, further study is required to replicate the results from our study.

  17. A pilot study of iPad-assisted cognitive training for schizophrenia.

    Science.gov (United States)

    Dang, Jin; Zhang, Jiangtao; Guo, Zhongwei; Lu, Weihong; Cai, Jun; Shi, Zhongying; Zhang, Chen

    2014-06-01

    In this pilot study, we aimed to examine whether iPad-assisted cognitive training could be beneficial in ameliorating some of the cognitive impairment that accompany schizophrenia. Totally, 20 first-episode schizophrenia patients were randomly assigned to an experiment group (with cognitive training) or to a control group (without cognitive training). The N-back task was assessed at baseline and after intervention, to see what effects iPad-assisted training might have (week 4). The experimental group exhibited significant improvement in the accuracy rate at 2-back, and reaction time at 0, 1 and 2-back tasks. These findings suggest that iPad- or other technically-assisted cognitive training may potentially be a valid strategy for pursuing cognitive rehabilitation among those with schizophrenia.

  18. Regional Abnormality of Grey Matter in Schizophrenia: Effect from the Illness or Treatment?

    Directory of Open Access Journals (Sweden)

    Ying Yue

    Full Text Available Both schizophrenia and antipsychotic treatment are known to modulate brain morphology. However, it is difficult to establish whether observed structural brain abnormalities are due to disease or the effects of treatment. The aim of this study was to investigate the effects of illness and antipsychotic treatment on brain structures in antipsychotic-naïve first-episode schizophrenia based on a longitudinal short-term design. Twenty antipsychotic-naïve subjects with first-episode schizophrenia and twenty-four age- and sex-matched healthy controls underwent 3T MRI scans. Voxel-based morphometry (VBM was used to examine the brain structural abnormality in patients compared to healthy controls. Nine patients were included in the follow-up examination after 8 weeks of treatment. Tensor-based morphometry (TBM was used to identify longitudinal brain structural changes. We observed significantly reduced grey matter volume in the right superior temporal gyrus in antipsychotic-naïve patients with schizophrenia compared with healthy controls. After 8 weeks of treatment, patients showed significantly increased grey matter volume primarily in the bilateral prefrontal cortex, insula, right thalamus, left superior occipital cortex and the bilateral cerebellum. In addition, a greater enlargement of the prefrontal cortex is associated with the improvement in negative symptoms, and a more enlarged thalamus is associated with greater improvement in positive symptoms. Our results suggest the following: (1 the abnormality in the right superior temporal gyrus is present in the early stages of schizophrenia, possibly representing the core region related to schizophrenia; and (2 atypical antipsychotics could modulate brain morphology involving the thalamus, cortical grey matter and cerebellum. In addition, examination of the prefrontal cortex and thalamus might facilitate an efficient response to atypical antipsychotics in terms of symptom improvement.

  19. Atypical visual and somatosensory adaptation in schizophrenia-spectrum disorders

    Science.gov (United States)

    Andrade, G N; Butler, J S; Peters, G A; Molholm, S; Foxe, J J

    2016-01-01

    Neurophysiological investigations in patients with schizophrenia consistently show early sensory processing deficits in the visual system. Importantly, comparable sensory deficits have also been established in healthy first-degree biological relatives of patients with schizophrenia and in first-episode drug-naive patients. The clear implication is that these measures are endophenotypic, related to the underlying genetic liability for schizophrenia. However, there is significant overlap between patient response distributions and those of healthy individuals without affected first-degree relatives. Here we sought to develop more sensitive measures of sensory dysfunction in this population, with an eye to establishing endophenotypic markers with better predictive capabilities. We used a sensory adaptation paradigm in which electrophysiological responses to basic visual and somatosensory stimuli presented at different rates (ranging from 250 to 2550 ms interstimulus intervals, in blocked presentations) were compared. Our main hypothesis was that adaptation would be substantially diminished in schizophrenia, and that this would be especially prevalent in the visual system. High-density event-related potential recordings showed amplitude reductions in sensory adaptation in patients with schizophrenia (N=15 Experiment 1, N=12 Experiment 2) compared with age-matched healthy controls (N=15 Experiment 1, N=12 Experiment 2), and this was seen for both sensory modalities. At the individual participant level, reduced adaptation was more robust for visual compared with somatosensory stimulation. These results point to significant impairments in short-term sensory plasticity across sensory modalities in schizophrenia. These simple-to-execute measures may prove valuable as candidate endophenotypes and will bear follow-up in future work. PMID:27163205

  20. Compare safety of amisulpride and olanzapine in the treatment of first-episode schizophrenia%氨磺必利与奥氮平治疗精神分裂症患者安全性比较

    Institute of Scientific and Technical Information of China (English)

