Quality of Life in Patients With Chronic Schizophrenia in Semnan, Iran

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Jamali

2016-03-01

Full Text Available Background Schizophrenia is one of the most common psychiatric disorders and one of the ten leading causes of mental disability. Level of education, family factors and individual culture affect the patients’ quality of life. Objectives Due to the greater prevalence of this disease and the impact of its symptoms on the one’s quality of life, this study was conducted on the people with chronic schizophrenia to determine in which aspects of their quality of life is more likely affected in Semnan, Iran. Patients and Methods This descriptive, analytical and cross-sectional study was conducted on 37 patients with non-paranoid schizophrenia. To evaluate their quality of life, the short-form of the questionnaire of world health organization quality of life (WHOQOL-26 was used. Data were analyzed using one-way analysis of variance. Results The participants in this study gained the highest quality of life in the domain of physical, environmental and psychological health and social relationships. There was no significant relationship between the different aspects of the quality of life in this study. Conclusions It can be concluded that schizophrenia can have an effect on the quality of life. Some items such as family care, early and on time treatment play an important role in increasing the quality of life.

Neuropsychology, Autobiographical Memory, and Hippocampal Volume in “Younger” and “Older” Patients with Chronic Schizophrenia

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Herold, Christina Josefa; Lässer, Marc Montgomery; Schmid, Lena Anna; Seidl, Ulrich; Kong, Li; Fellhauer, Iven; Thomann, Philipp Arthur; Essig, Marco; Schröder, Johannes

2015-01-01

Despite a wide range of studies on neuropsychology in schizophrenia, autobiographical memory (AM) has been scarcely investigated in these patients. Hence, less is known about AM in older patients and hippocampal contribution to autobiographical memories of varying remoteness. Therefore, we investigated hippocampal volume and AM along with important neuropsychological domains in patients with chronic schizophrenia and the respective relationships between these parameters. We compared 25 older patients with chronic schizophrenia to 23 younger patients and an older healthy control group (N = 21) with respect to AM, additional neuropsychological parameters, and hippocampal volume. Personal episodic and semantic memory was investigated using a semi-structured interview. Additional neuropsychological parameters were assessed by using a battery of standard neuropsychological tests. Structural magnetic resonance imaging data were analyzed with an automated region-of-interest procedure. While hippocampal volume reduction and neuropsychological impairment were more pronounced in the older than in the younger patients, both groups showed equivalent reduced AM performance for recent personal episodes. In the patient group, significant correlations between left hippocampal volume and recent autobiographical episodes as well as personal semantic memories arose. Verbal memory and working memory were significantly correlated with right hippocampal volume; executive functions, however, were associated with bilateral hippocampal volumes. These findings underline the complexity of AM and its impairments in the course of schizophrenia in comparison to rather progressive neuropsychological deficits and address the importance of hippocampal contribution. PMID:25954208

Comparison of first-episode and chronic patients diagnosed with schizophrenia: symptoms and childhood trauma.

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Wang, Zheng; Xue, Zhimin; Pu, Weidan; Yang, Bo; Li, Li; Yi, Wenyin; Wang, Peng; Liu, Chang; Wu, Guowei; Liu, Zhening; Rosenheck, Robert A

2013-02-01

There has been considerable interest in identifying and addressing the specific needs of early-episode patients diagnosed with schizophrenia in the hope that by addressing such needs early, chronic disabilities can be avoided. One hundred twenty-eight early-episode and 571 chronic patients were compared on socio-demographic characteristics, clinical symptoms and history of childhood trauma. Symptoms were measured with the Positive and Negative Syndrome Scale (PANSS), and trauma with the short version of the Childhood Trauma Questionnaire. First-episode patients scored 9.3% higher than chronic patients on the PANSS positive symptom scale and 16.3% lower on the negative symptom scale. More first episode patients reported childhood sexual abuse (P = 0.033); however, fewer reported childhood emotional neglect (P = 0.01). Childhood trauma was associated with positive symptoms, specifically with hallucinations in first-episode patients (r = 0.174; P = 0.049). Moreover, fewer parents of first episode patients were living alone (P = 0.008). On multiple logistic regression, the first-episode patients were younger (odds ratio = 0.92), had higher PANSS positive symptom scores (odds ratio 1.04) and lower negative symptom scores (odds ratio 0.948 recalculate). More positive symptoms, fewer negative symptoms, less isolated parents and greater risk of childhood sexual abuse might warrant attention in first episode schizophrenia and perhaps should be a focus for the development of targeted interventions. © 2012 Wiley Publishing Asia Pty Ltd.

The association between rehabilitation programs and metabolic syndrome in chronic inpatients with schizophrenia.

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Lin, Yi-Chun; Lai, Chien-Liang; Chan, Hung-Yu

2017-12-02

The correlation between different rehabilitation programs and the prevalence of metabolic syndrome in people with schizophrenia is unclear. We tested the association in chronic inpatients with schizophrenia of a psychiatric hospital in Taiwan. Patients with schizophrenia and age from 20 to 65 years old were included. The criteria of metabolic syndrome were according to the adapted Adult Treatment Protocol for Asians. According to different types of rehabilitations, patients were divided into work group, occupational therapy group and daily activities group. A total of 359 chronic inpatients with schizophrenia were recruited. Participants had a mean age of 45.9 years and the prevalence of metabolic syndrome was 37.3%. There was a significantly higher prevalence of metabolic syndrome in the work group than in the daily activity group (adjusted odds ratio (aOR) = 1.91, 95% CI = 1.019-3.564, p metabolic syndrome included old age, female gender, low psychotic symptoms severity and clozapine user. This study identified a high prevalence of metabolic syndrome in chronic inpatients with schizophrenia especially in patients with good occupational function. Further investigation of the relationship between the occupational function and metabolic syndrome is necessary for chronic inpatients with schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

Chronic non-fatal Datura abuse in a patient of paranoid schizophrenia: a case report.

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Khanra, Sourav; Khess, C R J; Srivastava, Naveen

2015-04-01

A range of psychoactive substances used by patients suffering from schizophrenia varies and may include those which are fatal and may cause serious toxicity leading to death. We here present a case report of a patient suffering from paranoid schizophrenia, who was abusing Datura stramonium over a prolonged period. A 32 year old male presented with aggressive behaviour, irritability for 6 years and regular intake of Datura seeds for 3 years. After taking detailed history and mental status examination (MSE), diagnoses of paranoid schizophrenia and mental and behavioral disorder due to use of hallucinogen were made. He had shown improvement on standard treatment with antipsychotics. D. stramonium is recognized among emerging new psychoactive substances being used across the world. Among various theories we discuss self-medication hypothesis as a mediating factor for this case. Though D. stramonium is notorious for its life threatening sequelae, clinicians should be aware of its chronic abuse as self-medication. Copyright © 2014 Elsevier Ltd. All rights reserved.

Quality of life of community-based chronic schizophrenia patients in Penang, Malaysia.

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Mubarak, A R; Baba, Ismail; Chin, Low Heng; Hoe, Quah Soon

2003-10-01

This is a study of the quality of life (QOL) of 174 community-based chronic schizophrenia patients in Penang, Malaysia. The study samples were selected from the Out Patient Department, Department of Psychiatry, Penang General Hospital, Malaysia. The data was collected through personal interviews with the respondents. A questionnaire prepared by the research team was used to collect data on background characteristics. Lehman's (1988) Quality of Life Interview was used to collect data on patients' QOL. Equal number of males and females participated in the study. The interviews on QOL indicated problems in the areas of life in general, place of living, daily activities, social relations, finance, work and general health. The results also revealed that community-based schizophrenia patients had acute poverty and experienced social isolation, discrimination and exploitation in the workplace. Implications of these results on the implementation process of National Mental Health Policy in Malaysia are discussed. The research paper also discusses the negative impacts of limited rehabilitation facilities available in the community and its implications on the QOL of severely mentally ill patients. The need for immediate research attention on QOL of such patients in the South-east Asian region has been highlighted.

Prevalence of neuroleptic-induced movement disorders in chronic schizophrenia inpatients.

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Janno, Sven; Holi, Matti; Tuisku, Katinka; Wahlbeck, Kristian

2004-01-01

Since most of the world's schizophrenia patients are treated with conventional antipsychotics, the authors evaluated various methods for establishing the prevalence of neuroleptic-induced movement disorders in these patients. DSM-IV criteria and established score thresholds on a movement disorder rating scale were used to identify cases of neuroleptic-induced movement disorder in a representative Estonian patient sample of 99 chronic institutionalized schizophrenia patients, 18-65 years old, treated with conventional neuroleptics (79.8%) or clozapine (20.2%). Neuroleptic-induced movement disorders according to DSM-IV criteria were found in 61.6% of the group: 31.3% had neuroleptic-induced akathisia, 23.2% had neuroleptic-induced parkinsonism, and 32.3% had neuroleptic-induced tardive dyskinesia. Prevalence rates for akathisia and tardive dyskinesia were similar when either DSM-IV criteria or rating scale scores were used, but the prevalence rate for parkinsonism was much lower per DSM-IV criteria than according to rating scale score. Nearly two-thirds of chronic schizophrenia patients suffered from a neuroleptic-induced movement disorder. Globally, extrapyramidal adverse effects still impose a huge burden on the majority of neuroleptic-treated individuals with schizophrenia. The discrepancy between the standard identification methods for neuroleptic-induced movement disorder indicate the need for further research.

Facial emotion recognition in Chinese with schizophrenia at early and chronic stages of illness.

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Leung, Joey Shuk-Yan; Lee, Tatia M C; Lee, Chi-Chiu

2011-12-30

Deficits in facial emotion recognition have been recognised in Chinese patients diagnosed with schizophrenia. This study examined the relationship between chronicity of illness and performance of facial emotion recognition in Chinese with schizophrenia. There were altogether four groups of subjects matched for age and gender composition. The first and second groups comprised medically stable outpatients with first-episode schizophrenia (n=50) and their healthy controls (n=26). The third and fourth groups were patients with chronic schizophrenic illness (n=51) and their controls (n=28). The ability to recognise the six prototypical facial emotions was examined using locally validated coloured photographs from the Japanese and Caucasian Facial Expressions of Emotion. Chinese patients with schizophrenia, in both the first-episode and chronic stages, performed significantly worse than their control counterparts on overall facial emotion recognition, (Pemotion did not appear to have worsened over the course of disease progression, suggesting that recognition of facial emotion is a rather stable trait of the illness. The emotion-specific deficit may have implications for understanding the social difficulties in schizophrenia. Copyright © 2011 Elsevier Ltd. All rights reserved.

Decision-making deficits in patients with chronic schizophrenia: Iowa Gambling Task and Prospect Valence Learning model.

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Kim, Myung-Sun; Kang, Bit-Na; Lim, Jae Young

2016-01-01

Decision-making is the process of forming preferences for possible options, selecting and executing actions, and evaluating the outcome. This study used the Iowa Gambling Task (IGT) and the Prospect Valence Learning (PVL) model to investigate deficits in risk-reward related decision-making in patients with chronic schizophrenia, and to identify decision-making processes that contribute to poor IGT performance in these patients. Thirty-nine patients with schizophrenia and 31 healthy controls participated. Decision-making was measured by total net score, block net scores, and the total number of cards selected from each deck of the IGT. PVL parameters were estimated with the Markov chain Monte Carlo sampling scheme in OpenBugs and BRugs, its interface to R, and the estimated parameters were analyzed with the Mann-Whitney U-test. The schizophrenia group received significantly lower total net scores compared to the control group. In terms of block net scores, an interaction effect of group × block was observed. The block net scores of the schizophrenia group did not differ across the five blocks, whereas those of the control group increased as the blocks progressed. The schizophrenia group obtained significantly lower block net scores in the fourth and fifth blocks of the IGT and selected cards from deck D (advantageous) less frequently than the control group. Additionally, the schizophrenia group had significantly lower values on the utility-shape, loss-aversion, recency, and consistency parameters of the PVL model. These results indicate that patients with schizophrenia experience deficits in decision-making, possibly due to failure in learning the expected value of each deck, and incorporating outcome experiences of previous trials into expectancies about options in the present trial.

A mentally retarded patient with schizophrenia.

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Rabia, K; Khoo, Em

2008-01-01

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

The Effects of Recreation Therapy on the Habit of Smoking and Positive–Negative Symptoms Among Patients with Chronic Schizophrenia

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Pirbalouti M. G.

2017-10-01

Full Text Available Schizophrenia is a psychiatric condition that has detrimental outcomes on an individual’s thinking, understanding and feelings. However, it not only affects one’s actions and emotions, but also, and quite specifically, creates an avenue for such antisocial behavior as seclusion. Hence, it is important to highlight the necessary requirements for the recovery of schizophrenic patients and subsequently delve deeper into the signs and symptoms of schizophrenia itself, especially among patients who have been confined to psychiatric care for too long. The aim of this study was to determine the effects of recreation therapy on smoking as well as the positive-negative symptoms of schizophrenia among patients who have reached the chronic stage of this condition. Essentially, this was a semi-experimental study with one pretest and one posttest. 50 patients under psychiatric care, aged between 30 to 50 years, were selected and then equally divided into the control and experimental groups. The instruments for this research were the Anderson questionnaire and the smoking cigarette questionnaire, the latter being created by the researcher. Data were analyzed using descriptive and inferential statistics. To evaluate the hypothesis of research, this study relied on a covariance analysis. Based on the results, it can be said that there were significant (p ≤ 0.05 differences between the control and experimental groups related to smoking as well as the positive-negative symptoms of schizophrenia. It shows that 4 months of recreation therapy was able to decrease the prevalence of smoking (19.9%, in addition to the positive symptoms (18.3% and negative symptoms (14.7% of schizophrenia within the experimental group. It is hoped that the results of this study will encourage the use of recreation therapy as a practical and non-pharmacological form of treatment for patients with chronic schizophrenia.

Toxoplasma gondii infection and chronic schizophrenia: is there any association?

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Salvina Maria de Campos-Carli

Full Text Available ABSTRACT Background: Toxoplasma gondii (T. gondii infection has been identified as a risk factor for schizophrenia. Objectives: Herein, we sought to evaluate the association between T. gondii infection and clinical symptoms and quality of life in patients with schizophrenia. Methods: We conducted a cross-sectional study with 48 patients with chronic schizophrenia and 40 controls. Peripheral blood was drawn, and IgM and IgG anti-T. gondii antibodies were evaluated by Enzyme-Linked Immunosorbent Assay (ELISA. Depressive, positive and negative symptoms were assessed, respectively, by the Calgary Depression Scale (CDS and the Positive and Negative Syndrome Scale (PANSS. Cognitive performance was assessed in patients by the Brazilian version of the Schizophrenia Cognition Rating Scale (SCoRS-BR. Quality of life was assessed by the Brazilian version of the Quality of Life in Schizophrenia scale (QLS-BR. Results: The prevalence and titers of T. gondii IgM and IgG antibodies did not differ between patients and controls. The positive serology for T. gondii IgG antibodies was not associated with illness symptoms, cognitive performance, depressive symptoms or quality of life. Discussion: Our findings suggest that toxoplasmosis infection is not associated with severity of symptoms, quality of life, cognitive or depressive symptoms in schizophrenia patients.

Prevalence of schizophrenia in patients with psoriasis: a nationwide study

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Hung-Pin Tu

2017-03-01

Conclusion: Schizophrenia is more prevalent in patients with psoriasis. Although the exact mechanisms remain to be clarified, the finding that psoriatic patients with comorbid cerebrovascular disease or chronic pulmonary disease have higher odds for schizophrenia may imply psoriatic patients with those comorbidities are likely to have higher inflammatory burden, which would contribute to the development of schizophrenia if a disruption of the blood–brain barrier is present. Further investigations are indicated to validate the hypothesis explaining the association between known comorbidies of psoriasis and schizophrenia.

Cognitive Remediation in Middle-Aged or Older Inpatients with Chronic Schizophrenia: A Randomized Controlled Trial in Korea

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Kee-Hong Choi

2018-02-01

Full Text Available Background: Accumulating evidence indicates that cognitive remediation (CR is effective for improving various cognitive deficits in adult patients with schizophrenia. Although reports of brain plasticity in older adults and the service needs for chronic patients with schizophrenia are increasing, very few randomized controlled trials of CR have been conducted in middle-aged or older inpatients with chronic schizophrenia. We investigated the efficacy of individualized CR on the cognitive impairments of middle-aged or older inpatients with chronic schizophrenia within the context of comprehensive psychiatric rehabilitation (PR by comparing the results obtained with PR only and treatment as usual (TAU.Method: Fifty-seven middle-aged and older individuals with chronic schizophrenia and mild to moderate cognitive deficits were enrolled. Thirty-eight who were undergoing PR were randomly assigned to CR + PR (N = 19 or PR-only (N = 19 groups. Nineteen participants who were undergoing TAU without CR or PR were evaluated pre- and post-treatment.Results: CR was easily provided and well received (drop-out rates = 5.3% by middle-aged or older psychiatric inpatients. Compared to the PR-Only or TAU patients, patients in the CR + PR group showed greater improvement in executive functioning. Compared to TAU patients, CR + PR and PR-only patients showed greater improvement in logical memory. More patients in the CR + PR group improved clinically significantly in executive functioning and logical memory, compared with the PR-only and TAU patients.Conclusions: These results suggested that CR improved some cognitive deficits in middle-aged or older inpatients with chronic schizophrenia and that it was effective as an adjunctive treatment to the usual PR services provided in inpatient settings.Clinical Registration: KCT0002609

A MENTALLY RETARDED PATIENT WITH SCHIZOPHRENIA

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KHOO EM

2008-01-01

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

Polygenic signal for symptom dimensions and cognitive performance in patients with chronic schizophrenia.

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Xavier, Rose Mary; Dungan, Jennifer R; Keefe, Richard S E; Vorderstrasse, Allison

2018-06-01

Genetic etiology of psychopathology symptoms and cognitive performance in schizophrenia is supported by candidate gene and polygenic risk score (PRS) association studies. Such associations are reported to be dependent on several factors - sample characteristics, illness phase, illness severity etc. We aimed to examine if schizophrenia PRS predicted psychopathology symptoms and cognitive performance in patients with chronic schizophrenia. We also examined if schizophrenia associated autosomal loci were associated with specific symptoms or cognitive domains. Case-only analysis using data from the Clinical Antipsychotics Trials of Intervention Effectiveness-Schizophrenia trials ( n  = 730). PRS was constructed using Psychiatric Genomics Consortium (PGC) leave one out genome wide association analysis as the discovery data set. For candidate region analysis, we selected 105-schizophrenia associated autosomal loci from the PGC study. We found a significant effect of PRS on positive symptoms at p -threshold ( P T ) of 0.5 ( R 2  = 0.007, p  = 0.029, empirical p  = 0.029) and negative symptoms at P T of 1e-07 ( R 2  = 0.005, p  = 0.047, empirical p  = 0.048). For models that additionally controlled for neurocognition, best fit PRS predicted positive ( p- threshold 0.01, R 2   =  0.007, p =  0.013, empirical p  = 0.167) and negative symptoms ( p- threshold 0.1, R 2   =  0.012, p =  0.004, empirical p  = 0.329). No associations were seen for overall neurocognitive and social cognitive performance tests. Post-hoc analyses revealed that PRS predicted working memory and vigilance performance but did not survive correction. No candidate regions that survived multiple testing corrections were associated with either symptoms or cognitive performance. Our findings point to potentially distinct pathogenic mechanisms for schizophrenia symptoms.

Ziprasidone versus olanzapine, risperidone or quetiapine in patients with chronic schizophrenia: a 12-week open-label, multicentre clinical trial

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Lublin, Henrik; Haug, Hans-Joachim; Koponen, Hannu

2009-01-01

The efficacy, safety and tolerability of ziprasidone versus the comparators olanzapine, risperidone or quetiapine were investigated in adult patients with chronic schizophrenia, schizoaffective and schizophreniform disorders, with lack of efficacy or intolerance to their previous antipsychotic tr...

Decision-making deficits in patients with chronic schizophrenia: Iowa Gambling Task and Prospect Valence Learning model

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Kim MS

2016-04-01

Full Text Available Myung-Sun Kim,1 Bit-Na Kang,1 Jae Young Lim2 1Department of Psychology, Sungshin Women’s University, Seoul, Republic of Korea; 2Department of Psychiatry, Keyo Medical Foundation, Keyo Hospital, Uiwang, Republic of Korea Purpose: Decision-making is the process of forming preferences for possible options, selecting and executing actions, and evaluating the outcome. This study used the Iowa Gambling Task (IGT and the Prospect Valence Learning (PVL model to investigate deficits in risk-reward related decision-making in patients with chronic schizophrenia, and to identify decision-making processes that contribute to poor IGT performance in these patients. Materials and methods: Thirty-nine patients with schizophrenia and 31 healthy controls participated. Decision-making was measured by total net score, block net scores, and the total number of cards selected from each deck of the IGT. PVL parameters were estimated with the Markov chain Monte Carlo sampling scheme in OpenBugs and BRugs, its interface to R, and the estimated parameters were analyzed with the Mann–Whitney U-test.Results: The schizophrenia group received significantly lower total net scores compared to the control group. In terms of block net scores, an interaction effect of group × block was observed. The block net scores of the schizophrenia group did not differ across the five blocks, whereas those of the control group increased as the blocks progressed. The schizophrenia group obtained significantly lower block net scores in the fourth and fifth blocks of the IGT and selected cards from deck D (advantageous less frequently than the control group. Additionally, the schizophrenia group had significantly lower values on the utility-shape, loss-aversion, recency, and consistency parameters of the PVL model. Conclusion: These results indicate that patients with schizophrenia experience deficits in decision-making, possibly due to failure in learning the expected value of each deck

Comparing the executive function of patients with schizophrenia, acute/chronic type I disorder (manic episode, and healthy controls on Wisconsin Card Sorting Test and Continuous Performance Test

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Hossein Zare

2017-05-01

Full Text Available Introduction: From among various cognitive deficits, deficits in executive processes have an effective role in limiting the patients’ ability to retain, acquire, and re-learn the skills necessary for real-life performance. Thus, the present study aimed to compare the executive function of patients with schizophrenia, acute/chronic type I disorder, and the healthy group. Methods: The present research was an analytical-comparative study. The statistical population consisted of all the outpatients and inpatients with acute/chronic schizophrenia and acute/chronic type I disorder (manic episode visiting Shafa Psychiatric Hospital, Rasht, Iran. Using convenience sampling, 60 male subjects aging 18-49 years old were selected in 2014-2015. They were matched for the variables of sex, age, and education level. The Wisconsin Card Sorting Test, Continuous Performance Test, and Raven’s Progressive Matrices were administered, and the data were analyzed using MANOVA and Tukey post-hoc test. Results: A significant difference was observed between the acute/chronic schizophrenia group, acute/chronic type I disorder (manic episode, and healthy group on the two tests. Patients with schizophrenia had a weaker executive function and attention deficit compared to those with type I disorder and the healthy group (P0.05. Conclusion: Both schizophrenia and type I disorder patients show deficits in executive function and attention. However, the former group manifests higher impairment in cognitive activities, concept formation, cognitive flexibility, and attention deficit.