    程万良; 朱文礼; 王伟; 王继轩; 储贝贝; 杨永春

    2016-01-01

    目的 比较氨磺必利与奥氮平治疗首发精神分裂症的安全性.方法 对80例使用氨磺必利或奥氮平的精神分裂症患者病案资料回顾性调查分析,统计一般人口学资料、副反应、精神症状测评、实验室检查结果.结果 全部80例病例中,氨磺必利组(amisulpride group,AG)性激素异常25例,奥氮平组(olanzapine group,OG)18例,差异有统计学意义(X2=4.220,P=0.40).进一步研究发现AG组在血清泌乳素水平高于OG组[(63.12±38.74) ng/mL;(37.84±36.50) ng/mL];差异有统计学意义(t=-3.003,P=0.004).AG组与OG组在一般人口学资料、副反应、精神症状测评等方面差异无统计学意义.结论 氨磺必利对治疗首发精神分裂症安全性与奥氮平相当,需注意氨磺必利对精神分裂症患者内分泌的影响.

  1. Primeiro episódio da esquizofrenia e assistência de enfermagem Primer episodio de la esquizofrenia y asistencia de enfermería First episode of schizophrenia and nursing care

    OpenAIRE

    Bianca Cristina Ciccone Giacon; Sueli Aparecida Frari Galera

    2006-01-01

    A esquizofrenia é um dos principais problemas de saúde da atualidade, exigindo considerável investimento do sistema de saúde. A intervenção no primeiro episódio do transtorno oferece uma oportunidade única no tratamento da esquizofrenia, influenciando no curso da doença. O presente artigo consiste em uma revisão crítica de literatura cujos objetivos são examinar o conhecimento sobre o primeiro surto de esquizofrenia e discutir a contribuição da enfermagem na assistência. Foi utilizada pesquis...

  2. Cognitive function and related factors in patients with the first-episode schizophrenia%首发未经治疗精神分裂症患者认知功能及其影响因素

    Institute of Scientific and Technical Information of China (English)

    王宏; 温盛霖; 岳计辉; 程敏锋

    2013-01-01

    目的 了解首发未经治疗精神分裂症患者认知功能及其影响因素,为精神分裂症的治疗提供依据.方法 对34例首发未经治疗精神分裂症患者(患者组)及33例健康者(对照组)进行数字符号编码测验(symbol coding)、符号搜索测验(symbol search)、连线测验(trail making test,TMT)、色字词测验(stroop test)、韦氏记忆测验(Wechsler memory scale,WMS)、改良版的威斯康辛卡片分类测验(Wisconsin card sorting test,WCST),评定认知功能,使用阳性与阴性症状量表(PANSS)评定临床症状.结果 患者组的部分认知测验成绩与受教育年限呈正相关,与病程呈负相关,而与年龄无关.男性精神分裂症患者WMS中的再认测验成绩及Stroop测验中的色词干扰测验成绩明显差于女性患者,差异有统计学意义(P<0.05),但在完成连线测验A时出现的错误数(0.25±0.78)却明显少于女性患者(1.07± 1.43),差异有统计学意义(P<0.05).患者组WMS中的再生测验成绩与PANSS阴性分呈负相关(r=-0.408,P<0.05),Stroop-字得分与PANSS阴性分呈负相关(r=-0.355,P<0.05),Stroop-字与Stroop-色词差异分数与PANSS阴性分呈负相关(r=-0.380,P<0.05).结论 精神分裂症患者认知功能损害可能受性别、受教育年限和病程等因素影响,精神分裂症认知功能损害与阴性症状密切相关.

  3. Clinical efficacy and safety of olanzapine and risperidone in the treatment of first episode schizophrenia%奥氮平与利培酮治疗首发精神分裂症的疗效及安全性

    Institute of Scientific and Technical Information of China (English)

    杨老虎; 魏昆岭; 苏顺英; 高良会; 成玉敏

    2010-01-01

    目的 评价奥氮平与利培酮治疗首发精神分裂症的疗效及安全性.方法 96例首发精神分裂症患者随机分为奥氮平组与利培酮组,分别治疗8周.采用阳性与阴性症状量表(PANSS)及副反应量表(TESS)评定疗效及副反应.结果 奥氮平组与利培酮组的总有效率分别为81.67%和79.36%,差异无统计学意义(P>0.05).2组不良反应发生率低、程度轻,奥氮平组体质量增加比例高于利培酮组;利培酮组锥体外系反应比例高于奥氮平组.结论 2种药物均为疗效好、安全性高的抗精神病药.