Impaired early visual response modulations to spatial information in chronic schizophrenia

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Knebel, Jean-François; Javitt, Daniel C.; Murray, Micah M.

2011-01-01

Early visual processing stages have been demonstrated to be impaired in schizophrenia patients and their first-degree relatives. The amplitude and topography of the P1 component of the visual evoked potential (VEP) are both affected; the latter of which indicates alterations in active brain networks between populations. At least two issues remain unresolved. First, the specificity of this deficit (and suitability as an endophenotype) has yet to be established, with evidence for impaired P1 responses in other clinical populations. Second, it remains unknown whether schizophrenia patients exhibit intact functional modulation of the P1 VEP component; an aspect that may assist in distinguishing effects specific to schizophrenia. We applied electrical neuroimaging analyses to VEPs from chronic schizophrenia patients and healthy controls in response to variation in the parafoveal spatial extent of stimuli. Healthy controls demonstrated robust modulation of the VEP strength and topography as a function of the spatial extent of stimuli during the P1 component. By contrast, no such modulations were evident at early latencies in the responses from patients with schizophrenia. Source estimations localized these deficits to the left precuneus and medial inferior parietal cortex. These findings provide insights on potential underlying low-level impairments in schizophrenia. PMID:21764264

The Relationship Between Depression And Positive Signs In Chronic Schizophrenia

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Bahaoddini S S

2004-06-01

Full Text Available Background: The results of studies about relationship between depression and positive signs in schizophrenia are controversial and clarifying the nature of this association may be difficult. The aim of present study is to investigate relationship between depressive symptoms and positive signs, in acute phase of patients with chronic schizophrenia, who have been admitted in Roozbeh Hospital. Materials and Methods: Assessments were performed using the Beck depression Inventory for depression (subjectively and positive and negative syndrome scale (PANSS for psychotic symptoms. Results: The results demonstrated a significant correlation between depressive symptoms and positive signs in these patients. Also, a significant correlation existed between depression and these items: delusions, hallucinatory behavior, excitement, hostility. Conclusion: depressive symptoms and positive signs in schizophrenia may have a common underlying pathophysiological origin.

Chronic persecutory delusion and autobiographical memories in patients with schizophrenia: a diary study.

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Berna, Fabrice; Huron, Caroline; Kazès, Mathilde; Offerlin-Meyer, Isabelle; Willard, Dominique; Verry, Paulina; Hedélin, Guy; Krebs, Marie-Odile; Danion, Jean-Marie

2014-01-01

While chronic persecutory delusions are typically anchored into patients' everyday life situations, no investigation has ever looked at how situations associated with a feeling of persecution are recorded and later retrieved. a diary methodology combined with a recognition task involving ten patients with schizophrenia who presented chronic persecutory delusions and ten control participants. Diaries of everyday persecutory events (Pe) and non-persecutory events (nPe) were kept. in both groups, 1) Pe were associated with higher anxiety scores than nPe, 2) Pe were experienced as less distinctive and more stereotyped than nPe, 3) the frequency of incorrect recognition of altered descriptions of Pe was higher than that of nPe. because high levels of motivation are required of the diarists, our sample size was small. Memories of persecutory events were highly emotional and semanticized. they were frequently incorrectly recognized, suggesting the existence of bias resulting from interactions between their processing and persecutory delusions.

Noun-Verb Ambiguity in Chronic Undifferentiated Schizophrenia

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Goldfarb, Robert; Bekker, Natalie

2009-01-01

This study investigated noun-verb retrieval patterns of 30 adults with chronic undifferentiated schizophrenia and 67 typical adults, to determine if schizophrenia affected nouns (associated with temporal lobe function) differently from verbs (associated with frontal lobe function). Stimuli were homophonic homographic homonyms, balanced according…

Mass spectrum analysis of serum biomarker proteins from patients with schizophrenia.

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Zhou, Na; Wang, Jie; Yu, Yaqin; Shi, Jieping; Li, Xiaokun; Xu, Bin; Yu, Qiong

2014-05-01

Diagnosis of schizophrenia does not have a clear objective test at present, so we aimed to identify the potential biomarkers for the diagnosis of schizophrenia by comparison of serum protein profiling between first-episode schizophrenia patients and healthy controls. The combination of a magnetic bead separation system with matrix-assisted laser desorption/ionization time-of-flight tandem mass spectrometry (MALDI-TOF/TOF-MS) was used to analyze the serum protein spectra of 286 first-episode patients with schizophrenia, 41 chronic disease patients and 304 healthy controls. FlexAnlysis 3.0 and ClinProTools(TM) 2.1 software was used to establish a diagnostic model for schizophrenia. The results demonstrated that 10 fragmented peptides demonstrated an optimal discriminatory performance. Among these fragmented peptides, the peptide with m/z 1206.58 was identified as a fragment of fibrinopeptide A. Receiver operating characteristic analysis for m/z 1206.58 showed that the area under the curve was 0.981 for schizophrenia vs healthy controls, and 0.999 for schizophrenia vs other chronic disease controls. From our result, we consider that the analysis of serum protein spectrum using the magnetic bead separation system and MALDI-TOF/TOF-MS is an objective diagnostic tool. We conclude that fibrinopeptide A has the potential to be a biomarker for diagnosis of schizophrenia. This protein may also help to elucidate schizophrenia disease pathogenesis. Copyright © 2013 John Wiley & Sons, Ltd.

Predictive factors of overall functioning improvement in patients with chronic schizophrenia and schizoaffective disorder treated with paliperidone palmitate and aripiprazole monohydrate.

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Girardi, Paolo; Del Casale, Antonio; Rapinesi, Chiara; Kotzalidis, Georgios D; Splendori, Francesca; Verzura, Claudio; Trovini, Giada; Sorice, Serena; Carrus, Dario; Mancinelli, Iginia; Comparelli, Anna; De Filippis, Sergio; Francomano, Antonio; Ballerini, Andrea; Marcellusi, Andrea; Mennini, Francesco S; Ducci, Giuseppe; Sani, Gabriele; Pompili, Maurizio; Brugnoli, Roberto

2018-05-01

Long-acting injectable (LAI) antipsychotics can improve medication adherence and reduce hospitalisation rates compared with oral treatments. Paliperidone palmitate (PAL) and aripiprazole monohydrate (ARI) LAI treatments were associated with improvements in global functioning in patients with schizophrenia. The objective of this study was to assess the predictive factors of better overall functioning in patients with chronic schizophrenia and schizoaffective disorder treated with PAL and ARI. Enrolled were 143 (97 males, 46 females, mean age 38.24 years, SD = 12.65) patients with a diagnosis of schizophrenia or schizoaffective disorder, whom we allocated in two groups (PAL and ARI treatments). We assessed global functioning, amount of oral medications, adherence to oral treatment, and number of hospitalisations before LAI introduction and at assessment time point. Longer treatment time with LAIs (p schizoaffective disorder. Better improvement in functioning could be achieved with ARI in young individuals with recent illness onset and PAL in patients at risk for recurrent hospitalisations. Copyright © 2018 John Wiley & Sons, Ltd.

Severity of psychosis syndrome and change of metabolic abnormality in chronic schizophrenia patients: severe negative syndrome may be related to a distinct lipid pathophysiology.

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Chen, S-F; Hu, T-M; Lan, T-H; Chiu, H-J; Sheen, L-Y; Loh, E-W

2014-03-01

Metabolic abnormality is common among schizophrenia patients. Some metabolic traits were found associated with subgroups of schizophrenia patients. We examined a possible relationship between metabolic abnormality and psychosis profile in schizophrenia patients. Three hundred and seventy-two chronic schizophrenia patients treated with antipsychotics for more than 2 years were assessed with the Positive and Negative Syndrome Scale. A set of metabolic traits was measured at scheduled checkpoints between October 2004 and September 2006. Multiple regressions adjusted for sex showed negative correlations between body mass index (BMI) and total score and all subscales; triglycerides (TG) was negatively correlated with total score and negative syndrome, while HDLC was positively correlated with negative syndrome. When sex interaction was concerned, total score was negatively correlated with BMI but not with others; negative syndrome was negatively correlated with BMI and positively with HDLC. No metabolic traits were correlated with positive syndrome or general psychopathology. Loss of body weight is a serious health problem in schizophrenia patients with severe psychosis syndrome, especially the negative syndrome. Schizophrenia patients with severe negative syndrome may have a distinct lipid pathophysiology in comparison with those who were less severe in the domain. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Adjunctive sarcosine plus benzoate improved cognitive function in chronic schizophrenia patients with constant clinical symptoms: A randomised, double-blind, placebo-controlled trial.

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Lin, Chun-Yuan; Liang, Sun-Yuan; Chang, Yue-Cune; Ting, Shuo-Yen; Kao, Ching-Ling; Wu, Yu-Hsin; Tsai, Guochuan E; Lane, Hsien-Yuan

2017-08-01

Objectives Hypofunction of NMDA receptor is implicated in the pathophysiology, particularly cognitive impairment, of schizophrenia. Sarcosine, a glycine transporter I (GlyT-1) inhibitor, and sodium benzoate, a d-amino acid oxidase (DAAO) inhibitor, can both enhance NMDA receptor-mediated neurotransmission. We proposed simultaneously inhibiting DAAO and GlyT-1 may be more effective than inhibition of either in improving the cognitive and global functioning of schizophrenia patients. Methods This study compared add-on sarcosine (2 g/day) plus benzoate (1 g/day) vs. sarcosine (2 g/day) for the clinical symptoms, as well as the cognitive and global functioning, of chronic schizophrenia patients in a 12-week, double-blind, randomised, placebo-controlled trial. Participants were measured with the Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale every 3 weeks. Seven cognitive domains, recommended by the Measurement and Treatment Research to Improve Cognition in Schizophrenia Committee, were measured at weeks 0 and 12. Results Adjunctive sarcosine plus benzoate, but not sarcosine alone, improved the cognitive and global functioning of patients with schizophrenia, even when their clinical symptoms had not improved. Conclusions This finding suggests N-methyl-d-aspartate receptor-enhancement therapy can improve the cognitive function of patients with schizophrenia, further indicating this pro-cognitive effect can be primary without improvement in clinical symptoms.

Serum total homocystein, folate and vitamin B12 levels and their correlation with antipsychotic drug doses in adult male patients with chronic schizophrenia.

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Eren, Esin; Yeğin, Ayşenur; Yilmaz, Necat; Herken, Hasan

2010-01-01

Elevated blood levels of homocysteine (hCY) have been associated with schizophrenic male patients. However, controversy remains regarding the association between lowered plasma folate and vitamin B12, hyperhomocysteinemia, and schizophrenia. Sixty-six (66) male patients with chronic schizophrenia were investigated to test the hypotheses that alterations in Hcy, folate, and vitamin B12 levels might be related to the antipsychotic drug doses used in treatment. Serum total homocysteine, folic acid, and vitamin B12 levels were determined by chemiluminescence methods in both patients and control subjects. The patients were grouped according to the antipsychotic drug doses used in their treatment. Patients had higher homocysteine levels but they did not differ from controls in terms of folate and vitamin B12 levels. On the other hand, only folate levels were negatively correlated in the patient group treated with higher therapeutic doses of chlorpromazine equivalents (> 400 mg/day) compared to the patient group with lower doses (< 400 mg/day). Our findings show that higher typical antipsychotic drugs may play a role as modifiying factor for folate metabolism in chronic schizoprenic male patients.

Brain-Wide Analysis of Functional Connectivity in First-Episode and Chronic Stages of Schizophrenia.

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Li, Tao; Wang, Qiang; Zhang, Jie; Rolls, Edmund T; Yang, Wei; Palaniyappan, Lena; Zhang, Lu; Cheng, Wei; Yao, Ye; Liu, Zhaowen; Gong, Xiaohong; Luo, Qiang; Tang, Yanqing; Crow, Timothy J; Broome, Matthew R; Xu, Ke; Li, Chunbo; Wang, Jijun; Liu, Zhening; Lu, Guangming; Wang, Fei; Feng, Jianfeng

2017-03-01

Published reports of functional abnormalities in schizophrenia remain divergent due to lack of staging point-of-view and whole-brain analysis. To identify key functional-connectivity differences of first-episode (FE) and chronic patients from controls using resting-state functional MRI, and determine changes that are specifically associated with disease onset, a clinical staging model is adopted. We analyze functional-connectivity differences in prodromal, FE (mostly drug naïve), and chronic patients from their matched controls from 6 independent datasets involving a total of 789 participants (343 patients). Brain-wide functional-connectivity analysis was performed in different datasets and the results from the datasets of the same stage were then integrated by meta-analysis, with Bonferroni correction for multiple comparisons. Prodromal patients differed from controls in their pattern of functional-connectivity involving the inferior frontal gyri (Broca's area). In FE patients, 90% of the functional-connectivity changes involved the frontal lobes, mostly the inferior frontal gyrus including Broca's area, and these changes were correlated with delusions/blunted affect. For chronic patients, functional-connectivity differences extended to wider areas of the brain, including reduced thalamo-frontal connectivity, and increased thalamo-temporal and thalamo-sensorimoter connectivity that were correlated with the positive, negative, and general symptoms, respectively. Thalamic changes became prominent at the chronic stage. These results provide evidence for distinct patterns of functional-dysconnectivity across FE and chronic stages of schizophrenia. Importantly, abnormalities in the frontal language networks appear early, at the time of disease onset. The identification of stage-specific pathological processes may help to understand the disease course of schizophrenia and identify neurobiological markers crucial for early diagnosis. © The Author 2016. Published by

Elevated gamma-aminobutyric acid levels in chronic schizophrenia.

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Ongür, Dost; Prescot, Andrew P; McCarthy, Julie; Cohen, Bruce M; Renshaw, Perry F

2010-10-01

Despite widely replicated abnormalities of gamma-aminobutyric acid (GABA) neurons in schizophrenia postmortem, few studies have measured tissue GABA levels in vivo. We used proton magnetic resonance spectroscopy to measure tissue GABA levels in participants with schizophrenia and healthy control subjects in the anterior cingulate cortex and parieto-occipital cortex. Twenty-one schizophrenia participants effectively treated on a stable medication regimen (mean age 39.0, 14 male) and 19 healthy control subjects (mean age 36.3, 12 male) underwent a proton magnetic resonance spectroscopy scan using GABA-selective editing at 4 Tesla after providing informed consent. Data were collected from two 16.7-mL voxels and analyzed using LCModel. We found elevations in GABA/creatine in the schizophrenia group compared with control subjects [F(1,65) = 4.149, p = .046] in both brain areas (15.5% elevation in anterior cingulate cortex, 11.9% in parieto-occipital cortex). We also found a positive correlation between GABA/creatine and glutamate/creatine, which was not accounted for by % GM or brain region. We found elevated GABA/creatinine in participants with chronically treated schizophrenia. Postmortem studies report evidence for dysfunctional GABAergic neurotransmission in schizophrenia. Elevated GABA levels, whether primary to illness or compensatory to another process, may be associated with dysfunctional GABAergic neurotransmission in chronic schizophrenia. Copyright © 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

The effect of regular aerobic exercise on both positive and negative symptoms of male patients with chronic Schizophrenia: A double blinded study

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Hossein Namdar areshtanab

2016-11-01

Full Text Available Nowadays in different communities, sport is being used as a mean to prevent diseases, improve health and have a sense of well-being. The evidences show that sport improves mental health, self-confidence, cognitive performance and on the other hand it decreases anxiety and depression. Therefore, this study aims to investigate the effect of regular aerobic exercise on both positive and negative symptoms of male patients with chronic Schizophrenia who are hospitalized at RAZI Psychiatric hospital, TABRIZ, IRAN. The present study, which has been done on 68 male patients with chronic Schizophrenia, is a double-blinded clinical trial study. Randomly chosen samples have been categorized in two groups of case(34 patients and control (34 patients. The case group samples participated in the designed exercise program during 24sessions over 8 weeks, 11hours in total. The positive and negative symptoms for both groups were assessed in two steps before starting the exercise program and also after that through Standard Anderson Positive and Negative questionnaire (SAPS.SANS. The data of both groups were compared using statistical tests, T-test, paired t-test , and Chi-square test. The results demonstrated that there is no significant relationship between before intervention in terms of positive and negative symptoms of disease (P>0.05. Furthermore, the results indicated that there is a significant statistical difference between the average total score of positive and negative symptoms of the disease in both case and control group after intervention (P<0.05.Health system officials and managers can implement programs and solutions for creating regular aerobic exercises for patients with Schizophrenia in order to reduce disease symptoms and improve the rate of recovery in patients with chronic mental disorders.

The effects of assertiveness training in patients with schizophrenia: a randomized, single-blind, controlled study.

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Lee, Tso-Ying; Chang, Shih-Chin; Chu, Hsin; Yang, Chyn-Yng; Ou, Keng-Liang; Chung, Min-Huey; Chou, Kuei-Ru

2013-11-01

In this study, we investigated the effects of group assertiveness training on assertiveness, social anxiety and satisfaction with interpersonal communication among patients with chronic schizophrenia. Only limited studies highlighted the effectiveness of group assertiveness training among inpatients with schizophrenia. Given the lack of group assertiveness training among patients with schizophrenia, further development of programmes focusing on facilitating assertiveness, self-confidence and social skills among inpatients with chronic schizophrenia is needed. This study used a prospective, randomized, single-blinded, parallel-group design. This study employed a prospective, randomized, parallel-group design. Seventy-four patients were randomly assigned to experimental group receiving 12 sessions of assertiveness training, or a supportive control group. Data collection took place for the period of June 2009-July 2010. Among patients with chronic schizophrenia, assertiveness, levels of social anxiety and satisfaction with interpersonal communication significantly improved immediately after the intervention and at the 3-month follow-up in the intervention group. The results of a generalized estimating equation (GEE) indicated that: (1) assertiveness significantly improved from pre- to postintervention and was maintained until the follow-up; (2) anxiety regarding social interactions significantly decreased after assertiveness training; and (3) satisfaction with interpersonal communication slightly improved after the 12-session intervention and at the 3-month follow-up. Assertivenss training is a non-invasive and inexpensive therapy that appears to improve assertiveness, social anxiety and interpersonal communication among inpatients with chronic schizophrenia. These findings may provide a reference guide to clinical nurses for developing assertiveness-training protocols. © 2013 Blackwell Publishing Ltd.

Increased levels of IL-6 in the cerebrospinal fluid of patients with chronic schizophrenia — significance for activation of the kynurenine pathway

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Schwieler, Lilly; Larsson, Markus K.; Skogh, Elisabeth; Kegel, Magdalena E.; Orhan, Funda; Abdelmoaty, Sally; Finn, Anja; Bhat, Maria; Samuelsson, Martin; Lundberg, Kristina; Dahl, Marja-Liisa; Sellgren, Carl; Schuppe-Koistinen, Ina; Svensson, Camilla I.; Erhardt, Sophie; Engberg, Göran

2015-01-01

Background Accumulating evidence indicates that schizophrenia is associated with brain immune activation. While a number of reports suggest increased cytokine levels in patients with schizophrenia, many of these studies have been limited by their focus on peripheral cytokines or confounded by various antipsychotic treatments. Here, well-characterized patients with schizophrenia, all receiving olanzapine treatment, and healthy volunteers were analyzed with regard to cerebrospinal fluid (CSF) levels of cytokines. We correlated the CSF cytokine levels to previously analyzed metabolites of the kynurenine (KYN) pathway. Methods We analyzed the CSF from patients and controls using electrochemiluminescence detection with regard to cytokines. Cell culture media from human cortical astrocytes were analyzed for KYN and kynurenic acid (KYNA) using high-pressure liquid chromatography or liquid chromatography/mass spectrometry. Results We included 23 patients and 37 controls in our study. Patients with schizophrenia had increased CSF levels of interleukin (IL)-6 compared with healthy volunteers. In patients, we also observed a positive correlation between IL-6 and the tryptophan:KYNA ratio, indicating that IL-6 activates the KYN pathway. In line with this, application of IL-6 to cultured human astrocytes increased cell medium concentration of KYNA. Limitations The CSF samples had been frozen and thawed twice before analysis of cytokines. Median age differed between patients and controls. When appropriate, all present analyses were adjusted for age. Conclusion We have shown that IL-6, KYN and KYNA are elevated in patients with chronic schizophrenia, strengthening the idea of brain immune activation in patients with this disease. Our concurrent cell culture and clinical findings suggest that IL-6 induces the KYN pathway, leading to increased production of the N-methyl-d-aspartate receptor antagonist KYNA in patients with schizophrenia. PMID:25455350

Unsuspected organic disease in chronic schizophrenia demonstrated by computed tomography

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Cunningham Owens, D.G.; Johnstone, E.C.; Bydder, G.M.; Kreel, L.