  4. Prevalence of diabetes, metabolic syndrome and metabolic abnormalities in schizophrenia over the course of the illness: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Wampers M

    2006-06-01

    Full Text Available Abstract Background Patients with schizophrenia are at high risk of developing metabolic abnormalities. Method A prospective study focusing on metabolic disturbances in patients with schizophrenia, including an oral glucose tolerance test, is currently ongoing at our University Hospital and affiliate services. The prevalence of metabolic abnormalities at baseline was assessed in a cohort of 415 patients with schizophrenia. The sample was divided into 4 groups according to duration of illness: first-episode patients (20 years. Results Metabolic abnormalities were already present in first-episode patients, and considerably increased with increasing duration of illness. When compared to the general population matched for age and gender, much higher rates of the metabolic syndrome (MetS and diabetes were observed for patients with schizophrenia. For MetS, the increase over time was similar to that of the general population. In contrast, the difference in the prevalence of diabetes in patients with schizophrenia and the general population dramatically and linearly increased from 1.6% in the 15–25 age-band to 19.2% in the 55–65 age-band. Conclusion Thus, the current data suggest that on the one hand metabolic abnormalities are an inherent part of schizophrenic illness, as they are already present in first-episode patients. On the other hand, however, our results suggest a direct effect of the illness and/or antipsychotic medication on their occurence. The data underscore the need for screening for metabolic abnormalities in patients diagnosed with schizophrenia, already starting from the onset of the illness.

  5. Association study between BDNF C-281A polymorphism and paranoid schizophrenia in Polish population.

    Science.gov (United States)

    Suchanek, Renata; Owczarek, Aleksander; Kowalski, Jan

    2012-01-01

    Brain-derived neurotrophic factor (BDNF) is one of the candidate genes for schizophrenia. Polymorphism C-281A (rs28383487) in BDNF gene leads to the reduction of promoter activity in the hippocampal neurons in vitro. To our knowledge, this is the first study to examine the influence of alleles and genotypes of BDNF C-281A polymorphism on development, as well as the clinical course (age of onset, suicidal behaviour and psychopathology) of paranoid schizophrenia. The psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) as subscale scores and also single-item scores. We have also performed the haplotype analysis with val66met BDNF polymorphism, which is known to be involved in the pathogenesis of schizophrenia. We have not found significant differences in the distribution of genotypes and alleles between schizophrenic patients and controls in both the overall analysis, as well as sex stratified. Also, we have not shown statistically significant differences between genotype groups and PANSS scale. However, an association between C-281A polymorphism and time of the first episode of paranoid schizophrenia was revealed. Genotype C/A had been connected with later age of onset of paranoid schizophrenia in men but not in women (p schizophrenia group compared to the controls.

  6. Autistic disorders and schizophrenia: related or remote? An anatomical likelihood estimation.

    Directory of Open Access Journals (Sweden)

    Charlton Cheung

    Full Text Available Shared genetic and environmental risk factors have been identified for autistic spectrum disorders (ASD and schizophrenia. Social interaction, communication, emotion processing, sensorimotor gating and executive function are disrupted in both, stimulating debate about whether these are related conditions. Brain imaging studies constitute an informative and expanding resource to determine whether brain structural phenotype of these disorders is distinct or overlapping. We aimed to synthesize existing datasets characterizing ASD and schizophrenia within a common framework, to quantify their structural similarities. In a novel modification of Anatomical Likelihood Estimation (ALE, 313 foci were extracted from 25 voxel-based studies comprising 660 participants (308 ASD, 352 first-episode schizophrenia and 801 controls. The results revealed that, compared to controls, lower grey matter volumes within limbic-striato-thalamic circuitry were common to ASD and schizophrenia. Unique features of each disorder included lower grey matter volume in amygdala, caudate, frontal and medial gyrus for schizophrenia and putamen for autism. Thus, in terms of brain volumetrics, ASD and schizophrenia have a clear degree of overlap that may reflect shared etiological mechanisms. However, the distinctive neuroanatomy also mapped in each condition raises the question about how this is arrived in the context of common etiological pressures.

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

    Science.gov (United States)

    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.

  8. Language lateralization in schizophrenia

    NARCIS (Netherlands)

    Sommer, I.E.C.

    2004-01-01

    Schizophrenia is a severe chronic psychiatric illness that affects approximately 1-2% of the populations worldwide. Schizophrenia is characterized by episodes of psychosis, in which patients experience hallucinations (false perceptions) and delusions (false beliefs). Apart from the psychotic episode

  9. CNVs conferring risk of autism or schizophrenia affect cognition in controls

    DEFF Research Database (Denmark)

    Stefansson, Hreinn; Meyer-Lindenberg, Andreas; Steinberg, Stacy

    2014-01-01

    to another. Controls carrying the chromosome 15q11.2 deletion between breakpoints 1 and 2 (15q11.2(BP1-BP2) deletion) have a history of dyslexia and dyscalculia, even after adjusting for IQ in the analysis, and the CNV only confers modest effects on other cognitive traits. The 15q11.2(BP1-BP2) deletion...... affects brain structure in a pattern consistent with both that observed during first-episode psychosis in schizophrenia and that of structural correlates in dyslexia....