1980-01-01

Unsuspected intracranial pathology was demonstrated in 12 of 136 chronic schizophrenic patients examined by computed tomography (CT). Seven cases of cerebral infarction were found, and one each of porencephalic cyst, meningioma, cystic enlargement of the pineal body, and two of subdural haematoma. Attention is drawn to the value of CT in demonstrating organic disease in schizophrenia. (author)

Toxoplasma Infection in Schizophrenia Patients: A Comparative Study with Control Group

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Alipour, A; Shojaee, S; Mohebali, M; Tehranidoost, M; Abdi Masoleh, F; Keshavarz, H

2011-01-01

Background: Schizophrenia is a serious, chronic, and often debilitating neuropsychiatric disor­der. Its causes are still poorly understood. Besides genetic and non-genetic (environmental) fac­tors are thought to be important as the cause of the structural and functional deficits that character­ize schizophrenia. This study aimed to compare Toxoplasma gondii infection between schizo­phrenia patients and non-schizophrenia individuals as control group.Methods: A case-control study was designed i...

Pattern of Psychotropic Drug Prescription in the Elderly with Chronic Schizophrenia

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Mohamad Reza Khodaei Ardakani

2013-04-01

Full Text Available Objectives: Psychotropic drug use in the elderly with chronic schizophrenia is an important issue in the field of psychiatry. The main goal of this study was to clarify the pattern of such drug use in these patients, in order to consider such therapy plan and focus on its cost attributing measures, for a more reasonable quality of care program. Methods: In this descriptive study, participants included 52 elderly patients at Tehran’s Razi Mental Hospital who had chronic schizophrenia in the residual phase. Selected patients were taking at least two psychotropic drugs equivalent to 500mg Chlorpromazine. We prepared the list of the drugs used by completing the pre-designed questionnaire charts. Data were analyzed with SPSS 17. Results: In one case (1.92% the entries were Risperidone, Chlorpromazine, Fluphenazine Decanoate, & Thiothixene. In 11 cases (21.2% there were three entries and in 40 cases (76.8% there were two. The Chlorpromazine equivalent dose in each group ranged from the lowest dose (750 mg to the highest (5600 mg. The highest Chlorpromazine dose (5600 mg equivalent per milligram belonged to the four entries of (Risperidone, Chlorpromazine, Fluphenazine Decanoate & Thiothixene. The lowest Chlorpromazine dose (750 mg was seen in 3 entries of Risperidone, Chlorpromazine & Fluphenazine Decanoate. Discussion: There was a high prevalence of using more than two psychotropic medications from the first atypical antipsychotic category. Less frequently, the second and the third typical antipsychotics were used. We recommend further research into more feasible patterns of psychotropic prescriptions, lowering the amount of medication use and considering their cost-benefits in the elderly with chronic schizophrenia.

Influence of background music on work attention in clients with chronic schizophrenia.

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Shih, Yi-Nuo; Chen, Chi-Sheng; Chiang, Hsin-Yu; Liu, Chien-Hsiou

2015-01-01

Work attention in persons with chronic schizophrenia is an important issue in vocational rehabilitation. Some of the research literature indicates that background music may influence visual attention performance. Based on the theory of occupational therapy, environmental sounds, colors and decorations may affect individual performance, this study thus examined the influence of music on work attention in persons with schizophrenia. Participants were recruited from a halfway house in Taipei. Forty-nine (49) patients with chronic schizophrenia volunteered. They had been accepted into vocational rehabilitation and a work-seeking program. The sample included 20 females and 29 males. The participant ages ranged between 29 and 63 years old, and their average age was 47 years old. Using a randomized controlled trial (RCT) study, the participants were assigned to one of three conditions: quiet environment as the control group (n= 16), classical light music as background music (n= 16), and popular music as background music (n= 17). For Group 1 (control group/quiet environment), there was no significant variance (sig = 0.172). For Group 2 (Classical light music), the intervention revealed significant variance (sig = 0.071*). For Group 3 (popular music), the intervention had significant variance (sig = 0.048**). The introduction of background music tended to increase attention test scores of persons with schizophrenia. Moreover, the increase in test attention scores was statistically significant when popular music was played in the background. This result suggested that background music may improve attention performance of persons with chronic schizophrenia. Future research is required with a larger sample size to support the study results.

Paliperidone Palmitate Improves and Maintains Functioning in Asia-Pacific Patients with Schizophrenia.

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Zhang, Hongyan; Turkoz, Ibrahim; Zhuo, Jianmin; Mathews, Maju; Tan, Wilson; Feng, Yu

2017-11-01

Post hoc analyses (two single-arm studies) were conducted to determine the impact of once-monthly injection of paliperidone palmitate on functioning in adult patients with schizophrenia in the Asia-Pacific region. Study 1 enrolled hospitalized patients with acute exacerbation of schizophrenia, and study 2 enrolled patients with recently diagnosed schizophrenia unsatisfactorily treated with oral antipsychotics. Patients received paliperidone palmitate, 150 mg eq. on day 1, 100 mg eq. on day 8, then once monthly (50-150 mg eq.) (study 1, days 36 and 64; study 2, 18 months). Functional status was evaluated by Personal and Social Performance score in both studies and employment only in study 2. In study 1, 54 of 184 patients (29.4%) with an unfavorable level of functioning at the baseline improved to a favorable level (Personal and Social Performance score greater than 70) at day 92. This improvement was significantly greater among patients with recently diagnosed schizophrenia (5 years or less) compared with patients with chronic schizophrenia (more than 5 years): 40% versus 22% (p schizophrenia. Janssen-Cilag Asia-Pacific Medical Affairs.

Relationships between brain-derived neurotrophic factor, clinical symptoms and decision-making in chronic schizophrenia: data from the Iowa Gambling Task

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Hikaru eHori

2014-12-01

Full Text Available The levels of brain-derived neurotrophic factor (BDNF are significantly decreased in patients with schizophrenia and correlate with impairments in cognitive function. However, no study has investigated the relationship between the serum BDNF levels and decision-making. We compared patients with schizophrenia to healthy controls with respect to their decision-making ability and serum BDNF levels. Eighty-six chronic schizophrenia patients and 51 healthy controls participated in this study. We controlled for gender, age, and estimated intelligence quotient (IQ, and we investigated the differences in decision-making performance on the Iowa Gambling Task (IGT between the schizophrenia patient and control groups. We also compared the IGT scores, the serum BDNF levels, and the clinical symptoms between the groups. The IGT scores of the schizophrenia patients were lower than those of the controls. A negative correlation was detected between the mean net scores on the trials in the final two blocks and the serum BDNF levels（p<0.05）. Multiple regression analysis revealed that depressive symptoms and the serum BDNF levels were significantly associated with the mean net scores on the trials in the final two blocks. Based on these results, impaired sensitivity to both reward and punishment is associated with depressive symptoms and reduced serum BDNF levels in chronic schizophrenia patients and may be related to their poor performance on the IGT.

Using virtual reality to assess theory of mind subprocesses and error types in early and chronic schizophrenia.

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Canty, Allana L; Neumann, David L; Shum, David H K

2017-12-01

Individuals with schizophrenia often demonstrate theory of mind (ToM) impairment relative to healthy adults. However, the exact nature of this impairment (first- vs. second-order ToM and cognitive vs. affective ToM) and the extent to which ToM abilities deteriorate with illness chronicity is unclear. Furthermore, little is known about the relationships between clinical symptoms and ToM error types (overmentalising, reduced mentalising and no ToM) in early and chronic schizophrenia. This study examined the nature and types of ToM impairment in individuals with early ( n  = 26) and chronic schizophrenia ( n  = 32) using a novel virtual reality task. Clinical participants and demographically-matched controls were administered the Virtual Assessment of Mentalising Ability, which provides indices of first- and second-order cognitive and affective ToM, and quantifies three different types of mentalising errors (viz., overmentalising, reduced mentalising, and no ToM). Individuals with early schizophrenia performed significantly poorer than healthy controls on first-order affective and second-order cognitive and affective ToM, but significantly higher than individuals with chronic schizophrenia on all ToM subscales. Whereas a lack of mental state concept was associated with negative symptoms, overmentalising was associated with positive symptoms. These findings suggest that ToM abilities selectively deteriorate with illness chronicity and error types are related to these individuals' presenting symptomology. An implication of the findings is that social-cognitive interventions for schizophrenia need to consider the nature, time course and symptomatology of the presenting patient.

Connectivity-enhanced diffusion analysis reveals white matter density disruptions in first episode and chronic schizophrenia

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Rachael G. Grazioplene

Full Text Available Reduced fractional anisotropy (FA is a well-established correlate of schizophrenia, but it remains unclear whether these tensor-based differences are the result of axon damage and/or organizational changes and whether the changes are progressive in the adult course of illness. Diffusion MRI data were collected in 81 schizophrenia patients (54 first episode and 27 chronic and 64 controls. Analysis of FA was combined with “fixel-based” analysis, the latter of which leverages connectivity and crossing-fiber information to assess both fiber bundle density and organizational complexity (i.e., presence and magnitude of off-axis diffusion signal. Compared with controls, patients with schizophrenia displayed clusters of significantly lower FA in the bilateral frontal lobes, right dorsal centrum semiovale, and the left anterior limb of the internal capsule. All FA-based group differences overlapped substantially with regions containing complex fiber architecture. FA within these clusters was positively correlated with principal axis fiber density, but inversely correlated with both secondary/tertiary axis fiber density and voxel-wise fiber complexity. Crossing fiber complexity had the strongest (inverse association with FA (r = −0.82. When crossing fiber structure was modeled in the MRtrix fixel-based analysis pipeline, patients exhibited significantly lower fiber density compared to controls in the dorsal and posterior corpus callosum (central, postcentral, and forceps major. Findings of lower FA in patients with schizophrenia likely reflect two inversely related signals: reduced density of principal axis fiber tracts and increased off-axis diffusion sources. Whereas the former confirms at least some regions where myelin and or/axon count are lower in schizophrenia, the latter indicates that the FA signal from principal axis fiber coherence is broadly contaminated by macrostructural complexity, and therefore does not necessarily reflect

Using patient-reported outcomes in schizophrenia: the Scottish Schizophrenia Outcomes Study.

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Hunter, Robert; Cameron, Rosie; Norrie, John

2009-02-01

The primary aim of the Scottish Schizophrenia Outcomes Study (SSOS) was to assess the feasibility and utility of routinely collecting outcome data in everyday clinical settings. Data were collected over three years in the Scottish National Health Service (NHS). There were two secondary aims of SSOS: first, to compare data from patient-rated, objective, and clinician-rated outcomes, and second, to describe trends in outcome data and service use across Scotland over the three years of the study (2002-2005). This study used a naturalistic, longitudinal, observational cohort design. A representative sample of 1,015 persons with ICD-10 F20-F29 diagnoses (schizophrenia, schizotypal disorders, or delusional disorders) was assessed annually using the clinician-rated measure, the Health of the Nation Outcome Scale (HoNOS), and the patient-reported assessment, the Avon Mental Health Measure (Avon). Objective outcomes data and information on services and interventions were collected. Data were analyzed with regression modeling. Of the 1,015 persons recruited, 78% of the cohort (N=789) completed the study. Over the study period, significant decreases were seen in the number of hospitalizations, incidence of attempted suicide and self-harm, and civil detentions. Avon scores indicated significant improvement on all subscales (behavior, social, access, and mental health) and on the total score. However, HoNOS scores on the behavior and symptom subscales did not change, scores on the impairment subscale increased significantly (indicating increased levels of impairment), and scores on the social subscale decreased significantly (indicating improved social functioning). This study has demonstrated that it is feasible within the Scottish NHS to routinely collect meaningful outcomes data in schizophrenia. Patient-reported assessments were also successfully collected and used in care plans. This model shows that it is possible to incorporate patient-reported assessments into routine

Neurological Soft Signs and Psychopathology in Chronic Schizophrenia: A Cross-Sectional Study in Three Age Groups.

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Herold, Christina J; Lässer, Marc M; Seidl, Ulrich Wilhelm; Hirjak, Dusan; Thomann, Philipp A; Schröder, Johannes

2018-01-01

As established in a wealth of studies subtle motor and sensory neurological abnormalities or neurological soft signs (NSS) are frequently found in patients with schizophrenia at any stage of their illness. However, the potential impact of chronicity and age on NSS was scarcely investigated. Therefore, we assessed NSS in 90 patients with subchronic ( n  = 22) or chronic ( n  = 68) schizophrenia and in 60 healthy controls who were assigned to three age groups (18-29, 30-49, and +50 years). NSS were measured on the Heidelberg Scale, psychopathological symptoms including apathy were rated on established instruments. As demonstrated by analysis of variance, NSS scores in patients were significantly ( p  age effects arose in all NSS subscores, with older subjects scoring well above the younger ones. These age effects were more pronounced in patients than controls, indicating that NSS in chronic schizophrenia exceed age-associated changes. Moreover, the NSS scores in patients were significantly associated with duration of illness, thought disturbance, positive symptoms, and apathy. These results were confirmed after age/duration of illness and years of education were partialed out and via regression analyses. Our findings conform to the hypothesis that NSS are associated with chronicity of the disorder as indicated by the correlations of NSS with both, duration of illness and apathy. The correlations between NSS and positive symptoms/thought disturbance correspond to the fluctuation of positive symptoms during the course of the disorder. The significantly more pronounced age effects on NSS in patients may either point to ongoing cerebral changes or to a greater susceptibility of patients toward physiological age effects, which may be mediated among other factors by a lower cognitive reserve.

PET imaging of putative microglial activation in individuals at ultra-high risk for psychosis, recently diagnosed and chronically ill with schizophrenia.

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Di Biase, M A; Zalesky, A; O'keefe, G; Laskaris, L; Baune, B T; Weickert, C S; Olver, J; McGorry, P D; Amminger, G P; Nelson, B; Scott, A M; Hickie, I; Banati, R; Turkheimer, F; Yaqub, M; Everall, I P; Pantelis, C; Cropley, V

2017-08-29

We examined putative microglial activation as a function of illness course in schizophrenia. Microglial activity was quantified using [ 11 C](R)-(1-[2-chrorophynyl]-N-methyl-N-[1-methylpropyl]-3 isoquinoline carboxamide ( 11 C-(R)-PK11195) positron emission tomography (PET) in: (i) 10 individuals at ultra-high risk (UHR) of psychosis; (ii) 18 patients recently diagnosed with schizophrenia; (iii) 15 patients chronically ill with schizophrenia; and, (iv) 27 age-matched healthy controls. Regional-binding potential (BP ND ) was calculated using the simplified reference-tissue model with four alternative reference inputs. The UHR, recent-onset and chronic patient groups were compared to age-matched healthy control groups to examine between-group BP ND differences in 6 regions: dorsal frontal, orbital frontal, anterior cingulate, medial temporal, thalamus and insula. Correlation analysis tested for BP ND associations with gray matter volume, peripheral cytokines and clinical variables. The null hypothesis of equality in BP ND between patients (UHR, recent-onset and chronic) and respective healthy control groups (younger and older) was not rejected for any group comparison or region. Across all subjects, BP ND was positively correlated to age in the thalamus (r=0.43, P=0.008, false discovery rate). No correlations with regional gray matter, peripheral cytokine levels or clinical symptoms were detected. We therefore found no evidence of microglial activation in groups of individuals at high risk, recently diagnosed or chronically ill with schizophrenia. While the possibility of 11 C-(R)-PK11195-binding differences in certain patient subgroups remains, the patient cohorts in our study, who also displayed normal peripheral cytokine profiles, do not substantiate the assumption of microglial activation in schizophrenia as a regular and defining feature, as measured by 11 C-(R)-PK11195 BP ND .

Gray matter volume reduction in rostral middle frontal gyrus in patients with chronic schizophrenia.

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Kikinis, Z; Fallon, J H; Niznikiewicz, M; Nestor, P; Davidson, C; Bobrow, L; Pelavin, P E; Fischl, B; Yendiki, A; McCarley, R W; Kikinis, R; Kubicki, M; Shenton, M E

2010-11-01

The dorsolateral prefrontal cortex (DLPFC) is a brain region that has figured prominently in studies of schizophrenia and working memory, yet the exact neuroanatomical localization of this brain region remains to be defined. DLPFC primarily involves the superior frontal gyrus and middle frontal gyrus (MFG). The latter, however is not a single neuroanatomical entity but instead is comprised of rostral (anterior, middle, and posterior) and caudal regions. In this study we used structural MRI to develop a method for parcellating MFG into its component parts. We focused on this region of DLPFC because it includes BA46, a region involved in working memory. We evaluated volume differences in MFG in 20 patients with chronic schizophrenia and 20 healthy controls. Mid-rostral MFG (MR-MFG) was delineated within the rostral MFG using anterior and posterior neuroanatomical landmarks derived from cytoarchitectonic definitions of BA46. Gray matter volumes of MR-MFG were then compared between groups, and a significant reduction in gray matter volume was observed (p<0.008), but not in other areas of MFG (i.e., anterior or posterior rostral MFG, or caudal regions of MFG). Our results demonstrate that volumetric alterations in MFG gray matter are localized exclusively to MR-MFG. 3D reconstructions of the cortical surface made it possible to follow MFG into its anterior part, where other approaches have failed. This method of parcellation offers a more precise way of measuring MR-MFG that will likely be important in further documentation of DLPFC anomalies in schizophrenia. Copyright © 2010 Elsevier B.V. All rights reserved.

Doubtful association of antipsychotic polypharmacy and high dosage with cognition in chronic schizophrenia.

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Kontis, Dimitrios; Theochari, Eirini; Kleisas, Spyridon; Kalogerakou, Stamatina; Andreopoulou, Angeliki; Psaras, Rafael; Makris, Yannis; Karouzos, Charalambos; Tsaltas, Eleftheria

2010-10-01

Despite consistent recommendations for antipsychotic monotherapy, antipsychotic polypharmacy (the use of two or more antipsychotic agents) and the administration of excessive doses (higher than 1000 mgr/day of chloropromazine equivalents) is a common practice in schizophrenia. The therapeutic and adverse effects of this practice are poorly studied, in particular with regards to the cognitive symptoms of the disease. In this cross-sectional study we investigated the cognitive effects of antipsychotic polypharmacy and excessive doses in 53 patients with chronic schizophrenia using non-verbal cognitive tasks involving speed of movement, memory and executive functions. No significant difference in performance scores was found between the groups under polypharmacy and monotherapy, or the groups receiving either excessive or normal doses of antipsychotics. Since these groups did not also differ in demographic, clinical, other pharmacologic parameters, in the relative anticholinergic potency of antipsychotics, or in intelligence scores, we raise doubts about the association of polypharmacy and excessive doses with non-verbal cognitive performance in chronic schizophrenia. Copyright © 2010 Elsevier Inc. All rights reserved.

Language Disorder In Schizophrenia Patient: A Case Study Of Five Schizophrenia Paranoid Patients In Simeulue District Hospital

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Kurnia, Beby Febri

2015-01-01

Language disorder in schizophrenia patients is an acquired language disorder due to thought disorder. This analysis analyzed language disorder in schizophrenia paranoid patients in Simeulue District Hospital. The objective of this analysis were: (1) to find out the types of schizophrenic speech found in schizophrenia paranoid patients, (2) to find out the most dominant type of schizophrenia speech found in schizophrenia paranoid patients, and (3) to find out which patient has most severe lang...

Vitamin D Supplementation in Chronic Schizophrenia Patients Treated with Clozapine: A Randomized, Double-Blind, Placebo-controlled Clinical Trial.

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Krivoy, Amir; Onn, Roy; Vilner, Yael; Hochman, Eldar; Weizman, Shira; Paz, Amir; Hess, Shmuel; Sagy, Roi; Kimhi-Nesher, Shiri; Kalter, Ehud; Friedman, Tal; Friedman, Zvi; Bormant, Gil; Trommer, Sharon; Valevski, Avi; Weizman, Abraham

2017-12-01

While accumulating evidence suggests that vitamin D deficiency may be involved in the risk to develop schizophrenia and its outcome, there are no studies on vitamin D supplementation in this context. We sought to assess the effect of vitamin D supplementation on psychiatric, cognitive and metabolic parameters in chronic clozapine-treated schizophrenia patients. This eight-week, randomized, double-blind, placebo-controlled clinical trial, recruited schizophrenia patients who had been maintained on clozapine treatment for at least 18weeks and had low levels of vitamin D (70 (to ascertain the presence of residual symptoms). Patients were randomly allocated to either weekly oral drops of vitamin D (14,000IU) or placebo and subsequently assessed at two-week intervals for psychosis severity, mood, cognition and metabolic profile. Twenty four patients were randomly assigned to vitamin D (aged 39.4±9.6years, 75% males) and the other 23 patients to the placebo arm (aged 42.5±11.2years, 60.9% males). After eight weeks, the vitamin D group exhibited a significant increase in vitamin D levels (31.4 vs -0.4nmol/l, pvitamin D on psychotic, depressive or metabolic parameters. However, in the vitamin D group, there was a trend towards improved cognition (effect size=0.17, significance lost following Bonferroni correction). Vitamin D supplementation was associated with a trend towards improved cognition, but did not affect psychosis, mood or metabolic status. It is possible that the robust decrease in the PANSS scores in both groups may have obscured an effect of vitamin D supplementation. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Neuropsychological correlates of remission in chronic schizophrenia subjects: The role of general and task-specific executive processes

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Thais Rabanea-Souza

2016-03-01

Conclusion: The present findings suggest that executive function deficits are present in chronic schizophrenic patients. In addition, specific executive processes might be associated to symptom remission. Future studies examining prospectively first-episode, drug naive patients diagnosed with schizophrenia may be especially elucidative.

Cigarette smoking in male patients with chronic schizophrenia in a Chinese population: prevalence and relationship to clinical phenotypes.

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Xiang Yang Zhang

Full Text Available The high prevalence of smoking in schizophrenia of European background may be related to smoking's reducing clinical symptoms and medication side effects. Because smoking prevalence and its associations with clinical phenotypes are less well characterized in Chinese than European patients with schizophrenia, we assessed these smoking behaviors using clinician-administered questionnaires and the Fagerstrom Test for Nicotine Dependence (FTND in 776 Chinese male schizophrenia and 560 control subjects. Patients also were rated on the Positive and Negative Symptom Scale (PANSS, the Simpson and Angus Extrapyramidal Symptom Rating Scale (SAES, and the Abnormal Involuntary Movement Scale (AIMS. We found that the schizophrenia patients had a higher lifetime incidence of smoking (79% vs 63%, were more likely to be heavy smokers (61% vs 31%, and had lower smoking cessation rates (4% vs 9% (all p0.05 than the non-smoking patients. These results suggest that Chinese males with schizophrenia smoke more frequently than the general population. Further, smokers with schizophrenia may display fewer negative symptoms and possibly less parkinsonism than non-smokers with schizophrenia.

Characteristics of the tree-drawing test in chronic schizophrenia.

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Kaneda, Ayako; Yasui-Furukori, Norio; Saito, Manabu; Sugawara, Norio; Nakagami, Taku; Furukori, Hanako; Kaneko, Sunao

2010-04-01

A tree-drawing test acts as both a projective psychological examination as well as a supplementary psychodiagnostic tool. There is little information relating the characteristics of schizophrenia and the tree-drawing test. The present study compared the structural and morphological differences in the results of the tree-drawing test between schizophrenic patients and healthy individuals, as well as between schizophrenic patients who responded well to treatment and those who responded poorly. The subjects included 202 chronic schizophrenic patients and 113 healthy individuals. The schizophrenic patients were categorized as 'good responders' or 'poor responders' based on their response to medical treatments. The tree-drawing test was performed on all subjects. The tree drawn by each subject was analyzed structurally and morphologically. There were significant differences between the trunk and branches drawn by schizophrenic patients and those drawn by healthy controls. There were no significant differences between the good responders and the poor responders in any aspect of the tree drawings. Multiple regression models showed that the ratio of the tree area to the total area of the drawing paper, the width of the trunk, the trunk base opening, and the size of the branch ends were significantly associated with schizophrenia. The present study suggests that the trees drawn by schizophrenic patients are significantly different from those drawn by healthy individuals, but among schizophrenic patients, it is difficult to distinguish between good responders and poor responders using the tree-drawing test.

Ventral medial prefrontal functional connectivity and emotion regulation in chronic schizophrenia: A pilot study

Institute of Scientific and Technical Information of China (English)

Feng-Mei Fan; Shu-Ping Tan; Fu-De Yang; Yun-Long Tan; Yan-Li Zhao; Nan Chen; Bin-Bin Li

2013-01-01

People with schizophrenia exhibit impaired social cognitive functions,particularly emotion regulation.Abnormal activations of the ventral medial prefrontal cortex (vMPFC) during emotional tasks have been demonstrated in schizophrenia,suggesting its important role in emotion processing in patients.We used the resting-state functional connectivity approach,setting a functionally relevant region,the vMPFC,as a seed region to examine the intrinsic functional interactions and communication between the vMPFC and other brain regions in schizophrenic patients.We found hypo-connectivity between the vMPFC and the medial frontal cortex,right middle temporal lobe (MTL),right hippocampus,parahippocampal cortex (PHC) and amygdala.Further,there was a decreased strength of the negative connectivity (or anticorrelation) between the vMPFC and the bilateral dorsal lateral prefrontal cortex (DLPFC) and pre-supplementary motor areas.Among these connectivity alterations,reduced vMPFCDLPFC connectivity was positively correlated with positive symptoms on the Positive and Negative Syndrome Scale,while vMPFC-right MTL/PHC/amygdala functional connectivity was positively correlated with the performance of emotional regulation in patients.These findings imply that communication and coordination throughout the brain networks are disrupted in schizophrenia.The emotional correlates of vMPFC connectivity suggest a role of the hypo-connectivity between these regions in the neuropathology of abnormal social cognition in chronic schizophrenia.

Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care.

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Oud, Marian J T; Meyboom-de Jong, Betty

2009-05-09

Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice. The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected. The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided. Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients.

Schizophrenia.

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Kahn, René S; Sommer, Iris E; Murray, Robin M; Meyer-Lindenberg, Andreas; Weinberger, Daniel R; Cannon, Tyrone D; O'Donovan, Michael; Correll, Christoph U; Kane, John M; van Os, Jim; Insel, Thomas R

2015-11-12

Schizophrenia is a chronic psychiatric disorder with a heterogeneous genetic and neurobiological background that influences early brain development, and is expressed as a combination of psychotic symptoms - such as hallucinations, delusions and disorganization - and motivational and cognitive dysfunctions. The mean lifetime prevalence of the disorder is just below 1%, but large regional differences in prevalence rates are evident owing to disparities in urbanicity and patterns of immigration. Although gross brain pathology is not a characteristic of schizophrenia, the disorder involves subtle pathological changes in specific neural cell populations and in cell-cell communication. Schizophrenia, as a cognitive and behavioural disorder, is ultimately about how the brain processes information. Indeed, neuroimaging studies have shown that information processing is functionally abnormal in patients with first-episode and chronic schizophrenia. Although pharmacological treatments for schizophrenia can relieve psychotic symptoms, such drugs generally do not lead to substantial improvements in social, cognitive and occupational functioning. Psychosocial interventions such as cognitive-behavioural therapy, cognitive remediation and supported education and employment have added treatment value, but are inconsistently applied. Given that schizophrenia starts many years before a diagnosis is typically made, the identification of individuals at risk and those in the early phases of the disorder, and the exploration of preventive approaches are crucial.

Clinical determinants of life satisfaction in chronic schizophrenia: data from the CATIE study.

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Fervaha, Gagan; Agid, Ofer; Takeuchi, Hiroyoshi; Foussias, George; Remington, Gary

2013-12-01

Quality of life is seen as an important outcome variable for patients with schizophrenia. However, the precise definition of this construct varies and has often been used to define health-related domains. The present study sought to focus on global life satisfaction as a key subjective domain and determine its relationship with clinical variables. The study sample included 1437 patients with chronic schizophrenia who participated in the Clinical Antipsychotic Trial of Intervention Effectiveness (CATIE) study. Patients were evaluated with a comprehensive battery of assessments capturing symptoms, cognition and medication side effects, among other variables. Life satisfaction was evaluated with a global self-report item. Greater depressive symptoms were the most robust indicator of worse life satisfaction. Lower life satisfaction was also associated with poorer psychosocial functioning, greater symptoms of anxiety, apathy and more negative attitudes toward medication. Taken together, these variables explained 20% of the variance in life satisfaction scores. Positive symptoms and other medication side effects also negatively influenced life satisfaction scores. These results affirm that clinical variables have an adverse effect on the overall subjective well-being of patients with schizophrenia. The relatively small amount of variance explained, though, argues for a better understanding of those other variables that contribute to life satisfaction. © 2013 Elsevier B.V. All rights reserved.

Quality of care and clinical outcomes of chronic obstructive pulmonary disease in patients with schizophrenia. A Danish nationwide study

DEFF Research Database (Denmark)

Jørgensen, Mette; Mainz, Jan; Lange, Peter

2018-01-01

antagonists (LAMA) or long-acting β2-agonists (LABA) (Relative risk (RR) 0.92, 95% CI: 0.87–0.98). Female sex was associated with a higher chance of receiving LAMA/LABA treatment among COPD patients with schizophrenia. COPD patients with schizophrenia had a higher risk of 30-day mortality (adjusted odds ratio...... (OR) 1.27, 95% CI: 1.01–1.59) but not a higher risk of readmission compared with COPD patients without schizophrenia.ConclusionsCOPD patients with schizophrenia had a slightly lower chance of receiving LAMA/LABA treatment, but a substantially increased risk of death following admission...

Inflammation and elevation of interleukin-12p40 in patients with schizophrenia

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Nora eBedrossian

2016-03-01

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

Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care

Directory of Open Access Journals (Sweden)

Meyboom-de Jong Betty

2009-05-01

Full Text Available Abstract Background Schizophrenia patients frequently develop somatic co-morbidity. Core tasks for GPs are the prevention and diagnosis of somatic diseases and the provision of care for patients with chronic diseases. Schizophrenia patients experience difficulties in recognizing and coping with their physical problems; however GPs have neither specific management policies nor guidelines for the diagnosis and treatment of somatic co-morbidity in schizophrenia patients. This paper systematically reviews the prevalence and treatment of somatic co-morbidity in schizophrenia patients in general practice. Methods The MEDLINE, EMBASE, PsycINFO data-bases and the Cochrane Library were searched and original research articles on somatic diseases of schizophrenia patients and their treatment in the primary care setting were selected. Results The results of this search show that the incidence of a wide range of diseases, such as diabetes mellitus, the metabolic syndrome, coronary heart diseases, and COPD is significantly higher in schizophrenia patients than in the normal population. The health of schizophrenic patients is less than optimal in several areas, partly due to their inadequate help-seeking behaviour. Current GP management of such patients appears not to take this fact into account. However, when schizophrenic patients seek the GP's help, they value the care provided. Conclusion Schizophrenia patients are at risk of undetected somatic co-morbidity. They present physical complaints at a late, more serious stage. GPs should take this into account by adopting proactive behaviour. The development of a set of guidelines with a clear description of the GP's responsibilities would facilitate the desired changes in the management of somatic diseases in these patients.

Is schizophrenia associated with an increased risk of chronic kidney disease? A nationwide matched-cohort study.

Science.gov (United States)

Tzeng, Nian-Sheng; Hsu, Yung-Ho; Ho, Shinn-Ying; Kuo, Yu-Ching; Lee, Hua-Chin; Yin, Yun-Ju; Chen, Hong-An; Chen, Wen-Liang; Chu, William Cheng-Chung; Huang, Hui-Ling

2015-01-27

The impact of schizophrenia on vital diseases, such as chronic kidney disease (CKD), has not as yet been verified. This study aims to establish whether there is an association between schizophrenia and CKD. A nationwide matched cohort study. Taiwan's National Health Insurance Research Database. A total of 2338 patients with schizophrenia, and 7014 controls without schizophrenia (1:3), matched cohort for sex, age group, geography, urbanisation and monthly income, between 1 January 2003 and 31 December 2007, based on the International Classifications of Disease Ninth Edition (ICD-9), Clinical Modification codes. After making adjustments for confounding risk factors, a Cox proportional hazards model was used to compare the risk of developing CKD during a 3-year follow-up period from the index date. Of the 2338-subject case cohort, 163 (6.97%) developed a CKD, as did 365 (5.20%) of the 7014 control participants. Cox proportional hazards regression analysis revealed that patients with schizophrenia were more likely to develop CKD (HR=1.36, 95% CI 1.13 to 1.63; pschizophrenia was 1.25 (95% CI 1.04 to 1.50; prisk of CKD in patients with schizophrenia. The findings from this population-based retrospective cohort study suggest that schizophrenia is associated with a 25% increase in the risk of developing CKD within only a 3-year follow-up period. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Toxoplasma gondii and schizophrenia: a review of published RCTs.

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Chorlton, Sam D

2017-07-01

Over the last 60 years, accumulating evidence has suggested that acute, chronic, and maternal Toxoplasma gondii infections predispose to schizophrenia. More recent evidence suggests that chronically infected patients with schizophrenia present with more severe disease. After acute infection, parasites form walled cysts in the brain, leading to lifelong chronic infection and drug resistance to commonly used antiparasitics. Chronic infection is the most studied and closely linked with development and severity of schizophrenia. There are currently four published randomized controlled trials evaluating antiparasitic drugs, specifically azithromycin, trimethoprim, artemisinin, and artemether, in patients with schizophrenia. No trials have demonstrated a change in psychopathology with adjunctive treatment. Published trials have either selected drugs without evidence against chronic infection or used them at doses too low to reduce brain cyst burden. Furthermore, trials have failed to achieve sufficient power or account for confounders such as previous antipsychotic treatment, sex, age, or rhesus status on antiparasitic effect. There are currently no ongoing trials of anti-Toxoplasma therapy in schizophrenia despite ample evidence to justify further testing.

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

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

2002-12-01

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

Reduced Structural Connectivity in Frontostriatal White Matter Tracts in the Associative Loop in Schizophrenia.

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Levitt, James J; Nestor, Paul G; Levin, Laura; Pelavin, Paula; Lin, Pan; Kubicki, Marek; McCarley, Robert W; Shenton, Martha E; Rathi, Yogesh

2017-11-01

The striatum receives segregated and integrative white matter tracts from the cortex facilitating information processing in the cortico-basal ganglia network. The authors examined both types of input tracts in the striatal associative loop in chronic schizophrenia patients and healthy control subjects. Structural and diffusion MRI scans were acquired on a 3-T system from 26 chronic schizophrenia patients and 26 matched healthy control subjects. Using FreeSurfer, the associative cortex was parcellated into ventrolateral prefrontal cortex and dorsolateral prefrontal cortex subregions. The striatum was manually parcellated into its associative and sensorimotor functional subregions. Fractional anisotropy and normalized streamlines, an estimate of fiber counts, were assessed in four frontostriatal tracts (dorsolateral prefrontal cortex-associative striatum, dorsolateral prefrontal cortex-sensorimotor striatum, ventrolateral prefrontal cortex-associative striatum, and ventrolateral prefrontal cortex-sensorimotor striatum). Furthermore, these measures were correlated with a measure of cognitive control, the Trail-Making Test, Part B. Results showed reduced fractional anisotropy and fewer streamlines in chronic schizophrenia patients for all four tracts, both segregated and integrative. Post hoc t tests showed reduced fractional anisotropy in the left ventrolateral prefrontal cortex-associative striatum and left ventrolateral prefrontal cortex-sensorimotor striatum and fewer normalized streamlines in the right dorsolateral prefrontal cortex-sensorimotor striatum and in the left and right ventrolateral prefrontal cortex-sensorimotor striatum in chronic schizophrenia patients. Furthermore, normalized streamlines in the right dorsolateral prefrontal cortex-sensorimotor striatum negatively correlated with Trail-Making Test, Part B, time spent in healthy control subjects but not in chronic schizophrenia patients. These findings demonstrated that structural connectivity is

Chronic LSD alters gene expression profiles in the mPFC relevant to schizophrenia.

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Martin, David A; Marona-Lewicka, Danuta; Nichols, David E; Nichols, Charles D

2014-08-01

Chronic administration of lysergic acid diethylamide (LSD) every other day to rats results in a variety of abnormal behaviors. These build over the 90 day course of treatment and can persist at full strength for at least several months after cessation of treatment. The behaviors are consistent with those observed in animal models of schizophrenia and include hyperactivity, reduced sucrose-preference, and decreased social interaction. In order to elucidate molecular changes that underlie these aberrant behaviors, we chronically treated rats with LSD and performed RNA-sequencing on the medial prefrontal cortex (mPFC), an area highly associated with both the actions of LSD and the pathophysiology of schizophrenia and other psychiatric illnesses. We observed widespread changes in the neurogenetic state of treated animals four weeks after cessation of LSD treatment. QPCR was used to validate a subset of gene expression changes observed with RNA-Seq, and confirmed a significant correlation between the two methods. Functional clustering analysis indicates differentially expressed genes are enriched in pathways involving neurotransmission (Drd2, Gabrb1), synaptic plasticity (Nr2a, Krox20), energy metabolism (Atp5d, Ndufa1) and neuropeptide signaling (Npy, Bdnf), among others. Many processes identified as altered by chronic LSD are also implicated in the pathogenesis of schizophrenia, and genes affected by LSD are enriched with putative schizophrenia genes. Our results provide a relatively comprehensive analysis of mPFC transcriptional regulation in response to chronic LSD, and indicate that the long-term effects of LSD may bear relevance to psychiatric illnesses, including schizophrenia. Copyright © 2014 Elsevier Ltd. All rights reserved.

First episode schizophrenia | Khamker | South African Family Practice

African Journals Online (AJOL)

Schizophrenia is a chronic psychiatric condition. Patients with schizophrenia present clinically with psychotic, negative and cognitive symptoms, which can become evident late in adolescence or in early adulthood. The peak age for presentation is 20 years in males and 25 years in females. This chronic condition follows a ...

Modelling approaches - The case of schizophrenia : the case of schizophrenia

NARCIS (Netherlands)

Heeg, Bart M.S.; Damen, Joep; Buskens, Erik; Caleo, Sue; de Charro, F.; van Hout, B.A.

2008-01-01

Schizophrenia is a chronic disease characterized by periods of relative stability interrupted by acute episodes (or relapses). The course of the disease may vary considerably between patients. Patient histories show considerable inter- and even intra-individual variability. We provide a critical

Analysis on breast X-ray of chronic schizophrenia and Iiterature review

International Nuclear Information System (INIS)

Dang Lianrong; Wang Xuqiang; Xie Junwei; Pei Genxiang

2008-01-01

Objective: To research the symptom of breast X-ray of chronic schizophrenia and the influence of its clinical features. Methods: Take 50 patients who have been under treatment in our hospital for over 5 years as sample of psychotic group and same number of healthy people as control group. Analyze their X-ray films, using statistics to deal with their lung area of both before and after 5 years. Evaluation Criteria of X-ray: (1) Double layer rise; (2)Single or double lung base subsegmental atelectasis; (3)Heart drown; (4)Heart turing with the heart apex extending to the left; (5)The double lung bottom have gathering stripes; (6)The upper layer have wider shadow. Results: The lung lobes of the patient group become smaller than they were 5 years ago. Data show great difference between two years (t=6.7099, P<0.01). The lung lobes of psychotic group become bigger than the control group in the first X-ray films (t=2.025, P<0.05), but smaller in the last X-ray films (t=5.512, P<0.01). Among them, 37 cases show double layer rise; 19 cases show single or double lung base subsegmental atelectasis; 24 cases show heart drown; 19 cases show heart turing and heart apex extending to the left; 37 cases show double lung bottom gathering stripes; 17 cases show wider shadow. Conclusion: Morphology and pathology changes of schizophrenia patients are related to the side effect of anti-schizophrenia medicine and endocrine disorders. (authors)

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

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

2016-08-01

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

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

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Holubova M

2016-06-01

Full Text Available Michaela Holubova,1,2 Jan Prasko,1 Radovan Hruby,3 Klara Latalova,1 Dana Kamaradova,1 Marketa Marackova,1 Milos Slepecky,4 Terezia Gubova2 1Department of Psychiatry, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic; 2Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic; 3Private Psychiatric Practice, Martin, Slovak Republic; 4Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University, Nitra, Slovak Republic Background: Maladaptive coping strategies may adversely disturb the overall functioning of people with mental disorders. Also, self-stigma is considered a maladaptive psychosocial phenomenon that can affect many areas of patient life. It has a negative impact on self-image, and may lead to dysphoria, social isolation, reduced adherence, using of negative coping strategies, and lower quality of life. The objective of this study was to determine the relationship between coping strategies and self-stigma among persons with schizophrenia and related psychotic disorders.Subjects and methods: A total of 104 clinically stable outpatients with chronic schizophrenia-spectrum disorders were enrolled in a cross-sectional study. Sociodemographic and clinical data were recorded. Patients were examined by psychiatrists with the Stress Coping Style Questionnaire, the Internalized Stigma of Mental Illness scale, and the Clinical Global Impression scale. Correlation and multiple-regression analyses were performed to discover contributing factors to self-stigma.Results: Positive coping strategies were used by patients with schizophrenia-spectrum disorders to the same extent as in the healthy population. Negative coping strategies were overused by these patients. There were significant associations between self-stigma, severity of the disorder, and coping strategies in schizophrenia. The ability to use positive coping

Negative attitude towards medication is associated with working memory impairment in schizophrenia patients.

Science.gov (United States)

Goodman, Craig; Knoll, Gabriella; Isakov, Victoria; Silver, Henry

2005-03-01

A lack of insight into illness and negative attitudes towards medication are common among individuals with schizophrenia and impact clinical outcomes. This study aimed to examine the relationships between attitudes towards medication and cognitive function in schizophrenia patients. Thirty-five male forensic inpatients who were suffering from chronic schizophrenia participated in the study. A drug attitude inventory was used to evaluate the attitudes of the patients towards medication. Neuropsychological function was assessed with a comprehensive battery of tests. Patients with positive attitudes towards medication performed significantly better than those with negative attitudes on tests of verbal working memory (digit span forwards and backwards), inhibition and set shifting (Penn Inhibition test), delayed object memory and overall mental status (Mini Mental State Examination). There were no differences in age, education, hospitalizations or clinical symptoms between the groups. Our findings support an association between negative attitudes towards medication and poor cognitive performance, particularly of working memory.

Influence of contact with schizophrenia on implicit attitudes towards schizophrenia patients held by clinical residents

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Omori Ataru

2012-11-01

Full Text Available Abstract Background Patients with schizophrenia and their families have suffered greatly from stigmatizing effects. Although many efforts have been made to eradicate both prejudice and stigma, they still prevail even among medical professionals, and little is known about how contact with schizophrenia patients affects their attitudes towards schizophrenia. Methods We assessed the impact of the renaming of the Japanese term for schizophrenia on clinical residents and also evaluated the influence of contact with schizophrenia patients on attitudes toward schizophrenia by comparing the attitudes toward schizophrenia before and after a one-month clinical training period in psychiatry. Fifty-one clinical residents participated. Their attitudes toward schizophrenia were assessed twice, before and one month after clinical training in psychiatry using the Implicit Association Test (IAT as well as Link’s devaluation-discrimination scale. Results The old term for schizophrenia, “Seishin-Bunretsu-Byo”, was more congruent with criminal than the new term for schizophrenia, “Togo-Shitcho-Sho”, before clinical training. However, quite opposite to our expectation, after clinical training the new term had become even more congruent with criminal than the old term. There was no significant correlation between Link's scale and IAT effect. Conclusions Renaming the Japanese term for schizophrenia still reduced the negative images of schizophrenia among clinical residents. However, contact with schizophrenia patients unexpectedly changed clinical residents’ attitudes towards schizophrenia negatively. Our results might contribute to an understanding of the formation of negative attitudes about schizophrenia and assist in developing appropriate clinical training in psychiatry that could reduce prejudice and stigma concerning schizophrenia.