  10. Altered functional connectivity links in neuroleptic-naïve and neuroleptic-treated patients with schizophrenia, and their relation to symptoms including volition

    Directory of Open Access Journals (Sweden)

    Weidan Pu

    2014-01-01

    Full Text Available In order to analyze functional connectivity in untreated and treated patients with schizophrenia, resting-state fMRI data were obtained for whole-brain functional connectivity analysis from 22 first-episode neuroleptic-naïve schizophrenia (NNS, 61 first-episode neuroleptic-treated schizophrenia (NTS patients, and 60 healthy controls (HC. Reductions were found in untreated and treated patients in the functional connectivity between the posterior cingulate gyrus and precuneus, and this was correlated with the reduction in volition from the Positive and Negative Symptoms Scale (PANSS, that is in the willful initiation, sustenance, and control of thoughts, behavior, movements, and speech, and with the general and negative symptoms. In addition in both patient groups interhemispheric functional connectivity was weaker between the orbitofrontal cortex, amygdala and temporal pole. These functional connectivity changes and the related symptoms were not treated by the neuroleptics. Differences between the patient groups were that there were more strong functional connectivity links in the NNS patients (including in hippocampal, frontal, and striatal circuits than in the NTS patients. These findings with a whole brain analysis in untreated and treated patients with schizophrenia provide evidence on some of the brain regions implicated in the volitional, other general, and negative symptoms, of schizophrenia that are not treated by neuroleptics so have implications for the development of other treatments; and provide evidence on some brain systems in which neuroleptics do alter the functional connectivity.

  11. Schizophrenia as segmental progeria

    OpenAIRE

    Papanastasiou, Evangelos; Gaughran, Fiona; Smith, Shubulade

    2011-01-01

    Schizophrenia is associated with a variety of physical manifestations (i.e. metabolic, neurological) and despite psychotropic medication being blamed for some of these (in particular obesity and diabetes), there is evidence that schizophrenia itself confers an increased risk of physical disease and early death. The observation that schizophrenia and progeroid syndromes share common clinical features and molecular profiles gives rise to the hypothesis that schizophrenia could be conceptualized...

  12. Xanthurenic Acid Activates mGlu2/3 Metabotropic Glutamate Receptors and is a Potential Trait Marker for Schizophrenia.

    Science.gov (United States)

    Fazio, Francesco; Lionetto, Luana; Curto, Martina; Iacovelli, Luisa; Cavallari, Michele; Zappulla, Cristina; Ulivieri, Martina; Napoletano, Flavia; Capi, Matilde; Corigliano, Valentina; Scaccianoce, Sergio; Caruso, Alessandra; Miele, Jessica; De Fusco, Antonio; Di Menna, Luisa; Comparelli, Anna; De Carolis, Antonella; Gradini, Roberto; Nisticò, Robert; De Blasi, Antonio; Girardi, Paolo; Bruno, Valeria; Battaglia, Giuseppe; Nicoletti, Ferdinando; Simmaco, Maurizio

    2015-12-08

    The kynurenine pathway of tryptophan metabolism has been implicated in the pathophysiology of psychiatric disorders, including schizophrenia. We report here that the kynurenine metabolite, xanturenic acid (XA), interacts with, and activates mGlu2 and mGlu3 metabotropic glutamate receptors in heterologous expression systems. However, the molecular nature of this interaction is unknown, and our data cannot exclude that XA acts primarily on other targets, such as the vesicular glutamate transporter, in the CNS. Systemic administration of XA in mice produced antipsychotic-like effects in the MK-801-induced model of hyperactivity. This effect required the presence of mGlu2 receptors and was abrogated by the preferential mGlu2/3 receptor antagonist, LY341495. Because the mGlu2 receptor is a potential drug target in the treatment of schizophrenia, we decided to measure serum levels of XA and other kynurenine metabolites in patients affected by schizophrenia. Serum XA levels were largely reduced in a large cohort of patients affected by schizophrenia, and, in patients with first-episode schizophrenia, levels remained low after 12 months of antipsychotic medication. As opposed to other kynurenine metabolites, XA levels were also significantly reduced in first-degree relatives of patients affected by schizophrenia. We suggest that lowered serum XA levels might represent a novel trait marker for schizophrenia.

  13. The validity of dysthymia to predict clinical depressive symptoms as measured by the Hamilton Depression Scale at the 5-year follow-up of patients with first episode depression

    DEFF Research Database (Denmark)

    Bech, Per; Kessing, Lars Vedel; Bukh, Jens Drachmann

    2016-01-01

    BACKGROUND: In long-term follow-up studies on depression, the Eysenck Neuroticism Scale (ENS) at the score level of dysthymia has been found to be valid at predicting poor outcome. AIMS: The ENS dysthymia level was compared with the Beck Depression Inventory (BDI) level to predict the prevalence...... as measured by the two self-rating scales ENS and BDI can be considered part of a 'double depression' in patients with first episode depression, implying an existence of depressive symptoms at the 5-year follow-up. CLINICAL IMPLICATIONS: Evaluation of dysthymia or neuroticism is important to perform, even...