Activity monitoring using a mHealth device and correlations with psychopathology in patients with chronic schizophrenia.

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Shin, Seunghwan; Yeom, Chan-Woo; Shin, Cheolmin; Shin, Jae-Hyun; Jeong, Jae Hoon; Shin, Jung Uk; Lee, Young Ryeol

2016-12-30

There are few studies of mobile-Health (mHealth) device application with schizophrenic patients. We aimed to quantitatively assess patient's activity and the relationship between their physical activity and the severity of their psychopathologies. Then we attempted to identify the patients who required intervention and evaluated the feasibility of using the mHealth device. A total of 61 of the 76 available hospitalized patients with chronic schizophrenia who participated in the activity programs were enrolled. They wore a mHealth device for a week to assess their activity (steps/day). The Positive and Negative Syndrome Scale (PANSS) was completed by the subjects. As a result, the positive subscale of the PANSS and the positive and negative factors of the PANSS 5-factor structure showed a predictive value for low levels of physical activity. The group of subjects with a high total PANSS score had a significantly lower level of physical activity than the other groups. In conclusion, physical activity showed a significant association with positive symptoms as well as negative symptoms. The mHealth device showed relatively good feasibility for schizophrenic patients. We should pay more attention to the activity of patients with high PANSS scores. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Medications Used for Cognitive Enhancement in Patients With Schizophrenia, Bipolar Disorder, Alzheimer's Disease, and Parkinson's Disease.

Science.gov (United States)

Hsu, Wen-Yu; Lane, Hsien-Yuan; Lin, Chieh-Hsin

2018-01-01

Cognitive impairment, which frequently occurs in patients with schizophrenia, bipolar disorder, Alzheimer's disease, and Parkinson's disease, has a significant impact on the daily lives of both patients and their family. Furthermore, since the medications used for cognitive enhancement have limited efficacy, the issue of cognitive enhancement still remains a clinically unsolved challenge. We reviewed the clinical studies (published between 2007 and 2017) that focused on the efficacy of medications used for enhancing cognition in patients with schizophrenia, bipolar disorder, Alzheimer's disease, and Parkinson's disease. Acetylcholinesterase inhibitors and memantine are the standard treatments for Alzheimer's disease and Parkinson's disease. Some studies have reported selective cognitive improvement in patients with schizophrenia following galantamine treatment. Newer antipsychotics, including paliperidone, lurasidone, aripiprazole, ziprasidone, and BL-1020, have also been reported to exert cognitive benefits in patients with schizophrenia. Dopaminergic medications were found to improve language function in patients with Parkinson's disease. However, no beneficial effects on cognitive function were observed with dopamine agonists in patients with schizophrenia. The efficacies of nicotine and its receptor modulators in cognitive improvement remain controversial, with the majority of studies showing that varenicline significantly improved the cognitive function in schizophrenic patients. Several studies have reported that N -methyl-d-aspartate glutamate receptor (NMDAR) enhancers improved the cognitive function in patients with chronic schizophrenia. NMDAR enhancers might also have cognitive benefits in patients with Alzheimer's disease or Parkinson's disease. Raloxifene, a selective estrogen receptor modulator, has also been demonstrated to have beneficial effects on attention, processing speed, and memory in female patients with schizophrenia. Clinical trials with

Psychosis among "healthy" siblings of schizophrenia patients

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Arajärvi, Ritva; Ukkola, Jonna; Haukka, Jari; Suvisaari, Jaana; Hintikka, Jukka; Partonen, Timo; Lönnqvist, Jouko

2006-01-01

Abstract Background Schizophrenia aggregates in families and accurate diagnoses are essential for genetic studies of schizophrenia. In this study, we investigated whether siblings of patients with schizophrenia can be identified as free of any psychotic disorder using only register information. We also analyzed the emergence of psychotic disorders among siblings of patients with schizophrenia during seven to eleven years of follow-up. Methods A genetically homogenous population isolate in no...

Registered criminality and sanctioning of schizophrenia patients

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Munkner, Runa; Haastrup, Soeren; Joergensen, Torben

2009-01-01

BACKGROUND: Patients with schizophrenia have been shown to have an increased risk of criminality, especially violent crimes. AIMS: The aim of the current study was to describe the pattern of crimes committed by Danish patients with schizophrenia and examine the sanctions given for crimes in relat...... than imprison, individuals with schizophrenia. CONCLUSION: The findings suggest that greater alertness is needed in the judicial system for individuals diagnosed with schizophrenia....

Magnetic resonance imaging study of corpus callosum abnormalities in patients with different subtypes of schizophrenia

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Ebru Unlu

2014-11-01

Full Text Available Background. Reductions in the size of the corpus callosum (CC have been described for schizophrenia patients, but little is known about the possible regional differences in schizophrenia subtypes (paranoid, disorganised, undifferentiated, residual.  Methods. We recruited 58 chronically schizophrenic patients with different subtypes, and 31 age-and-gender matched healthy controls. The callosum was extracted from a midsagittal slice from T1 weighted magnetic resonance images, and areas of the total CC, its five subregions, CC length and total brain volume were compared between schizophrenia subtypes and controls. Five subregions were approximately matched to fibre pathways from cortical regions.  Results. Schizophrenia patients had reduced CC total area and length when compared with controls. Disorganised and undifferentiated schizophrenics had a smaller prefrontal area, while there was no significant difference for the paranoid and residual groups. The premotor/supplementary motor area was smaller in all schizophrenia subtypes. The motor area was smaller only in the disorganised group. A smaller sensory area was found in all subtypes except the residual group. Parietal, temporal and occipital areas were smaller in the paranoid and undifferentiated groups. Total brain volume was smaller in all schizophrenia subtypes compared with controls, but did not reach statistical significance.  Conclusion. These findings suggest that the heterogeneity of symptoms may lead to the different CC morphological characteristics in schizophrenia subtypes.

Registered criminality and sanctioning of schizophrenia patients

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Munkner, Runa; Haastrup, Soeren; Joergensen, Torben

2009-01-01

BACKGROUND: Patients with schizophrenia have been shown to have an increased risk of criminality, especially violent crimes. AIMS: The aim of the current study was to describe the pattern of crimes committed by Danish patients with schizophrenia and examine the sanctions given for crimes...... in relation to the different periods in the patients' lives: not yet known to the psychiatric hospital system, known to the system but not yet diagnosed with schizophrenia, and after being diagnosed with schizophrenia. METHODS: Information from the Danish Psychiatric Central Research Register was correlated...... with data from the Danish National Crime Register. RESULTS: One of the more prominent findings was that 16% of patients diagnosed with schizophrenia receive a prison sentence or a suspended prison sentence, despite the fact that Denmark is a co-signatory of the European Prison Rules and should treat, rather...

Accelerated aging in schizophrenia patients: the potential role of oxidative stress.

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Okusaga, Olaoluwa O

2014-08-01

Several lines of evidence suggest that schizophrenia, a severe mental illness characterized by delusions, hallucinations and thought disorder is associated with accelerated aging. The free radical (oxidative stress) theory of aging assumes that aging occurs as a result of damage to cell constituents and connective tissues by free radicals arising from oxygen-associated reactions. Schizophrenia has been associated with oxidative stress and chronic inflammation, both of which also appear to reciprocally induce each other in a positive feedback manner. The buildup of damaged macromolecules due to increased oxidative stress and failure of protein repair and maintenance systems is an indicator of aging both at the cellular and organismal level. When compared with age-matched healthy controls, schizophrenia patients have higher levels of markers of oxidative cellular damage such as protein carbonyls, products of lipid peroxidation and DNA hydroxylation. Potential confounders such as antipsychotic medication, smoking, socio-economic status and unhealthy lifestyle make it impossible to solely attribute the earlier onset of aging-related changes or oxidative stress to having a diagnosis of schizophrenia. Regardless of whether oxidative stress can be attributed solely to a diagnosis of schizophrenia or whether it is due to other factors associated with schizophrenia, the available evidence is in support of increased oxidative stress-induced cellular damage of macromolecules which may play a role in the phenomenon of accelerated aging presumed to be associated with schizophrenia.

Cerebral perfusion changes in schizophrenia patients evaluated with Tc-99 HMPAO

International Nuclear Information System (INIS)

Sehweil, A.; El-Hilu, S.; Jahan, S.; Higazi, E.; Salhat, M.; Al-Mohannadi, S.; Abdel-Dayem, H.M.

1989-01-01

Tc-99m HMPAO has been used to image cerebral perfusion changes in 20 chronic schizophrenia patients (19 men and 1 woman), with an average age of 29 years (range, 22-48 years). All were receiving neuroleptic drugs. Twelve had received electroconvulsive therapy. All patients had abnormal studies (except one, which was normal) and poor response to treatment. Ventricular dilation and cerebral atrophy were seen in 11 patients. Seventy-seven focal lesions were detected. Forty-two lesions showed increased HMPAO retention: 26 in the basal ganglia in 14 patients (12, bilateral, two unilateral), 10 along the sylvian fissure in the parietotemporal region, three in the frontal region, and one in each of the temporal, parietal, and occipital regions. Thirty-five focal lesions showed decreased perfusion: 10 parietal, eight frontal, seven temporal, six cerebellar, and four occipital. This study demonstrates the potential value of Tc-99m HMPAO in the study of schizophrenia and other psychiatric disorders

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

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Schaub Michael

2010-09-01

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

Correlation between plasma homovanillic acid levels and the response to atypical antipsychotics in male patients with schizophrenia.

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Kaneda, Yasuhiro; Kawamura, Ichiro; Ohmori, Tetsuro

2005-01-01

The authors investigated the effects of atypical antipsychotic drugs-olanzapine, perospirone, and quetiapine-on plasma homovanillic acid (pHVA) in male patients with chronic schizophrenia. In this prospective, open-label study, the subjects were 30 inpatients who were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, criteria for schizophrenia. The authors switched patients from typical antipsychotic drugs to olanzapine, perospirone, or quetiapine. Each patient gave informed consent for the research. pHVA was assessed before and after switching medications. After the switch, the authors found a significant improvement in psychotic symptoms, nonsignificant improvement in extrapyramidal symptoms, and a nonsignificant reduction in pHVA. In addition, the baseline pHVA correlated positively with the score changes from baseline in the Brief Psychiatric Rating Scale (BPRS) total, positive, and negative symptoms in the group with a whole sample and in the olanzapine-treated group, and with the score changes in the BPRS total and positive symptoms in the quetiapine-treated group. Our findings indicated that the preswitching pHVA levels could be used to predict changes in the psychotic symptoms of male patients with chronic schizophrenia when switching to atypical antipsychotic drugs.

Increased plasma agmatine levels in patients with schizophrenia.

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Uzbay, Tayfun; Goktalay, Gokhan; Kayir, Hakan; Eker, Salih S; Sarandol, Asli; Oral, Sema; Buyukuysal, Levent; Ulusoy, Gokhan; Kirli, Selcuk

2013-08-01

Agmatine is an endogenous substance, synthesized from l-arginine, and it is proposed to be a new neurotransmitter. Preclinical studies indicated that agmatine may have an important role in the pathophysiology of schizophrenia. This study was organized to investigate plasma agmatine in patients with schizophrenia and in healthy controls. Eighteen patients with schizophrenia and 19 healthy individuals constituted the subjects. Agmatine levels in the plasma were measured using the HPLC method. The S100B protein level, which is a peripheral biomarker for brain damage, was also measured using the ELISA method. While plasma levels of agmatine in patients with schizophrenia were significantly increased (p agmatine levels as a clinical diagnostic test would significantly differentiate between patients with schizophrenia and those in the control group (predictive value: 0.969; p  0.05). A multiple regression analysis revealed that the age of the patient and the severity of the illness, as indicated by the PANSS score, significantly contributed the plasma agmatine levels in patients with schizophrenia. These results support the hypothesis that an excess agmatine release is important in the development of schizophrenia. The findings also imply that the plasma agmatine level may be a potential biomarker of schizophrenia. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comorbidities and risk factors among patients with schizophrenia.

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Harrison, Christopher; Charles, Janice; Britt, Helena

2015-01-01

General practitioners (GPs) are charged with maintaining a holistic approach to their patients' health. While most patients with schizophrenia attend public mental health services and/or non-government organisations supporting people with mental illness, 88.2% of people with a psychotic illness (the majority being schizophrenia or schizoaffective disorder) had visited a GP in the previous year. For at least 30-40% of people living with schizophrenia in Australia, ongoing management is provided by their GP alone. Moreover, there is evidence that patients with schizophrenia value the help provided by GPs. Patients with schizophrenia have reduced life expectancy. Overseas research (primarily from the UK and US) has found that the poor physical health of patients with schizophrenia can be attributed to a number of factors such as modifiable lifestyle risk factors and side effects of medication, compounded by causes intrinsic to the illness such as mental stress and loss of initiative.

GABA concentration in schizophrenia patients and the effects of antipsychotic medication: a proton magnetic resonance spectroscopy study.

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Tayoshi, Shin'Ya; Nakataki, Masahito; Sumitani, Satsuki; Taniguchi, Kyoko; Shibuya-Tayoshi, Sumiko; Numata, Shusuke; Iga, Jun-ichi; Ueno, Shu-ichi; Harada, Masafumi; Ohmori, Tetsuro

2010-03-01

Gamma-amino butyric acid (GABA) is thought to play a role in the pathophysiology of schizophrenia. High magnetic field proton magnetic resonance spectroscopy ((1)H-MRS) provides a reliable measurement of GABA in specific regions of the brain. This study measured GABA concentration in the anterior cingulate cortex (ACC) and in the left basal ganglia (ltBG) in 38 patients with chronic schizophrenia and 29 healthy control subjects. There was no significant difference in GABA concentration between the schizophrenia patients and the healthy controls in either the ACC (1.36+/-0.45 mmol/l in schizophrenia patients and 1.52+/-0.54 mmol/l in control subjects) or the ltBG (1.13+/-0.26 mmol/l in schizophrenia patients and 1.18+/-0.20 mmol/l in control subjects). Among the right handed schizophrenia patients, the GABA concentration in the ltBG was significantly higher in patients taking typical antipsychotics (1.25+/-0.24 mmol/l) than in those taking atypical antipsychotics (1.03+/-0.24 mmol/l, p=0.026). In the ACC, the GABA concentration was negatively correlated with the dose of the antipsychotics (rs=-0.347, p=0.035). In the ltBG, the GABA concentration was positively correlated with the dose of the anticholinergics (rs=0.403, p=0.015). To the best of our knowledge, this is the first study to have directly measured GABA concentrations in schizophrenia patients using (1)H-MRS. Our results suggest that there are no differences in GABA concentrations in the ACC or the ltBG of schizophrenia patients compared to healthy controls. Antipsychotic medication may cause changes in GABA concentration, and atypical and typical antipsychotics may have differing effects. It is possible that medication effects conceal inherent differences in GABA concentrations between schizophrenia patients and healthy controls. (c) 2009 Elsevier B.V. All rights reserved.

Conflict adaptation in patients diagnosed with schizophrenia.

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Abrahamse, Elger; Ruitenberg, Marit; Boddewyn, Sarah; Oreel, Edith; de Schryver, Maarten; Morrens, Manuel; van Dijck, Jean-Philippe

2017-11-01

Cognitive control impairments may contribute strongly to the overall cognitive deficits observed in patients diagnosed with schizophrenia. In the current study we explore a specific cognitive control function referred to as conflict adaptation. Previous studies on conflict adaptation in schizophrenia showed equivocal results, and, moreover, were plagued by confounded research designs. Here we assessed for the first time conflict adaptation in schizophrenia with a design that avoided the major confounds of feature integration and stimulus-response contingency learning. Sixteen patients diagnosed with schizophrenia and sixteen healthy, matched controls performed a vocal Stroop task to determine the congruency sequence effect - a marker of conflict adaptation. A reliable congruency sequence effect was observed for both healthy controls and patients diagnosed with schizophrenia. These findings indicate that schizophrenia is not necessarily accompanied by impaired conflict adaptation. As schizophrenia has been related to abnormal functioning in core conflict adaptation areas such as anterior cingulate and dorsolateral prefrontal cortex, further research is required to better understand the precise impact of such abnormal brain functioning at the behavioral level. Copyright © 2017 Elsevier B.V. All rights reserved.

Gender differences measured by the MATRICS consensus cognitive battery in chronic schizophrenia patients

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Zhang, Baohua; Han, Mei; Tan, Shuping; De Yang, Fu; Tan, Yunlong; Jiang, Shurong; Zhang, Xiangyang; Huang, Xu-Feng

2017-01-01

Using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), previous study showed significant gender differences for cognitive deficits in immediate and delayed memory in schizophrenia patients. However, RBANS does not include reasoning and problem solving, and social cognition. These cognitive functions can significantly affect the outcomes and daily life in patients. This study examined the gender differences of cognition using the measurement and treatment research to...

Chronicity and a low anteroposterior gradient of cerebral blood flow in schizophrenia

International Nuclear Information System (INIS)

Mathew, R.J.; Wilson, W.H.

1990-01-01

Regional cerebral blood flow (CBF) was measured with the 133xenon inhalation technique in 27 patients with schizophrenia of less than 5 years' duration and in 27 patients with schizophrenia of more than 12 years' duration, under resting conditions. Similar measurements were also performed in 54 normal control subjects matched for age and sex. Patients with schizophrenia of long duration had lower anteroposterior gradients of CBF than patients with schizophrenia of short duration and matched control subjects. Covarying out age and end-tidal levels of CO2 did not alter the results

Schizophrenia patients and 22q11.2 deletion syndrome adolescents at risk express the same deviant patterns of resting state EEG microstates: A candidate endophenotype of schizophrenia

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Miralena I. Tomescu

2015-09-01

Full Text Available Schizophrenia is a complex psychiatric disorder and many of the factors contributing to its pathogenesis are poorly understood. In addition, identifying reliable neurophysiological markers would improve diagnosis and early identification of this disease. The 22q11.2 deletion syndrome (22q11DS is one major risk factor for schizophrenia. Here, we show further evidence that deviant temporal dynamics of EEG microstates are a potential neurophysiological marker by showing that the resting state patterns of 22q11DS are similar to those found in schizophrenia patients. The EEG microstates are recurrent topographic distributions of the ongoing scalp potential fields with temporal stability of around 80 ms that are mapping the fast reconfiguration of resting state networks. Five minutes of high-density EEG recordings was analysed from 27 adult chronic schizophrenia patients, 27 adult controls, 30 adolescents with 22q11DS, and 28 adolescent controls. In both patient groups we found increased class C, but decreased class D presence and high transition probabilities towards the class C microstates. Moreover, these aberrant temporal dynamics in the two patient groups were also expressed by perturbations of the long-range dependency of the EEG microstates. These findings point to a deficient function of the salience and attention resting state networks in schizophrenia and 22q11DS as class C and class D microstates were previously associated with these networks, respectively. These findings elucidate similarities between individuals at risk and schizophrenia patients and support the notion that abnormal temporal patterns of EEG microstates might constitute a marker for developing schizophrenia.

Effects of Relaxation Exercises and Music Therapy on the Psychological Symptoms and Depression Levels of Patients with Schizophrenia.

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Kavak, Funda; Ünal, Süheyla; Yılmaz, Emine

2016-10-01

This study aims to identify the effects of relaxation exercises and music therapy on the psychological symptoms and depression levels of patients with chronic schizophrenia. This semi-experimental study was conducted using pre- and post-tests with a control group. The study population consists of patients with schizophrenia who regularly attended community mental health centers in the Malatya and Elazığ provinces of Turkey between May 2015 and September 2015. The study's sample consists of 70 patients with schizophrenia (n=35 in the control group; n=35 in the experimental group) who were selected randomly based on power analysis. The "Patient Information Form," the "Brief Psychiatric Rating Scale (BPRS)" and the "Calgary Depression Scale for Schizophrenia (CDSS)" were used for data collection. Patients in the experimental group participated in relaxation exercises and music therapy 5 times a week for 4 weeks. The experimental group of 35 persons was divided into three groups of approximately 10-12 individuals in order to enable all participants to attend the program. No intervention was applied to the patients in the control group. The data were evaluated using percentage distribution, arithmetic means, standard deviations, Chi-square and independent samples t-tests. The study found that patients in the experimental group showed a decrease in total mean scores on the BPRS and CDSS; the difference between the post-test scores of the experimental group and the post-test scores of the control group was statistically significant (ptherapy was proven to be effective in reducing schizophrenic patients' psychological symptoms and levels of depression. Relaxation exercises and music therapy can be used as a complementary therapy in the medical treatment of patients with chronic schizophrenia. Copyright © 2016 Elsevier Inc. All rights reserved.

Model of Management (Mo.Ma) for the patient with schizophrenia: crisis control, maintenance, relapse prevention, and recovery with long-acting injectable antipsychotics (LAIs).