  14. Evidence-based guidelines for the pharmacological treatment of schizophrenia: recommendations from the British Association for Psychopharmacology.

    Science.gov (United States)

    Barnes, Thomas R E

    2011-05-01

    These guidelines from the British Association for Psychopharmacology address the scope and targets of pharmacological treatment for schizophrenia. A consensus meeting, involving experts in schizophrenia and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from the participants and interested parties, and cover the pharmacological management and treatment of schizophrenia across the various stages of the illness, including first-episode, relapse prevention, and illness that has proved refractory to standard treatment. The practice recommendations presented are based on the available evidence to date, and seek to clarify which interventions are of proven benefit. It is hoped that the recommendations will help to inform clinical decision making for practitioners, and perhaps also serve as a source of information for patients and carers. They are accompanied by a more detailed qualitative review of the available evidence. The strength of supporting evidence for each recommendation is rated.

  15. [Depression in schizophrenia].

    Science.gov (United States)

    Rigaud, A S

    1991-03-01

    Depressive symptoms are frequent during schizophrenia. Depression occurs in the course of a schizo affective psychose or in the course of a schizophrenia (either with acute psychotic symptoms, either without acute psychotic symptoms). Differentiating depression from negative symptoms of schizophrenia or from antipsychotic drug induced side effects can be difficult. The question to know whether depression is intrinsic to the disease process itself whether it is secondary to the schizophrenic process is still a matter of inquiry. Efficacy of antidepressive drugs during depression in schizophrenia remains a matter of controversy. Depression increases the risk for pejorative evolution and for suicide in schizophrenia.

  16. Mismatch negativity and P3a/reorienting complex in subjects with schizophrenia or at-risk mental state

    Directory of Open Access Journals (Sweden)

    Yuko eHiguchi

    2014-05-01

    Full Text Available Introduction: Shorter duration of untreated psychosis has been associated with better prognosis in patients with schizophrenia. In Introduction: In this study, we measured duration mismatch negativity (dMMN, P3a and reorienting negativity (RON in subjects with at-risk mental state (ARMS, patients with first-episode or chronic schizophrenia, and healthy volunteers. The main interest was to determine if these event-related potentials provide a biomarker associated with progression to overt schizophrenia in ARMS subjects.Methods: Seventeen ARMS subjects meeting the criteria of the Comprehensive Assessment of At-Risk Mental State, 38 patients with schizophrenia (19 first-episode and 19 chronic, and 19 healthy controls participated in the study. dMMN, P3a and RON were measured with an auditory odd-ball paradigm at baseline. Results: During the follow-up period (2.2 years, 4 out of the 19 ARMS subjects transitioned to schizophrenia (Converters while 15 did not (non-Converters. dMMN amplitudes of Converters were significantly smaller than those of non-Converters at frontal and central electrodes before onset of illness. dMMN amplitudes of non-Converters did not differ from those of healthy controls, while Converters showed significantly smaller dMMN amplitudes compared to control subjects. RON amplitudes were also reduced at frontal and central electrodes in subjects with schizophrenia, but not ARMS. Converter subjects tended to show smaller RON amplitudes compared to non-Converters. Conclusions: Our data confirm that diminished dMMN amplitudes provide a biomarker which is present before and after the development of psychosis. In this respect, RON amplitudes may also be useful, as suggested for the first time in this study.

  17. 首发、复发和双相抑郁患者精神症状的比较%Comparison of the mental symptoms in patients with first episode depression, recurrent depression and bipolar depression

    Institute of Scientific and Technical Information of China (English)

    任志斌; 马永春; 金卫东; 王鹤秋; 王乃信

    2013-01-01

    目的:探讨首发、复发及双相抑郁患者精神症状的差异. 方法:对首次抑郁发作患者(首发组,24例)、复发性抑郁症患者(复发组,57例)及双相抑郁患者(双相组,25例)进行汉密尔顿抑郁评定量表(HAMD)、汉密尔顿焦虑评定量表(HAMA)、杨氏躁狂评定量表(YMRS)以及阳性和阴性症状评定量表(PANSS)评定和比较. 结果:HAMD、HAMA评分在3组间差异无统计学意义;YMRS评分3组间差异有统计学意义(F=5.2,P=0.007);双相组(6.6±9.0)显著高于首发组(2.8±3.4)和复发组(2.2±3.2)(q =3.86,g =4.40;P均<0.05).双相组HAMD中的躯体焦虑因子分、体重因子分均显著低于复发组(P<0.05或P<0.01);双相组精神病理学症状评分如意志活动、愤怒、幻觉、易激惹、激越、思维联想加快、破坏或攻击行为、活动增加显著高于首发组及复发组(P<0.05或P<0.01). 结论:双相障碍患者抑郁发作时可出现与躁狂相关精神症状.%Objective:To explore the difference in mental symptoms among depressive patients with first episode,recurrent and bipolar episode.Method:The evaluations of Hamilton depression scale (HAMD),Hamilton anxiety scale(HAMA),Young mania rating scale (YMRS) and positive and negative symptoms rating scale (PANSS) were preformed in 24 patients with first episode (first episode group),57 patients with recurrence depression (recurrence group) and 24 patients with bipolar depression (bipolar group).The results were compared among the three groups.Results:The scores of HAMD,HAMA among the three groups were no significant difference,but score of YMRS among the three groups were significantly different (F =5.2,P =0.007).The score of YMRS in bipolar group (6.6 ± 9.0) was significantly higher than first episode group (2.8 ± 3.4) and recurrence group (2.2 ± 3.2) (q =3.86,q =4.40 ; all P < 0.05).The scors of somatic anxiety factor and weight factor of HAMD in bipolar group were significantly lower than those in