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Brugnoli, Roberto; Rapinesi, Chiara; Kotzalidis, Georgios D; Marcellusi, Andrea; Mennini, Francesco S; De Filippis, Sergio; Carrus, Dario; Ballerini, Andrea; Francomano, Antonio; Ducci, Giuseppe; Del Casale, Antonio; Girardi, Paolo

2016-01-01

Schizophrenia is a severe mental disease that affects approximately 1% of the population with a relevant chronic impact on social and occupational functioning and daily activities. People with schizophrenia are 2-2.5 times more likely to die early than the general population. Non-adherence to antipsychotic medications, both in chronic and first episode schizophrenia, is one of the most important risk factors for relapse and hospitalization, that consequently contributes to increased costs due to psychiatric hospitalization. Atypical long-acting injectable (LAI) antipsychotics can improve treatment adherence and decrease re-hospitalization rates in patients with schizophrenia since its onset. The primary goals in the management of schizophrenia are directed not only at symptom reduction in the short and long term, but also at maintaining physical and mental functioning, improving quality of life, and promoting patient recovery. To propose a scientific evidence-based integrated model that provides an algorithm for recovery of patients with schizophrenia and to investigate the effectiveness and safety of antipsychotics LAI in the treatment, maintenance, relapse prevention, and recovery of schizophrenia. After an accurate literature review we identified, collected and analyzed the crucial points in taking care schizophrenia patients, through which we defined the steps described in the model of management and the choice of the better treatment option. Results. In the management model we propose, the choice of a second generation long acting antipsychotic, could allow from the earliest stages of illness better patient management, especially for young individuals with schizophrenia onset, a better recovery and significant reductions of relapse and health care costs. LAI formulations of antipsychotics are valuable, because they help patients to remain adherent to their medication through regular contact with healthcare professionals and to prevent covert non-adherence. The

Subjective burden on spouses of schizophrenia patients

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Surekha Kumari

2009-01-01

Full Text Available Background : There is limited information from India on subjective burden on spouses of schizophrenia patients. The aim of the present study was to assess and compare patterns of subjective burden on spouses of schizophrenia patients. Materials and Methods: The present study was conducted at the OPD level, and follow-up was done at the Ranchi Institute of Neuropsychiatry and Sciences (RINPAS during the period May 2008 to November 2008. Tools utilized were sociodemographic data sheet, Family Burden Interview Schedule developed by Pai and R. L. Kapur (1981. The sample comprised of 50 samples of spouses (25 male and 25 female spouses of schizophrenia patients. Results: The findings suggest that both the groups, viz., male and female spouses of schizophrenia patients, showed moderate level of subjective burden, i.e., 13 (52% and 15 (60% male and female spouses, respectively, which was statistically found to be insignificant. Conclusion : No significant difference was found between male and female spouses of schizophrenia patients with regard to the level of subjective burden.

Effectiveness of high-intensity interval training on the mental and physical health of people with chronic schizophrenia.

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Wu, Meng Hsiu; Lee, Chin Pang; Hsu, Shih Chieh; Chang, Chia Ming; Chen, Ching Yen

2015-01-01

Low-volume high-intensity interval training (HIIT) is emerging as a time-efficient exercise strategy for improving cardiorespiratory fitness and for controlling blood sugar levels and hypertension. In addition, patient acceptance of HIIT may improve adherence to exercise programs. This study evaluated the effectiveness of HIIT for improving the mental and physical health of people with chronic schizophrenia. Twenty patients attending a psychiatric day care unit volunteered for an 8-week program of HIIT. Blood pressure, resting heart rate, body weight, body mass index, waist and hip circumference, and waist-to-hip ratio were measured weekly. The Positive and Negative Syndrome Scale score was recorded at baseline and at the end of the study. Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scores were recorded every 2 weeks. Statistically significant changes occurred in the physical and mental parameters measured in the 18 patients who completed the study. Body weight, body mass index, resting heart rate, and pulse pressure decreased significantly. Mean arterial pressure and diastolic blood pressure increased significantly. Mental health scores improved, with the Negative Scale score decreasing from 31.17±5.95 to 27.78±3.57 (PHIIT has positive effects on the physical and mental health of patients with chronic schizophrenia.

Long acting risperidone in Australian patients with chronic schizophrenia: 24-month data from the e-STAR database

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Lambert Tim

2012-03-01

Full Text Available Abstract Background This observational study was designed to collect treatment outcomes data in patients using the electronic Schizophrenia Treatment Adherence Registry (e-STAR. Methods Patients with schizophrenia or schizoaffective disorder in Australia who were prescribed risperidone long-acting injection (RLAI between 2003 and 2007 were assessed 12-months retrospectively, at baseline and 24-months prospectively at 3-monthly intervals. The intent-to-treat population, defined as all patients who received at least one dose of RLAI at baseline, was used for the efficacy and safety analyses. Results At total of 784 patients (74% with schizophrenia, 69.8% male with a mean age of 37.1 ± 12.5 years and 10.6 ± 9.5 years since diagnosis were included in this Australian cohort. A significant improvement in mean Clinical Global Impression - severity score was observed at 24-months (4.52 ± 1.04 at baseline, 3.56 ± 1.10 at 24-months. Most of this improvement was seen by 3-months and was also reflected in mean Global Assessment of Functioning score, which improved significantly at 24-months (42.9 ± 14.5 at baseline, 59 ± 15.4 at 24-months. For patients still receiving RLAI at 24-months there was an increase from a mean baseline RLAI dose of 26.4 ± 5 mg to 43.4 ± 15.7 mg. Sixty-six percent of patients discontinued RLAI before the 24-month period--this decreased to 46% once patients lost to follow-up were excluded. Conclusion Over the 24-month period, initiation of RLAI was associated with improved patient functioning and illness severity in patients with schizophrenia or schizoaffective disorder. Improved outcomes were observed early and sustained throughout the study. Trial Registration Clinical Trials Registration Number, NCT00283517.

Evidence for regional hippocampal damage in patients with schizophrenia

International Nuclear Information System (INIS)

Singh, Sadhana; Khushu, Subash; Kumar, Pawan; Goyal, Satnam; Bhatia, Triptish; Deshpande, Smita N.

2018-01-01

Schizophrenia patients show cognitive and mood impairments, including memory loss and depression, suggesting damage in the brain regions. The hippocampus is a brain structure that is significantly involved in memory and mood function and shows impairment in schizophrenia. In the present study, we examined the regional hippocampal changes in schizophrenia patients using voxel-based morphometry (VBM), Freesurfer, and proton magnetic resonance spectroscopy ( 1 H MRS) procedures. 1 H MRS and high-resolution T1-weighted magnetic resonance imaging were collected in both healthy control subjects (N = 28) and schizophrenia patients (N = 28) using 3-Tesla whole body MRI system. Regional hippocampal volume was analyzed using VBM and Freesufer procedures. The relative ratios of the neurometabolites were calculated using linear combination model (LCModel). Compared to controls, schizophrenia patients showed significantly decreased gray matter volume in the hippocampus. Schizophrenia patients also showed significantly reduced glutamate (Glu) and myo-inositol (mI) ratios in the hippocampus. Additionally, significant positive correlation between gray matter volume and Glu/tCr was also observed in the hippocampus in schizophrenia. Our findings provide an evidence for a possible association between structural deficits and metabolic alterations in schizophrenia patients. (orig.)

Evidence for regional hippocampal damage in patients with schizophrenia

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Singh, Sadhana; Khushu, Subash; Kumar, Pawan [DRDO, NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS), Delhi (India); Goyal, Satnam; Bhatia, Triptish; Deshpande, Smita N. [RML Hospital, Post Graduate Institute of Medical Education and Research (PGIMER), New Delhi (India)

2018-02-15

Schizophrenia patients show cognitive and mood impairments, including memory loss and depression, suggesting damage in the brain regions. The hippocampus is a brain structure that is significantly involved in memory and mood function and shows impairment in schizophrenia. In the present study, we examined the regional hippocampal changes in schizophrenia patients using voxel-based morphometry (VBM), Freesurfer, and proton magnetic resonance spectroscopy ({sup 1}H MRS) procedures. {sup 1}H MRS and high-resolution T1-weighted magnetic resonance imaging were collected in both healthy control subjects (N = 28) and schizophrenia patients (N = 28) using 3-Tesla whole body MRI system. Regional hippocampal volume was analyzed using VBM and Freesufer procedures. The relative ratios of the neurometabolites were calculated using linear combination model (LCModel). Compared to controls, schizophrenia patients showed significantly decreased gray matter volume in the hippocampus. Schizophrenia patients also showed significantly reduced glutamate (Glu) and myo-inositol (mI) ratios in the hippocampus. Additionally, significant positive correlation between gray matter volume and Glu/tCr was also observed in the hippocampus in schizophrenia. Our findings provide an evidence for a possible association between structural deficits and metabolic alterations in schizophrenia patients. (orig.)

7T Proton Magnetic Resonance Spectroscopy of Gamma-Aminobutyric Acid, Glutamate, and Glutamine Reveals Altered Concentrations in Patients With Schizophrenia and Healthy Siblings

DEFF Research Database (Denmark)

Thakkar, Katharine N; Rösler, Lara; Wijnen, Jannie P

2017-01-01

BACKGROUND: The N-methyl-D-aspartate receptor hypofunction model of schizophrenia predicts dysfunction in both glutamatergic and gamma-aminobutyric acidergic (GABAergic) transmission. We addressed this hypothesis by measuring GABA, glutamate, glutamine, and the sum of glutamine plus glutamate...... concentrations in vivo in patients with schizophrenia using proton magnetic resonance spectroscopy at 7T, which allows separation of metabolites that would otherwise overlap at lower field strengths. In addition, we investigated whether altered levels of GABA, glutamate, glutamine, and the sum of glutamine plus...... glutamate reflect genetic vulnerability to schizophrenia by including healthy first-degree relatives. METHODS: Proton magnetic resonance spectroscopy at 7T was performed in 21 patients with chronic schizophrenia who were taking medication, 23 healthy first-degree relatives of patients with schizophrenia...

Medications Used for Cognitive Enhancement in Patients With Schizophrenia, Bipolar Disorder, Alzheimer’s Disease, and Parkinson’s Disease

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Wen-Yu Hsu

2018-04-01

Full Text Available Background/aimsCognitive impairment, which frequently occurs in patients with schizophrenia, bipolar disorder, Alzheimer’s disease, and Parkinson’s disease, has a significant impact on the daily lives of both patients and their family. Furthermore, since the medications used for cognitive enhancement have limited efficacy, the issue of cognitive enhancement still remains a clinically unsolved challenge.Sampling and methodsWe reviewed the clinical studies (published between 2007 and 2017 that focused on the efficacy of medications used for enhancing cognition in patients with schizophrenia, bipolar disorder, Alzheimer’s disease, and Parkinson’s disease.ResultsAcetylcholinesterase inhibitors and memantine are the standard treatments for Alzheimer’s disease and Parkinson’s disease. Some studies have reported selective cognitive improvement in patients with schizophrenia following galantamine treatment. Newer antipsychotics, including paliperidone, lurasidone, aripiprazole, ziprasidone, and BL-1020, have also been reported to exert cognitive benefits in patients with schizophrenia. Dopaminergic medications were found to improve language function in patients with Parkinson’s disease. However, no beneficial effects on cognitive function were observed with dopamine agonists in patients with schizophrenia. The efficacies of nicotine and its receptor modulators in cognitive improvement remain controversial, with the majority of studies showing that varenicline significantly improved the cognitive function in schizophrenic patients. Several studies have reported that N-methyl-d-aspartate glutamate receptor (NMDAR enhancers improved the cognitive function in patients with chronic schizophrenia. NMDAR enhancers might also have cognitive benefits in patients with Alzheimer’s disease or Parkinson’s disease. Raloxifene, a selective estrogen receptor modulator, has also been demonstrated to have beneficial effects on attention, processing

Predictive utility of blood pressure, waist circumference and body mass index for metabolic syndrome in patients with schizophrenia in Singapore.

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Nurjono, Milawaty; Lee, Jimmy

2013-05-01

This study aims to examine and compare the predictive utility of blood pressure (BP), waist circumference (WC) and body mass index (BMI), and to determine optimal cut-off values in prediction of metabolic syndrome (MetS) in patients with chronic schizophrenia. About 100 patients with chronic schizophrenia were recruited. BMI and BP were measured and laboratory tests to evaluate patients' high-density lipoprotein cholesterol, triglycerides and glucose levels were performed. Presence of MetS was examined according to AHA/NHLBI guidelines. Predictive utility of BP, WC and BMI was examined using receiver operating curve and discriminant indices were determined accordingly. Forty-six (46%) patients were identified to have MetS. BMI of ≥23 kg m(-2) was most accurate (AUC = 0.83, P < 0.001), with sensitivity of 93.5%, specificity of 48.1%, positive predictive value of 60.6% and negative predictive value of 92.9% in identifying MetS. This finding has immediate and significant clinical implications in the local population with schizophrenia. © 2012 Wiley Publishing Asia Pty Ltd.

Serum levels of brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) in depressed patients with schizophrenia.

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Wysokiński, Adam

2016-01-01

Brain-derived neurotrophic factor (BDNF) and neurotrophin-3 (NT-3) are neurotrophins-proteins that induce the survival, development, and function of neurons. Their role in the development of schizophrenia and mood disorders is widely studied. This study was aimed to determine whether depression affects levels of BDNF and NT-3 in patients with schizophrenia. Data for 53 Caucasian adult hospitalized patients with chronic paranoid schizophrenia was compared with 27 healthy subjects. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and positive, negative and general sub-scores, the Calgary Depression Scale for Schizophrenia (CDSS), the Hamilton Depression Rating Scale (HDRS), and the Clinical Global Impressions scale (CGI). Patients were defined as depressed (SHZ-DEP) with scores CDSS > 6 and HDRS > 7, otherwise they were included into the non-depressed group (SHZ-nonDEP). In total, 17 patients (32.1%) with schizophrenia met criteria for depression. SHZ-DEP patients had higher scores in HDRS, CDSS, PANSS total, PANSS negative, PANSS general and CGI (p BDNF or NT-3 levels between patients with schizophrenia and controls. BDNF levels were lower in SHZ-DEP compared to SHZ-nonDEP: 18.82 ± 5.95 versus 22.10 ± 5.31 ng/mL, p = 0.045. NT-3 levels were higher in SHZ-DEP compared to SHZ-nonDEP: 133.31 ± 222.19 versus 56.04 ± 201.28 pg/mL, p = 0.033. There were no differences in neurotrophin levels between patients with schizophrenia and controls. We found lower BDNF and higher NT-3 serum levels in depressed patients with schizophrenia.

Visual binding abilities in the initial and advanced stages of schizophrenia

DEFF Research Database (Denmark)

Parnas, Josef; Vianin, P; Saebye, D

2001-01-01

OBJECTIVE: The study tests the hypothesis that intramodal visual binding is disturbed in schizophrenia and should be detectable in all illness stages as a stable trait marker. METHOD: Three groups of patients (rehospitalized chronic schizophrenic, first admitted schizophrenic and schizotypal...... to schizophrenic patients and to healthy subjects. Furthermore, chronic schizophrenia was associated with a poor performance on cortical tests of SWM, global local and on Raven. This association appears to be mediated by or linked to the chronicity of the illness. CONCLUSION: The study confirms a variety...... of neurocognitive deficits in schizophrenia which, however, in this sample seem to be linked to chronicity of illness. However, certain aspects of visual processing concerned with Gestalt extraction deserve attention as potential vulnerability- or prodrome- indicators. The initial hypothesis of the study...

Psychosis among "healthy" siblings of schizophrenia patients

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Partonen Timo

2006-01-01

Full Text Available Abstract Background Schizophrenia aggregates in families and accurate diagnoses are essential for genetic studies of schizophrenia. In this study, we investigated whether siblings of patients with schizophrenia can be identified as free of any psychotic disorder using only register information. We also analyzed the emergence of psychotic disorders among siblings of patients with schizophrenia during seven to eleven years of follow-up. Methods A genetically homogenous population isolate in north-eastern Finland having 365 families with 446 patients with a diagnosis of schizophrenia was initially identified in 1991 using four nationwide registers. Between 1998 and 2002, 124 patients and 183 siblings in 110 families were contacted and interviewed using SCID-I, SCID-II and SANS. We also compared the frequency of mental disorders between siblings and a random population comparison group sample. Results Thirty (16% siblings received a diagnosis of psychotic disorder in the interview. 14 siblings had had psychotic symptoms already before 1991, while 16 developed psychotic symptoms during the follow-up. Over half of the siblings (n = 99, 54% had a lifetime diagnosis of any mental disorder in the interview. Conclusion Register information cannot be used to exclude psychotic disorders among siblings of patients with schizophrenia. The high rate of emergence of new psychotic disorders among initially healthy siblings should be taken into account in genetic analysis.

Rehabilitation of Schizophrenia: At the End or in the Beginning?

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Farbod Fadai

2007-09-01

Full Text Available The Majority of the long stay psychiatric patients who are in need of rehabilitation suffer from schizophrenia. Most of them enter the old age with this illness, and besides the consequences of schizophrenia, they are facing the deprivation and misery due to the old age. In contrast to the previous decades in which there was no effective treatment for schizophrenia, today with the immediate diagnosis of schizophrenia and its treatment with effective medications, we can prevent chronicity and resistance to the treatment. By these means, we can improve the prognosis and the quality of life of patients and their care givers. Sine last decade, the unfair discrimination of schizophrenic patients to chronic and non-chronic has lost its validity. It is widely recommended that instead of constructing the special and isolated hospitals for the mentally ill, psychiatric wards in the general hospitals be established. By all these efforts, the schizophrenics can have a better treatment and rehabilitation, and can be saved from the social and psychological consequences of staying in the isolated mental hospitals.

Increased suicidal risk among smoking schizophrenia patients.

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Iancu, Iulian; Sapir, Anna Piccone; Shaked, Ginette; Poreh, Amir; Dannon, Pinhas Nadim; Chelben, Joseph; Kotler, Moshe

2006-01-01

Schizophrenia patients display a high suicidal risk, although this risk is difficult to predict. One of the variables associated with increased suicide risk is smoking. In the present study, we assessed the suicidal risk in schizophrenia patients, smokers and nonsmokers. We also evaluated the impact of various variables such as psychotic symptoms, impulsivity, and extra-pyramidal side effects on suicidal risk. Sixty-one schizophrenia patients responded to a battery of measures, including the suicidal risk scale (SRS), the positive and negative syndrome scale (PANSS), the impulsivity control scale, and the Simpson Angus Scale for extrapyramidal side effects. The effect of smoking on the various measures, especially suicidal risk, was examined. Schizophrenia patients who smoke obtained higher PANSS scores (both total score and positive and negative subscales), but did not differ on the Simpson Angus scale of extrapyramidal side effects. They also exhibited higher suicide risk as reflected by higher scores on the SRS, and a trend for higher impulsivity as measured by the impulsivity control scale. Women that smoked had higher SRS scores as compared with female nonsmokers, and also higher than in males, smokers and nonsmokers. Smoking and a history of suicide attempt predicted in our regression analysis a higher SRS score. When conducting separate analyses for the male and female patients, the significant contributors were the PANSS total score among the males and the number of pack-years among the female patients. Despite hints toward the role of smoking in suicidal behavior in Schizophrenia, especially among female patients, more studies are needed to elucidate the association between smoking and suicidality in schizophrenia patients.

Treatment patterns for schizoaffective disorder and schizophrenia among Medicaid patients.

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Olfson, Mark; Marcus, Steven C; Wan, George J

2009-02-01

This study compared background characteristics, pharmacologic treatment, and service use of adults treated for schizoaffective disorder and adults treated for schizophrenia. Medicaid claims data from two states were analyzed with a focus on adults treated for schizoaffective disorder or schizophrenia. Patient groups were compared regarding demographic characteristics, pharmacologic treatment, and health service use during 180 days before and after a claim for either schizophrenia or schizoaffective disorder. A larger proportion of patients were treated for schizophrenia (N=38,760; 70.1%) than for schizoaffective disorder (N=16,570; 29.9%). During the 180 days before the index diagnosis claim, significantly more patients with schizoaffective disorder than those with schizophrenia were treated for depressive disorder (19.6% versus 11.4%, pschizoaffective disorder, 87.3%; schizophrenia, 87.0%), although patients with schizoaffective disorder were significantly more likely than patients with schizophrenia to receive antidepressants (61.7% versus 44.0%, pschizoaffective disorder were also significantly more likely than patients with schizophrenia to receive psychotherapy (23.4% versus 13.0%, pSchizoaffective disorder is commonly diagnosed among Medicaid beneficiaries. These patients often receive complex pharmacologic regimens, and many also receive treatment for mood disorders. Differences in service use patterns between schizoaffective disorder and schizophrenia argue for separate consideration of their health care needs.

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

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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.

Criterion and construct validity of the CogState Schizophrenia Battery in Japanese patients with schizophrenia.

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Taisuke Yoshida

Full Text Available BACKGROUND: The CogState Schizophrenia Battery (CSB, a computerized cognitive battery, covers all the same cognitive domains as the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS Consensus Cognitive Battery but is briefer to conduct. The aim of the present study was to evaluate the criterion and construct validity of the Japanese language version of the CSB (CSB-J in Japanese patients with schizophrenia. METHODOLOGY/PRINCIPAL FINDINGS: Forty Japanese patients with schizophrenia and 40 Japanese healthy controls with matching age, gender, and premorbid intelligence quotient were enrolled. The CSB-J and the Brief Assessment of Cognition in Schizophrenia, Japanese-language version (BACS-J were performed once. The structure of the CSB-J was also evaluated by a factor analysis. Similar to the BACS-J, the CSB-J was sensitive to cognitive impairment in Japanese patients with schizophrenia. Furthermore, there was a significant positive correlation between the CSB-J composite score and the BACS-J composite score. A factor analysis showed a three-factor model consisting of memory, speed, and social cognition factors. CONCLUSIONS/SIGNIFICANCE: This study suggests that the CSB-J is a useful and rapid automatically administered computerized battery for assessing broad cognitive domains in Japanese patients with schizophrenia.

Systematic Suicide Risk Assessment for Patients With Schizophrenia

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Pedersen, Charlotte Gjørup; Wallenstein Jensen, Signe Olrik; Gradus, Jaimie

2013-01-01

Objectives: Systematic suicide risk assessment is recommended for patients with schizophrenia; however, little is known about the implementation of suicide risk assessment in routine clinical practice. The study aimed to determine the use of systematic suicide risk assessment at discharge...... and predictors of suicide attempt among hospitalized patients with schizophrenia in Denmark. Methods: A one-year follow-up study was conducted of 9,745 patients with schizophrenia who were discharged from psychiatric wards and registered in a national population-based schizophrenia registry between 2005 and 2009....... Results: The proportion of patients receiving suicide risk assessment at discharge from a psychiatric ward increased from 72% (95% confidence interval [CI]=71%-74%) in 2005, when the national monitoring began, to 89% (CI.89%-90%) in 2009. Within one year after discharge, 1% of all registered patients had...

Pleasure Experience and Emotion Expression in Patients with Schizophrenia

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CHU, Min-yi; LI, Xu; LV, Qin-yu; Yl, Zheng-hui; CHEUNG, Eric F. C.; CHAN, Raymond C. K.

2017-01-01

Background Impairments in emotional experience and expression have been observed in patients with schizophrenia. However, most previous studies have been limited to either emotional experience (especially anhedonia) or expression. Few studies have examined both the experience and expression of emotion in schizophrenia patients at the same time. Aims The present study aimed to examine pleasure experience and emotion expression in patients with schizophrenia. In particular, we specifically examined the relationship between emotion impairments (both pleasure experience and expression) and negative symptoms. Methods One hundred and fifty patients completed the Temporal Experience of Pleasure Scale and Emotional Expressivity Scale. Results Schizophrenia patients exhibited deficits in experiencing pleasure, but showed intact reported emotion expression. Patients with prominent negative symptoms showed reduced anticipatory pleasure, especially in abstract anticipatory pleasure. Conclusion The present findings suggest that patients with schizophrenia have deficits in pleasure experience, while their abilities to express emotion appear intact. Such deficits are more severe in patients with prominent negative symptoms. PMID:29276350

Cerebral asymmetry in patients with schizophrenia: a voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) study.

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Takao, Hidemasa; Abe, Osamu; Yamasue, Hidenori; Aoki, Shigeki; Kasai, Kiyoto; Ohtomo, Kuni

2010-01-01

To evaluate the differences in gray- and white-matter asymmetry between schizophrenia patients and normal subjects. Forty-eight right-handed patients with chronic schizophrenia (24 males and 24 females) and 48 right-handed age- and sex-matched healthy controls (24 males and 24 females) were included in this study. The effects of diagnosis on gray-matter volume asymmetry and white-matter fractional anisotropy (FA) asymmetry were evaluated with use of voxel-based morphometry (VBM) and voxel-based analysis of FA maps derived from diffusion tensor imaging (DTI), respectively. The mean gray- and white-matter volumes were significantly smaller in the schizophrenia group than in the control group. The voxel-based morphometry (VBM) showed no significant effect of diagnosis on gray-matter volume asymmetry. The voxel-based analysis of DTI also showed no significant effect of diagnosis on white-matter FA asymmetry. Our results of voxel-based analyses showed no significant differences in either gray-matter volume asymmetry or white-matter FA asymmetry between schizophrenia patients and normal subjects. (c) 2009 Wiley-Liss, Inc.

Disturbed neural circuits in a subtype of chronic catatonic schizophrenia demonstrated by F-18-FDG-PET and F-18-DOPA-PET

International Nuclear Information System (INIS)

Lauer, M.; Beckmann, H.; Stoeber, G.; Schirrmeister, H.; Gerhard, A.; Ellitok, E.; Reske, S.N.

2001-01-01

Permanent verbal, visual scenic and coenaestetic hallucinations are the most prominent psychopathological symptoms aside from psychomotor disorders in speech-sluggish catatonia, a subtype of chronic catatonic schizophrenia according to Karl Leonhard. These continuous hallucinations serve as an excellent paradigm for the investigation of the assumed functional disturbances of cortical circuits in schizophrenia. Data from positron emission tomography (F-18-FDG-PET and F-18-DOPA-PET) from three patients with this rare phenotype were available (two cases of simple speech-sluggish catatonia, one case of a combined speech-prompt/speech-sluggish subtype) and were compared with a control collective. During their permanent hallucinations, all catatonic patients showed a clear bitemporal hypometabolism in the F-18-FDG-PET. Both patients with the simple speech-sluggish catatonia showed an additional bilateral thalamic hypermetabolism and an additional bilateral hypometabolism of the frontal cortex, especially on the left side. In contrast, the patient with the combined speech-prompt/speech-sluggish catatonia showed a bilateral thalamic hypo-metabolism combined with a bifrontal cortical hypermetabolism. However, the left/right ratio of the frontal cortex also showed a lateralization effect with a clear relative hypometabolism of the left frontal cortex. The F-18-DOPA-PET of both schizophrenic patients with simple speech-sluggish catatonia showed a normal F-18-DOPA storage in the striatum, whereas in the right putamen of the patient with the combined form a higher right/left ratio in F-DOPA storage was discernible, indicating an additional lateralized influence of the dopaminergic system in this subtype of chronic catatonic schizophrenia. (author)

Motor Synchronization in Patients With Schizophrenia: Preserved Time Representation With Abnormalities in Predictive Timing

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Hélène Wilquin

2018-05-01

Full Text Available Objective: Basic temporal dysfunctions have been described in patients with schizophrenia, which may impact their ability to connect and synchronize with the outer world. The present study was conducted with the aim to distinguish between interval timing and synchronization difficulties and more generally the spatial-temporal organization disturbances for voluntary actions. A new sensorimotor synchronization task was developed to test these abilities.Method: Twenty-four chronic schizophrenia patients matched with 27 controls performed a spatial-tapping task in which finger taps were to be produced in synchrony with a regular metronome to six visual targets presented around a virtual circle on a tactile screen. Isochronous (time intervals of 500 ms and non-isochronous auditory sequences (alternated time intervals of 300/600 ms were presented. The capacity to produce time intervals accurately versus the ability to synchronize own actions (tap with external events (tone were measured.Results: Patients with schizophrenia were able to produce the tapping patterns of both isochronous and non-isochronous auditory sequences as accurately as controls producing inter-response intervals close to the expected interval of 500 and 900 ms, respectively. However, the synchronization performances revealed significantly more positive asynchrony means (but similar variances in the patient group than in the control group for both types of auditory sequences.Conclusion: The patterns of results suggest that patients with schizophrenia are able to perceive and produce both simple and complex sequences of time intervals but are impaired in the ability to synchronize their actions with external events. These findings suggest a specific deficit in predictive timing, which may be at the core of early symptoms previously described in schizophrenia.

Calorimetric monitoring of the serum proteome in schizophrenia patients

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Krumova, Sashka [Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 21, Sofia 1113 (Bulgaria); Rukova, Blaga [Department of Medical Genetics, Medical University of Sofia, 2 Zdrave Str., Sofia 1431 (Bulgaria); Todinova, Svetla [Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 21, Sofia 1113 (Bulgaria); Gartcheva, Lidia [National Specialized Hospital for Active Treating of Haematological Diseases, 6 Plovdivsko pole Str., Sofia 1756 (Bulgaria); Milanova, Vihra [Department of Psychiatry, Medical University of Sofia, 1 Sv. Georgi Sofiiski Str., Sofia 1431 (Bulgaria); Toncheva, Draga [Department of Medical Genetics, Medical University of Sofia, 2 Zdrave Str., Sofia 1431 (Bulgaria); Taneva, Stefka G., E-mail: stefka.germanova@ehu.es [Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 21, Sofia 1113 (Bulgaria)

2013-11-20

Highlights: • DSC reveals modified thermal behavior of blood serum from schizophrenic patients. • The high-abundance portion of the serum proteome is thermally stabilized in Sz. • The Sz plasma thermograms are classified in four distinct calorimetric groups. • The effectiveness of drug treatment correlates with the plasma thermodynamic behavior. - Abstract: Schizophrenia (Sz) is a multifactorial mental disorder with high frequency. Due to its chronic and relapsing nature there is a strong need for biomarkers for early psychosis detection and objective evaluation of drug (usually antipsychotics) treatment effect. Here differential scanning calorimetry (DSC) is applied to thermodynamically characterize the blood serum proteome of paranoid schizophrenia patients on routine antipsychotic treatment in comparison to healthy controls. DSC revealed significant modifications in the thermodynamic behavior of blood sera from Sz patients, the overall thermal profile being changed in all Sz cases under study. The calorimetric profiles were classified in four distinct groups, reflecting different thermal stabilization of the high-abundance portion of the serum proteome. The observed positive (thermograms becoming closer to the healthy profile) or negative (thermograms deviating stronger from the healthy profile) proteome thermal stability switches and the Sz thermograms persistence in patients’ follow-up corresponded well with the effect of drug treatment.

Calorimetric monitoring of the serum proteome in schizophrenia patients

International Nuclear Information System (INIS)

Krumova, Sashka; Rukova, Blaga; Todinova, Svetla; Gartcheva, Lidia; Milanova, Vihra; Toncheva, Draga; Taneva, Stefka G.

2013-01-01

Highlights: • DSC reveals modified thermal behavior of blood serum from schizophrenic patients. • The high-abundance portion of the serum proteome is thermally stabilized in Sz. • The Sz plasma thermograms are classified in four distinct calorimetric groups. • The effectiveness of drug treatment correlates with the plasma thermodynamic behavior. - Abstract: Schizophrenia (Sz) is a multifactorial mental disorder with high frequency. Due to its chronic and relapsing nature there is a strong need for biomarkers for early psychosis detection and objective evaluation of drug (usually antipsychotics) treatment effect. Here differential scanning calorimetry (DSC) is applied to thermodynamically characterize the blood serum proteome of paranoid schizophrenia patients on routine antipsychotic treatment in comparison to healthy controls. DSC revealed significant modifications in the thermodynamic behavior of blood sera from Sz patients, the overall thermal profile being changed in all Sz cases under study. The calorimetric profiles were classified in four distinct groups, reflecting different thermal stabilization of the high-abundance portion of the serum proteome. The observed positive (thermograms becoming closer to the healthy profile) or negative (thermograms deviating stronger from the healthy profile) proteome thermal stability switches and the Sz thermograms persistence in patients’ follow-up corresponded well with the effect of drug treatment

Temporal information processing in short- and long-term memory of patients with schizophrenia.

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Landgraf, Steffen; Steingen, Joerg; Eppert, Yvonne; Niedermeyer, Ulrich; van der Meer, Elke; Krueger, Frank

2011-01-01

Cognitive deficits of patients with schizophrenia have been largely recognized as core symptoms of the disorder. One neglected factor that contributes to these deficits is the comprehension of time. In the present study, we assessed temporal information processing and manipulation from short- and long-term memory in 34 patients with chronic schizophrenia and 34 matched healthy controls. On the short-term memory temporal-order reconstruction task, an incidental or intentional learning strategy was deployed. Patients showed worse overall performance than healthy controls. The intentional learning strategy led to dissociable performance improvement in both groups. Whereas healthy controls improved on a performance measure (serial organization), patients improved on an error measure (inappropriate semantic clustering) when using the intentional instead of the incidental learning strategy. On the long-term memory script-generation task, routine and non-routine events of everyday activities (e.g., buying groceries) had to be generated in either chronological or inverted temporal order. Patients were slower than controls at generating events in the chronological routine condition only. They also committed more sequencing and boundary errors in the inverted conditions. The number of irrelevant events was higher in patients in the chronological, non-routine condition. These results suggest that patients with schizophrenia imprecisely access temporal information from short- and long-term memory. In short-term memory, processing of temporal information led to a reduction in errors rather than, as was the case in healthy controls, to an improvement in temporal-order recall. When accessing temporal information from long-term memory, patients were slower and committed more sequencing, boundary, and intrusion errors. Together, these results suggest that time information can be accessed and processed only imprecisely by patients who provide evidence for impaired time comprehension

Subject-chosen activities in occupational therapy for the improvement of psychiatric symptoms of inpatients with chronic schizophrenia: a controlled trial.

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Hoshii, Junko; Yotsumoto, Kayano; Tatsumi, Eri; Tanaka, Chito; Mori, Takashi; Hashimoto, Takeshi

2013-07-01

To compare the therapeutic effects of subject-chosen and therapist-chosen activities in occupational therapy for inpatients with chronic schizophrenia. Prospective comparative study. A psychiatric hospital in Japan. Fifty-nine patients with chronic schizophrenia who had been hospitalized for many years. The subjects received six-months occupational therapy, participating in either activities of their choice (subject-chosen activity group, n = 30) or activities chosen by occupational therapists based on treatment recommendations and patient consent (therapist-chosen activity group, n = 29). The Positive and Negative Syndrome Scale and the Global Assessment of Functioning (GAF) Scale were used to evaluate psychiatric symptoms and psychosocial function, respectively. After six-months occupational therapy, suspiciousness and hostility scores of the positive scale and preoccupation scores of the general psychopathology scale significantly improved in the subject-chosen activity group compared with the therapist-chosen activity group, with 2(2) (median (interquartile range)) and 3(1.25), 2(1) and 2.5(1), and 2(1) and 3(1), respectively. There were no significant differences in psychosocial functions between the two groups. In within-group comparisons before and after occupational therapy, suspiciousness scores of the positive scale, preoccupation scores of the general psychopathology scale, and psychosocial function significantly improved only in the subject-chosen activity group, with 3(1) to 2(2), 3(1) to 2(1), and 40(9) to 40(16) respectively, but not in the therapist-chosen activity group. The results suggested that the subject-chosen activities in occupational therapy could improve the psychiatric symptoms, suspiciousness, and preoccupation of the inpatients with chronic schizophrenia.

Theory of mind reasoning in schizophrenia patients and non-psychotic relatives.

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Cassetta, Briana; Goghari, Vina

2014-08-15

Research consistently demonstrates that schizophrenia patients have theory of mind (ToM) impairments. Additionally, there is some evidence that family members of schizophrenia patients also demonstrate impairments in ToM, suggesting a genetic vulnerability for the disorder. This study assessed ToM abilities (i.e., sarcasm comprehension) in schizophrenia patients and their first-degree biological relatives during video-taped social interactions, to be representative of real-world interactions and to assess for disease-specific and/or genetic liability effects. Additionally, we assessed whether ToM abilities predicted social and global functioning in schizophrenia patients, and whether symptoms were associated with ToM deficits. Schizophrenia patients demonstrated impairments in sarcasm comprehension compared to controls and relatives, whereas relatives showed intact comprehension. Symptoms of schizophrenia significantly predicted worse ToM abilities. Furthermore, in schizophrenia patients, impaired ToM reasoning predicted worse social and global functioning. Given schizophrenia patients demonstrated impairments in ToM reasoning in a task that resembles real-life interactions, this might be a key area for remediation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

The MMPI-2 in chronic psychiatric illness.

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Bosch, Peggy; Van Luijtelaar, Gilles; Van Den Noort, Maurits; Schenkwald, Julia; Kueppenbender, Nicole; Lim, Sabina; Egger, Jos; Coenen, Anton

2014-10-01

While previous studies on the MMPI-2 in patients with schizophrenia and depression have used mixed samples of both early stage and chronic psychiatric patients. Here, it is investigated whether chronicity itself might have a differential effect on the MMPI-2 profiles of these patients and whether demoralization 'associated with long-term illness' affects the scales of the MMPI-2. Thirty long-term patients with schizophrenia, 30 long-term patients with depression, and 30 healthy participants completed the MMPI-2. Groups were compared on Clinical Scales and on the Restructured Clinical (RC) Scales. Patients with schizophrenia differed from patients with depression on 14 MMPI-2 scales and from healthy controls on 10 scales, generally showing mean UT-scores 65, indicating impaired functioning. Demoralization was higher in patients with depression than in patients with schizophrenia and both psychiatric groups differed from the healthy control group. It is concluded that long-term patients with depression show impaired functioning and high demoralization, while long-term patients with schizophrenia surprisingly show near normal functioning and less demoralization. © 2014 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

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

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Bentolhoda Mousavi

2015-08-01

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

Quantitative iodine-123 IMP imaging of brain perfusion in schizophrenia

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Cohen, M.B.; Lake, R.R.; Graham, L.S.

1989-01-01

Decreased perfusion in the frontal lobes of patients with chronic schizophrenia has been reported by multiple observes using a variety of techniques. Other observers have been unable to confirm this finding using similar techniques. In this study quantitative single photon emission computed tomography brain imaging was performed using p,5n [ 123 I]IMP in five normal subjects and ten chronically medicated patients with schizophrenia. The acquisition data were preprocessed with an image dependent Metz filter and reconstructed using a ramp filtered back projection technique. The uptake in each of 50 regions of interest in each subject was normalized to the uptake in the cerebellum. There were no significant confirmed differences in the comparable ratios of normal subjects and patients with schizophrenia even at the p = 0.15 level. Hypofrontality was not observed

Motivation and Social Cognition in Patients with Schizophrenia.

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

2015-07-01

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

Investigation of cigarette smoking among male schizophrenia patients.

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Jundong Jiang

Full Text Available Male schizophrenia patients are known to have a heavier smoking pattern compared with the general population. However, the mechanism for this association is not known, though hypothesis that smoking could alleviate symptomatology of schizophrenia and reduce side effects of antipsychotics has been suggested. The aims of this study were to validate the heavier smoking pattern among male schizophrenia patients and to investigate the possible mechanisms for the association. To enhance the reliability of the study, we recruited two large independent samples with 604 and 535 male Chinese schizophrenia patients, and compared their smoking pattern with that of 535 healthy male controls recruited from general population. Validated multiple indicators and multiple causes structure equation model and regression models were used to investigate the association of smoking with factors of schizophrenia symptomatology and with the usage of antipsychotics and their extra-pyramidal side effects (EPS. Schizophrenia patients had significantly heavier smoking pattern compared with healthy controls in our sample (42.4% vs. 16.8%, p<0.001 for current smoking prevalence; 23.5% vs. 43.3%, p<0.001 for smoking cessation rate; 24.5% vs. 3.0%, p<0.001 for heavy smoker proportion. Their smoking status was also found to be consistently and significantly associated with reduced negative factor scores for schizophrenia symptomatology (β = -0.123, p = 0.051 for sample-A; β = -0.103, p = 0.035 for sample-B; β = -0.082, p = 0.017 for the combined sample. However, no significant association was found between smoking and antipsychotics usage or risk of EPS. These results support that smoking is associated with improved negative symptoms, which could account for the heavier smoking pattern among schizophrenia patients.

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

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

2014-10-01

Basic visual dysfunctions are commonly reported in schizophrenia; however their value as diagnostic tools remains uncertain. This study reports a novel electrophysiological approach using checkerboard visual evoked potentials (VEP). Sources of spectral resolution VEP-components C1, P1 and N1 were estimated by LORETA, and the band-effects (BSE) on these estimated sources were explored in each subject. BSEs were Z-transformed for each component and relationships with clinical variables were assessed. Clinical effects were evaluated by ROC-curves and predictive values. Forty-eight patients with schizophrenia (SZ) and 55 healthy controls participated in the study. For each of the 48 patients, the three VEP components were localized to both dorsal and ventral brain areas and also deviated from a normal distribution. P1 and N1 deviations were independent of treatment, illness chronicity or gender. Results from LORETA also suggest that deficits in thalamus, posterior cingulum, precuneus, superior parietal and medial occipitotemporal areas were associated with symptom severity. While positive symptoms were more strongly related to sensory processing deficits (P1), negative symptoms were more strongly related to perceptual processing dysfunction (N1). Clinical validation revealed positive and negative predictive values for correctly classifying SZ of 100% and 77%, respectively. Classification in an additional independent sample of 30 SZ corroborated these results. In summary, this novel approach revealed basic visual dysfunctions in all patients with schizophrenia, suggesting these visual dysfunctions represent a promising candidate as a biomarker for schizophrenia. Copyright © 2014 Elsevier B.V. All rights reserved.

Effect of antipsychotic medication on overall life satisfaction among individuals with chronic schizophrenia: findings from the NIMH CATIE study.

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Fervaha, Gagan; Agid, Ofer; Takeuchi, Hiroyoshi; Foussias, George; Remington, Gary

2014-07-01

The field of schizophrenia is redefining optimal outcome, moving beyond clinical remission to a more comprehensive model including functional recovery and improved subjective well-being. Although numerous studies have evaluated subjective outcomes within the domain of subjective quality of life in patients with schizophrenia, less is known about global evaluations of subjective well-being. This study examined the effects of antipsychotic medication on overall life satisfaction in patients with chronic schizophrenia. Data were drawn from the Clinical Antipsychotic Trial of Intervention Effectiveness (CATIE) study, where participants with a DSM-IV diagnosis of schizophrenia were randomized to receive olanzapine, perphenazine, quetiapine, risperidone or ziprasidone under double-blind conditions (N=753). The primary outcome measure was prospective change in subjectively evaluated overall life satisfaction scores following 12 months of antipsychotic treatment. Psychopathology, medication side effects and functional status were also evaluated, among other variables. Patients experienced modest improvements in overall life satisfaction (d=0.22, p0.05). Change in severity of positive, negative, and depressive symptoms as well as functional status each demonstrated a small, albeit statistically significant, association with change in life satisfaction (r=0.10-0.21, p׳slife satisfaction scores (explained variance satisfaction with life. Clinicians should be aware that these two domains are not inextricably linked. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

Episodic Memory for Dynamic Social Interaction Across Phase of Illness in Schizophrenia.