  18. Comparison of overgeneral autobiographical memory between first-episode and recurrent depressive patients%首发与复发抑郁症患者的过度概括化自传体记忆比较

    Institute of Scientific and Technical Information of China (English)

    柳艳松; 王军; 张付全; 王国强; 陈新宇; 王志强

    2013-01-01

    Object To explore the difference of overgeneral autobiographical memory (OGM) between first-episode and recurrent depressive patients,and whether the overgeneral autobiographical memory can affect the symptoms of depression or not.Methods 34 first-episode depression patients and 31 recurrent depression patients were enrolled.All patients were measured by autobiographical memory test (AMT),Hamilton Depression Scale-17 (HAMD-17) and Beck depression rating scale(BDI).Results ①The OGM score was higher in recurrent depressive group than that in first-episode group (respectively,(3.90 ± 1.65),(3.10± 1.57),t =2.035,P<0.05).②The positive OGM score was higher in recurrent depressive group than that in first-episode group(respectively,(2.40± 1.36),(1.70± 1.08),t =2.308,P< 0.05).③The correlation coefficient (r value) between the total score of OGM and total score of BDI,total score of HAMD,two subfactors (cognitive disorder and slow)scores of HAMD in recurrent depressive group were 0.497,0.552,0.631,and 0.553 respectively,which significantly correlated.Conclusion Compared with first-episode depressive patients,the OGM in recurrent depressive patients is more severe.The OGM can increase the symptoms of depression,the cognitive disorder and slow.%目的 探索复发性抑郁症与首发抑郁症患者过度概括化自传体记忆(OGM)的差异,以及过度概括化自传体记忆对抑郁症状的影响.方法 对34例首发性抑郁症患者以及31例复发性抑郁症患者,采用自传体记忆测评(autobiographical memory test,AMT)评定过度概括化自传体记忆水平、汉密尔顿抑郁量表测评(HAMD-17)及贝克抑郁量表(BDI)评定抑郁严重程度.结果 ①复发性抑郁症组OGM总分显著高于首发抑郁症组[分别为(3.90± 1.65)分,(3.10±1.57)分,t=2.035,P<0.05];②复发性抑郁症组积极线索词诱导的OGM总分显著高于首发抑郁症组[分别为(2.40± 1.36)分,(1.70±1.08)分,t=2.308,P<0.05];③OGM与BDI总分

  19. Theory of mind and the social brain: implications for understanding the genetic basis of schizophrenia.

    Science.gov (United States)

    Martin, A K; Robinson, G; Dzafic, I; Reutens, D; Mowry, B

    2014-01-01

    Genome-wide association studies in schizophrenia have recently made significant progress in our understanding of the complex genetic architecture of this disorder. Many genetic loci have been identified and now require functional investigation. One approach involves studying their correlation with neuroimaging and neurocognitive endophenotypes. Theory of Mind (ToM) deficits are well established in schizophrenia and they appear to fulfill criteria for being considered an endophenotype. We aim to review the behavioral and neuroimaging-based studies of ToM in schizophrenia, assess its suitability as an endophenotype, discuss current findings, and propose future research directions. Suitable research articles were sourced from a comprehensive literature search and from references identified through other studies. ToM deficits are repeatable, stable, and heritable: First-episode patients, those in remission and unaffected relatives all show deficits. Activation and structural differences in brain regions believed important for ToM are also consistently reported in schizophrenia patients at all stages of illness, although no research to date has examined unaffected relatives. Studies using ToM as an endophenotype are providing interesting genetic associations with both single nucleotide polymorphisms (SNPs) and specific copy number variations (CNVs) such as the 22q11.2 deletion syndrome. We conclude that ToM is an important cognitive endophenotype for consideration in future studies addressing the complex genetic architecture of schizophrenia, and may help identify more homogeneous clinical sub-types for further study.

  20. The timing of neurodevelopmental abnormality in schizophrenia: an integrative review of the neuroimaging literature.

    Science.gov (United States)

    Lencz, T; Bilder, R M; Cornblatt, B

    2001-03-01

    In this paper we will review recent neuroimaging research in schizophrenia, with an aim to critically evaluate several recent proposals concerning the nature and the timing of the neuroanatomic abnormalities underlying the disorder. Specifically, enlargement of cerebrospinal fluid spaces, deficits in cortical gray matter, and reduced volume of mesiotemporal structures have all been reported in patients in the first episode of schizophrenia, their first-degree relatives, and individuals with schizotypal personality disorder, supporting the possibility that these abnormalities reflect a genetically mediated neurodevelopmental disorder. These findings from the empirical literature will be synthesized from the perspective of dual cytoarchitectonic trends theory of neurodevelopment, as well as in relation to current conceptions of the schizophrenia prodrome. We believe that the evidence shows that sufficient groundwork has been laid to begin longitudinal neuroimaging studies of adolescents at clinical risk for schizophrenia, in order to more definitively determine the pathophysiology of the disorder. Such information could have significant implications in terms of understanding the prediction, treatment, and ultimately the prevention of schizophrenia.

  1. Subjective disturbance of perception is related to facial affect recognition in schizophrenia.

    Science.gov (United States)

    Comparelli, Anna; De Carolis, Antonella; Corigliano, Valentina; Romano, Silvia; Kotzalidis, Giorgio D; Campana, Chiara; Ferracuti, Stefano; Tatarelli, Roberto; Girardi, Paolo

    2011-10-01

    To examine the relationship between facial affect recognition (FAR) and subjective perceptual disturbances (SPDs), we assessed SPDs in 82 patients with DSM-IV schizophrenia (44 with first-episode psychosis [FEP] and 38 with multiple episodes [ME]) using two subscales of the Frankfurt Complaint Questionnaire (FCQ), WAS (simple perception) and WAK (complex perception). Emotional judgment ability was assessed using Ekman and Friesen's FAR task. Impaired recognition of emotion correlated with scores on the WAS but not on the WAK. The association was significant in the entire group and in the ME group. FAR was more impaired in the ME than in the FEP group. Our findings suggest that there is a relationship between SPDs and FAR impairment in schizophrenia, particularly in multiple-episode patients.

  2. [Impairment of attention and executive functions in patients with paranoid schizophrenia].

    Science.gov (United States)

    Tsygankov, B D; Khannanova, A N; Nekrasova, S V

    2013-01-01

    To study changes in attention and executive functions during psychopharmacotherapy in patients with paranoid schizophrenia, we have examined 120 patients with a first episode of paranoid schizophrenia treated with typical and atypical neuroleptics. Clinical and statistical analyses have revealed the heterogeneity within treatment groups that allowed to define two subgroups. These subgroups were characterized by a differed disease course (favorable or poor type). Before remission was achieved, the effect of atypical neuroleptics on cognitive performance was higher compared to typical neuroleptics. After remission, when doses of neuroleptics were decreased, a type of disease course played a main role. At 6 months after remission, attention and executive functions have improved in subgroups with favorable course of disease regardless of treatment.

  3. SCHIZOPHRENIA: A REVIEW

    Directory of Open Access Journals (Sweden)

    Parle Milind

    2013-02-01

    Full Text Available Schizophrenia continues to be a mysterious disease fascinating the minds of psychiatrists, pharmacologists and neuroscientists all over the world for more than a century. The crucial welfare of the millions afflicted with schizophrenia is at stake. The cause of schizophrenia is not yet identified. However, it appears from the available reports that schizophrenia results from genetic, occupational and environmental risk factors, which act independently or combine synergistically to develop schizophrenia. In any case, schizophrenia should not be confined to split personality or multiple personality- disorder. Typically, a schizophrenic patient shows both, positive symptoms such as delusions, hallucinations or cognitive dysfunction and negative symptoms such as social withdrawal, inability to articulate or loss of emotional tone. Some psycho-active drugs such as Cocaine, Heroin, LSD, Prozac, and Ketamine produce positive symptoms of schizophrenia. Brain regions affected in schizophrenia are amygdala, ventral striatum, frontal cortex, temporal cortex, hippocampus and thalamus. The levels of neurotransmitters such as dopamine, glutamate, GABA, acetylcholine, serotonin and nor-epinephrine are significantly altered in schizophrenia. The enigma of schizophrenia has fascinated neuroscientists all over the world to develop parallel animal models in an attempt to discover new medicines for the effective management of this psychiatric disorder.

  4. 氨磺必利治疗首发精神分裂症的泌乳素水平与临床疗效分析%The effect of amisulpride on prolactin level and clinical efficacy in first-episode schizophrenic patients

    Institute of Scientific and Technical Information of China (English)

    仲照希; 吕路线

    2015-01-01

    目的 探讨氨磺必利对首发精神分裂症患者血清泌乳素水平的影响及其与症状的关系.方法 对符合DSM-IV精神分裂症诊断标准的45例患者和年龄、性别相匹配的45例健康对照,用阳性和阴性症状量表(PANSS)进行症状评定,利用酶联免疫法进行泌乳素水平测定,用配对t检验比较患者氨磺必利治疗前后血清泌乳素水平,用相关性分析研究血清泌乳素水平与症状的关系.结果 首发精神分裂症患者氨磺必利治疗后血清泌乳素水平较治疗前显著升高[(12.52±8.85) ng/ml,(52.60±22.93) ng/ml,t=12.165,P<0.001];患者治疗后血清泌乳素水平与阴性症状分减分率呈正相关(r=0.24,P<0.05).结论 氨磺必利能引起血清泌乳素升高;血清泌乳素升高与阴性症状改善密切相关.%Objective To discuss the effect of amisulpride on the prolactin level in serum of first-episode schizophrenic patients and its relationship with symptoms.Methods 45 patients who met the DSM-IV schizophrenia diagnostic criteria and 45 age-and gender-matched healthy controls were assessed the clinical symptoms using positive and negative syndrome scale(PANSS) and pmlactin level in serum was detected using enzymelinked immunosorbent assay.Student's t test was used to compare the prolactin level before and after amisulpride treatment and correlation analysis was used to investigate the relationship between prolactin level in serum and symptoms with P<0.05 were considered significantly different.Results There was significant increase in prolactin level in serum after amisulpride treatment in first-episode schizophrenic patients((12.52±8.85) ng/ml,(52.60±22.93 ng/ml,t=12.165,P<0.001).There was a positive correlation between prolactin level in serum and reduction rate of negative symptoms (r=0.24,P<0.05).Conclusion Amisulpride can increase prolactin level in serum;and the rise of serum prolactin is closely related to the improvement of negative symptoms.

  5. 首发精神分裂症患者认知功能与多巴胺D1受体基因的关联研究%Association study of dopamine D1 receptor gene and cognitive function of first-episode schizophrenic patients

    Institute of Scientific and Technical Information of China (English)

    张晨; 李则挚; 吴志国; 陈俊; 彭代辉; 方贻儒; 禹顺英

    2011-01-01

    目的 探讨首发精神分裂症患者认知功能与多巴胺D1受体基因间的关系.方法 使用韦氏成人智力量表(WAIS-R)、韦氏记忆量表(WMS)、威斯康星卡片分类测验(WCST)评定112例首发精神分裂症患者和60例健康对照者的认知功能,并利用TaqMan荧光探针SNP基因分型技术对DRD1基因rs4532位点进行基因分型.结果 患者组与对照组间DRD1基因rs4532位点基因型及等位基因频率分布的差异无统计学意义(分别为x2=2.90,P=0.35;x2=0.01,P=0.93);WCST各指标在病例组与对照组之间存在显著性差异(P<0.01);携带rs4532G等位基因的精神分裂症患者WCST中持续性错误率显著高于不携带rs4532G等位基因的患者[分别为(60.9±13.2)%,(44.9±21.3)%,t=4.79,P=0.00002].结论 DRD1基因rs4532多态性位点可能与精神分裂症患者执行功能损害有关.%Objective To investigate the relationship between cognitive function of first-episode schizophrenic patients and dopamine D1 receptor gene. Methods A total of 112 first-episode schizophrenic patients and 60 healthy controls were evaluated with Wechsler adult intelligence scale ( WAIS-R), Wechsler memory scale (WMS) and Wisconsin card sort test (WCST) ,and genotyped one polymorphism (rs4532) within DRD1 gene using TaqMan SNP genotyping assay. Results There were no significant differences on the frequencies of the genotypes and alleles of rs4532 polymorphism between patients with schizophrenia and normal controls ( x2 =2.90, P=0.35; x2 = 0.01, P= 0. 93 ). There were significant differences in all index of WCST between two groups (P <0.01 ). Patients with rs4532G allele had worse WCST performance than those without G allele ((60.9 ± 13.2)%vs (44.9 ±21.3)%, t=4.79, P=0.00002). Conclusion Rs4532 polymorphism of DRD1 gene may be associated with executive function impairment in schizophrenic patients.

  6. Analysis of correlation between 3 single nucleotide polymorphisms of catechol-O-methyltransferase gene and therapeutic effect of risperidone in first-episode schizophrenics%精神分裂症患者儿茶酚胺氧位甲基转移酶基因单核苷酸多态位点与利培酮疗效的关联研究

    Institute of Scientific and Technical Information of China (English)

    吕路线; 贾梅志; 李文强

    2008-01-01

    目的 分析利培酮治疗首次发病(以下简称首发)的精神分裂症患者疗效与儿茶酚胺氧位甲基转移酶(COMT)基因多态性的关联,探讨利培酮疗效的敏感基因.方法 对203例首发精神分裂症患者给予利培酮治疗8周(2~8 ms/d),分别于治疗前和治疗第2~8周末采用阳性和阴性症状量表(PANSS)评分,以减分率评定疗效.并采用限制性片段长度多态技术和序列特异性引物聚合酶链反应技术测定基因型.