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Lee, Junghee; Nuechterlein, Keith H; Knowlton, Barbara J; Bearden, Carrie E; Cannon, Tyrone D; Fiske, Alan P; Ghermezi, Livon; Hayata, Jacqueline N; Hellemann, Gerhard S; Horan, William P; Kee, Kimmy; Kern, Robert S; Subotnik, Kenneth L; Sugar, Catherine A; Ventura, Joseph; Yee, Cindy M; Green, Michael F

2017-07-06

Although a number of studies examined recollection and familiarity memory in schizophrenia, most of studies have focused on nonsocial episodic memory. Little is known about how schizophrenia patients remember social information in everyday life and whether social episodic memory changes over the course of illness. This study aims to examine episodic memory for dynamic social interaction with multimodal social stimuli in schizophrenia across phase of illness. Within each phase of illness, probands and demographically matched controls participated: 51 probands at clinical high risk (CHR) for psychosis and 36 controls, 80 first-episode schizophrenia patients and 49 controls, and 50 chronic schizophrenia patients and 39 controls. The participants completed the Social Remember-Know Paradigm that assessed overall social episodic memory, social recollection and familiarity memory, and social context memory, in addition to social cognitive measures and measures on community functioning. Probands showed impairment for recollection but not in familiarity memory and this pattern was similar across phase of illness. In contrast, impaired social context memory was observed in the first-episode and chronic schizophrenia samples, but not in CHR samples. Social context memory was associated with community functioning only in the chronic sample. These findings suggest that an impaired recollection could be a vulnerability marker for schizophrenia whereas impaired social context memory could be a disease-related marker. Further, a pattern of impaired recollection with intact familiarity memory for social stimuli suggests that schizophrenia patients may have a different pattern of impaired episodic memory for social vs nonsocial stimuli. © The Author 2017. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Unrecognised myocardial infarction in patients with schizophrenia

DEFF Research Database (Denmark)

Nielsen, Jimmi; Juel, Jacob; Alzuhairi, Karam

2015-01-01

OBJECTIVE: Schizophrenia is associated with a reduction of the lifespan by 20 years, with type II diabetes and cardiovascular disease contributing the most to the increased mortality. Unrecognised or silent myocardial infarction (MI) occurs in ~30% of the population, but the rates of unrecognised...... MI in patients with schizophrenia have only been sparsely investigated. METHOD: Electrocardiograms (ECG) from three psychiatric hospitals in Denmark were manually interpreted for signs of previous MI. Subsequently, ECGs were linked to the National Patient Registry in order to determine whether...... with unrecognised MI in a stepwise multiple logistic regression model compared with patients with no history of MI, OR: 1.03 per year of age, 95% CI: 1.00-1.06, p=0.021. CONCLUSION: Unrecognised MI is common among patients with schizophrenia and may contribute to the increased mortality found in this patient group....

Prevalence of obsessive compulsive symptoms among patients with schizophrenia

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Smita Hemrom

2009-01-01

Full Text Available Background: Obsessive compulsive symptoms in schizophrenia are well recognized but are a less-researched entity. These symptoms have important implications for management and prognosis. Aim: To find out the prevalence of obsessive compulsive symptoms among patients with schizophrenia. Materials and Methods: A total of 90 hospitalized patients with schizophrenia diagnosed according to DCR of ICD-10 criteria were selected for the study. Padua inventory and Yale-Brown Obsessive Compulsive Scale were applied to find out the prevalence and nature of obsessive compulsive symptoms . Results: It was found that 10% of schizophrenic patients had obsessive compulsive symptoms. Conclusion: Obsessive compulsive symptoms are prevalent in patients with schizophrenia. The presence of comorbidity should be explored for adequate management.

Ritanserin as add-on medication to neuroleptic therapy for patients with chronic or subchronic schizophrenia

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Den Boer, JA; Vahlne, JO; Post, P; Heck, AH; Daubenton, F; Olbrich, R

The effect of ritanserin, a potent 5HT(2A/2C) receptor antagonist, used as an add-on medication to neuroleptic treatmentin patients with schizophrenia, was compared with that of placebo, in an international, double-blind, parallel-group study. Previously established neuroleptic therapy was

The relationship between hope and patient activation in consumers with schizophrenia: Results from longitudinal analyses.

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Oles, Sylwia K; Fukui, Sadaaki; Rand, Kevin L; Salyers, Michelle P

2015-08-30

Hope (goal-directed thinking) and patient activation (knowledge and skills to manage one's illness) are both important in managing chronic conditions like schizophrenia. The relationship between hope and patient activation has not been clearly defined. However, hope may be viewed as a foundational, motivating factor that can lead to greater involvement in care and feelings of efficacy. The purpose of the present study was to understand the prospective relationship between hope and patient activation in a sample of adults with schizophrenia (N=118). This study was a secondary data analysis from a study on Illness Management and Recovery (IMR) - a curriculum-based approach to schizophrenia self-management. Data were collected at baseline (prior to any intervention), and at 9 and 18-month follow-up. As predicted, hope and patient activation were significantly related with each other, showing large positive concurrent correlations. Demographics and background characteristics were not significantly related to patient activation or hope. Longitudinal analyses found no specific directional effect, yet suggested that hope and patient activation mutually influence each other over time. Our findings add flexibility in designing recovery-based interventions - fostering hope may not be a pre-requisite for activating consumers to be more involved in their own care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Dementia in middle-aged patients with schizophrenia.

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Nicolas, Gaël; Beherec, Laurène; Hannequin, Didier; Opolczynski, Gaëlle; Rothärmel, Maud; Wallon, David; Véra, Pierre; Martinaud, Olivier; Guillin, Olivier; Campion, Dominique

2014-01-01

Although numerous studies have assessed cognitive dysfunction in patients with schizophrenia, very few have focused on the diagnosis of dementia. Our objectives were to accurately diagnose dementia in a cohort of middle-aged patients with schizophrenia and to assess the type of dementia. 96 patients with schizophrenia (46 inpatients and 50 outpatients), aged 50 to 70 years, underwent a psychiatric, neurological, and neuropsychological evaluation at baseline and after a 20-month follow-up. We established a 3-step procedure: 1) diagnose dementia according to the DSM-IV criteria, using the Mattis Dementia Rating and Activities of Daily Living scales; 2) characterize dementia using brain imaging, perfusion by 99mTc-ECD-SPECT and laboratory tests including Alzheimer's disease cerebrospinal fluid biomarkers; and 3) search for genetic determinants. Fourteen patients fulfilled the diagnostic criteria of dementia. Four were diagnosed with possible or probable behavioral-variant frontotemporal dementia (bvFTD), two with probable Alzheimer's disease, two with probable vascular dementia (including one due to CADASIL), one with CNS inflammatory disease, and six could not be fully characterized. The diagnosis of dementia in middle-aged patients with schizophrenia is challenging but possible, using a multistep procedure. The most frequent condition, bvFTD, could reflect the presence of an evolutive neurodegenerative process in some patients.

Assessment of the psychopathological effects of a horticultural therapy program in patients with schizophrenia.

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Oh, Yun-Ah; Park, Sin-Ae; Ahn, Byung-Eun

2018-02-01

This study assessed the psychopathological effects of participation in a 10-session horticultural therapy program in patients with schizophrenia. The study design was pre and post test design of experimental and control groups. Twenty-eight Korean patients with schizophrenia, recruited from a mental health clinic and two mental health rehabilitation centers in Suwon, South Korea, were voluntarily assigned to either a control group (average age: 33.4±9.4years) or a horticultural therapy group (average age: 42.1±13.0years). The participants in the horticultural therapy group participated in a 10-session horticultural therapy program designed around various plant cultivating activities. The horticultural therapy program involved sessions once a week from April 2017 to June 2017. A psychiatrist evaluated the psychopathological symptoms of schizophrenic patients in both groups. To assess the clinical psychopathological effects, the Korean version of the Positive and Negative Syndrome Scale (PANSS) and Brief Psychiatric Rating Scale (BPRS) were used. The horticultural therapy group significantly improved in terms of positive, negative, and general symptoms on the PANSS after the 10-session horticultural therapy program. Moreover, the horticultural therapy group significantly improved in terms of clinical symptoms of schizophrenia in BPRS after the 10-session horticultural therapy program. However, there was no change in the PANSS and BPRS scores in the control group. This study showed the potential of horticultural therapy in improving psychopathological symptoms in psychiatric patients. Future studies should investigate the effects of long-term horticultural therapy program on the chronic symptoms of patients with schizophrenia. Copyright © 2017 Elsevier Ltd. All rights reserved.

Low serum vitamin D concentrations in patients with schizophrenia.

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Itzhaky, Dganit; Amital, Daniela; Gorden, Katya; Bogomolni, Alisa; Arnson, Yoav; Amital, Howard

2012-02-01

Vitamin D is increasingly associated with the pathology of cognition and mental illness. Vitamin D receptors have been detected on neurons that regulate behavior. To assess vitamin D serum concentrations in patients with major depression and schizophrenia as compared to healthy controls and to determine if a correlation exists between serum levels of vitamin D and disease activity. We recruited 50 patients with schizophrenia and compared them to 33 patients with major depression and 50 controls with no major psychopathology. The Positive and Negative Syndrome Scale (PANSS) for schizophrenia and the Hamilton Depression scale for depression were administered on the same day the blood samples were drawn. We used LIAISON 25-OH vitamin D (DiaSorin) immunoassay to measure serum concentrations of 25-OH vitamin D. Lower serum vitamin D concentrations were detected among patients with schizophrenia (15.0 +/- 7.3 ng/ml) compared to patients with depression (19.6 +/- 8.3 ng/ml) and to controls (20.2 +/- 7.8 ng/ml, P vitamin D levels. Serum vitamin D levels were lower in patients with schizophrenia as compared to patients with depression and to healthy controls. No correlation was found between serum concentration and disease activity. Additional studies are needed to elucidate the role of vitamin D in the autoimmune mechanism and in the pathogenesis of schizophrenia.

Investigation of Fasciculation and Elongation Protein ζ-1 (FEZ1 in Peripheral Blood Reveals Differences in Gene Expression in Patients with Schizophrenia

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Vachev T.I.

2015-06-01

Full Text Available Schizophrenia (SZ is a chronic neuropsychiatric disorder characterized by affective, neuromorphological and cognitive impairment, deteriorated social functioning and psychosis with underlying molecular abnormalities, including gene expression changes. Observations have suggested that fasciculation and elongation protein ζ-1 (FEZ1 may be implicated in the pathogenesis of schizophrenia. Nevertheless, our current knowledge of the expression of FEZ1 in peripheral blood of schizophrenia patients remains unclear. The purpose of this study was to identify the characteristic gene expression patterns of FEZ1 in peripheral blood samples from schizophrenia patients. We performed quantitative reverse-transcriptase (qRT-PCR analysis using peripheral blood from drug-free schizophrenia patients (n = 29 and age and gender-matched general population controls (n = 24. For the identification of FEZ1 gene expression patterns, we applied a comparative threshold cycle (CT method. A statistically significant difference of FEZ1 mRNA level was revealed in schizophrenia subjects compared to healthy controls (p = 0.0034. To the best of our knowledge, this study is the first describing a down-regulation of FEZ1 gene expression in peripheral blood of patients with schizophrenia. Our results suggested a possible functional role of FEZ1 in the pathogenesis of schizophrenia and confirmed the utility of peripheral blood samples for molecular profiling of psychiatric disorders including schizophrenia. The current study describes FEZ1 gene expression changes in peripheral blood of patients with schizophrenia with significantly down-regulation of FEZ1 mRNA. Thus, our results provide support for a model of SZ pathogenesis that includes the effects of FEZ1 expression.

Chronic pain and quality of life in schizophrenic patients

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Jouce Gabriela de Almeida

2013-03-01

Full Text Available OBJECTIVE: To identify the prevalence and characteristics of chronic pain in schizophrenic patients and to compare the quality of life in patients with and without chronic pain. METHODS: Crossover design with a probablistic sample of 205 adult schizophrenic outpatients (80% paranoid schizophrenia. Socio-demographic, psychiatric disorder, pain and quality of life (WHOQOL- brief data were collected between June and September 2008. RESULTS: Mean age was 37 years, 65% were men, and the mean time spent in school was 9 years; 87% were single, 65% lived with parents and 25% had a job. Among patients with chronic pain, 70% did not receive treatment for pain. Regarding quality of life, patients with pain had more physical disabilities compared to those without pain (p < .001. There were no differences in other domains. Comparisons between patients with and without pain did not show any differences in how much they felt their mental health problems disabled them. Conclusion: Chronic pain was common in schizophrenic patients (similar to the general population of a similar age and decreased their quality of life. It is necessary to pay more attention to this co-morbidity.

Achieving recovery in patients with schizophrenia through psychosocial interventions: A retrospective study.

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Buonocore, Mariachiara; Bosia, Marta; Baraldi, Maria A; Bechi, Margherita; Spangaro, Marco; Cocchi, Federica; Bianchi, Laura; Guglielmino, Carmelo; Mastromatteo, Antonella R; Cavallaro, Roberto

2018-01-01

Recovery, or functional remission, represents the ultimate treatment goal in schizophrenia. Despite its importance, a standardized definition of remission is still lacking, thus reported rates significantly vary across studies. Moreover, the effects of rehabilitative interventions on recovery have not been thoroughly investigated. This study aimed to evaluate recovery in a sample of patients with chronic schizophrenia engaged in rehabilitation programs and to explore contributing factors, with a focus on sociocognitive rehabilitative interventions. Data from 104 patients with schizophrenia treated either with a standard rehabilitation program, including cognitive remediation (n = 46), or the latter plus a specific sociocognitive intervention (n = 58), and assessed for psychopathology, cognition, social cognition, and Quality of Life Scale, were retrospectively analyzed for this study. Recovery, evaluated with the Quality of Life Scale, was achieved by 56.76% of patients in our sample. While no effects were observed for clinical, cognitive, or sociocognitive variables, participation in the sociocognitive rehabilitative interventions was positively associated with recovery. Our results indicate that high rates of recovery can be achieved in patients treated with psychosocial interventions and suggest that rehabilitative programs targeting social cognition may further facilitate the process of recovery. If confirmed, these results may have relevant implications for daily clinical practice and service provision, allowing clinicians to develop and optimize specific rehabilitation programs in order to promote recovery. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

Mismatch Negativity in Han Chinese Patients with Schizophrenia: A Meta-Analysis.

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Xiong, Yanbing; Ll, Xianbin; Zhao, Lei; Wang, Chuanyue

2017-10-25

Previous meta-analysis revealed that mismatch negativity(MMN) amplitude decreased in patients with schizophrenia compared with healthy controls (Cohen's d, d about 1), leading to the possibility of mismatch negativity being used as a biomarker for schizophrenia. However, it is unknown whether MMN is reliably changed in Chinese patients. It is necessary to carry out a meta-analysis on MMN of Han Chinese patients with schizophrenia. To investigate whether MMN could be used as a biomarker for Han Chinese patients with schizophrenia. A literature search was conducted to identify clinical trials on MMN in Han Chinese schizophrenia patients published before May 8, 2017, by searching the Chinese language databases CNKI, WanFang Data, VIP Data and PubMed. The effects of MMN deficits were evaluated for MMN amplitude by calculating standard mean difference (SMDs) between schizophrenia patient groups and healthy control groups. A total of 11 studies were included in the analysis. The total quality of all the studies were more than 6 as evaluated by Newcastle-Ottawa Scale (NOS). Meta-analysis of data from these studies had a pooled sample of 432 patients with schizophrenia and 392 healthy controls. There exists significant MMN deficit in schizophrenia patients compared to healthy controls (Cohen's d =1.004). When studies were excluded due to heterogeneity, the pooled effect size of the MMN differences between the patient group and healthy controls dropped to 0.79 (Cohen's d =0.79). Subgroup analysis showed that MMN amplitude deficits of schizophrenia over three years had the pooled effect size of 0.95, and less than three years had the pooled effect size of 0.77. Publication bias conducted via Egger regression test ( t = 1.83; p = 0.101), suggested that there was no publication bias. The effect size of MMN amplitude between Chinese patients with schizophrenia and healthy controls is consistent with other meta-analyses published on this topic, suggesting that Han Chinese

A study to assess the effectiveness of planned exercise programme in patients with schizophrenia

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Bineeta Nath

2015-01-01

Full Text Available Background: Psychotic disorders are some of the most severe, chronic, and intractable psychiatric disorders. Schizophrenia is a common and unsolved mental health problem in the world today. Negative symptoms are those symptoms that tend to reflect diminution or loss of normal functions like apathy, anhedonia, alogia, avolition, affective flattening, or social isolation. Exercise is useful for the reduction of some of the negative symptoms of schizophrenia, depression, and anxiety, and also to reduce auditory hallucinations and improve sleep patterns, self-esteem, and general behaviour in people living with schizophrenia. Aim of the study was to assess the effectiveness of planned exercise programme in negative symptoms among patients with schizophrenia. Methodology: A quasi experimental research design was used for this study. Total 60 samples were assigned into two groups with 30 in control group and 30 in experimental group. The data was collected by using structured socio-demographic proforma, Positive and Negative Syndrome Scale, and Scale for Assessment of Negative symptoms. Result: There was a statistically significant difference in pre and post test scores in both control and experimental groups. But statistically significant difference in post test mean scores on negative symptoms between control and experimental groups indicated effectiveness of planned exercise programme along with medical and nursing care. Conclusion: The findings concluded that planned exercise programme with routine medical and nursing care was effective in reduction of negative symptoms in schizophrenia patients.

Emotion recognition and oxytocin in patients with schizophrenia

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Averbeck, B. B.; Bobin, T.; Evans, S.; Shergill, S. S.

2012-01-01

Background Studies have suggested that patients with schizophrenia are impaired at recognizing emotions. Recently, it has been shown that the neuropeptide oxytocin can have beneficial effects on social behaviors. Method To examine emotion recognition deficits in patients and see whether oxytocin could improve these deficits, we carried out two experiments. In the first experiment we recruited 30 patients with schizophrenia and 29 age- and IQ-matched control subjects, and gave them an emotion recognition task. Following this, we carried out a second experiment in which we recruited 21 patients with schizophrenia for a double-blind, placebo-controlled cross-over study of the effects of oxytocin on the same emotion recognition task. Results In the first experiment we found that patients with schizophrenia had a deficit relative to controls in recognizing emotions. In the second experiment we found that administration of oxytocin improved the ability of patients to recognize emotions. The improvement was consistent and occurred for most emotions, and was present whether patients were identifying morphed or non-morphed faces. Conclusions These data add to a growing literature showing beneficial effects of oxytocin on social–behavioral tasks, as well as clinical symptoms. PMID:21835090

7T Proton Magnetic Resonance Spectroscopy of Gamma-Aminobutyric Acid, Glutamate, and Glutamine Reveals Altered Concentrations in Patients With Schizophrenia and Healthy Siblings.

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Thakkar, Katharine N; Rösler, Lara; Wijnen, Jannie P; Boer, Vincent O; Klomp, Dennis W J; Cahn, Wiepke; Kahn, René S; Neggers, Sebastiaan F W

2017-03-15

The N-methyl-D-aspartate receptor hypofunction model of schizophrenia predicts dysfunction in both glutamatergic and gamma-aminobutyric acidergic (GABAergic) transmission. We addressed this hypothesis by measuring GABA, glutamate, glutamine, and the sum of glutamine plus glutamate concentrations in vivo in patients with schizophrenia using proton magnetic resonance spectroscopy at 7T, which allows separation of metabolites that would otherwise overlap at lower field strengths. In addition, we investigated whether altered levels of GABA, glutamate, glutamine, and the sum of glutamine plus glutamate reflect genetic vulnerability to schizophrenia by including healthy first-degree relatives. Proton magnetic resonance spectroscopy at 7T was performed in 21 patients with chronic schizophrenia who were taking medication, 23 healthy first-degree relatives of patients with schizophrenia, and 24 healthy nonrelatives. Glutamate, glutamine, and GABA were measured cortically and subcortically in bilateral basal ganglia and occipital cortex. Patients with schizophrenia had reduced cortical GABA compared with healthy relatives and the combined sample of healthy relatives and healthy nonrelatives, suggesting that altered GABAergic systems in schizophrenia are associated with either disease state or medication effects. Reduced cortical glutamine relative to healthy control subjects was observed in patients with schizophrenia and the combined sample of healthy relatives and patients with schizophrenia, suggesting that altered glutamatergic metabolite levels are associated with illness liability. No group differences were found in the basal ganglia. Taken together, these findings are consistent with alterations in GABAergic and glutamatergic systems in patients with schizophrenia and provide novel insights into these systems in healthy relatives. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Component structure of the positive and negative syndrome scale (PANSS) in patients with recent-onset schizophrenia and spectrum disorders

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Wolthaus, J. E.; Dingemans, P. M.; Schene, A. H.; Linszen, D. H.; Knegtering, H.; Holthausen, E. A.; Cahn, W.; Hijman, R.

2000-01-01

RATIONALE: Earlier studies have examined the symptom dimensions of the PANSS (Positive And Negative Syndrome Scale) in patients with chronic schizophrenia. Results have suggested that three to eight component solutions best explain underlying symptom dimensions. OBJECTIVES: To examine the component

Component structure of the Positive And Negative Syndrome Scale (PANSS) in patients with recent-onset schizophrenia and spectrum disorders

NARCIS (Netherlands)

Wolthaus, JED; Dingemans, PMAJ; Schene, AH; Linszen, DH; Knegtering, H; Holthausen, EAE; Cahn, W; Hijman, R

Rationale: Earlier studies have examined the symptom dimensions of the PANSS (Positive And Negative Syndrome Scale) in patients with chronic schizophrenia. Results have suggested that three to eight component solutions best explain underlying symptom dimensions. Objectives: To examine the component

Prevalence of dental caries in hospitalized patients with schizophrenia

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Đorđević Vladan

2016-01-01

Full Text Available Background/Aim. It is considered that over 450 million people worldwide suffer from some form of mental disorder. Previous studies in other countries have shown that schizophrenia is among the most frequent. Oral health is significant for general health and should not be separated from mental health. Studies in other countries have shown an increased incidence of carious and extracted teeth, and less incidence of filled teeth in this group of psychiatric patients. The aim of this study was to establish condition of the existing teeth, to determine the prevalence of caries and to consider possible risk factors that contribute to the current oral health status of hospitalized patients with schizophrenia. Methods. The study comprised 190 patients with schizophrenia, hospitalized at the Clinic for Psychiatric Disorders “Dr. Laza Lazarević” in Belgrade, and 190 mentally healthy patients at the Clinic for Periodontology and Oral Medicine, Faculty of Dental Medicine in Belgrade. The decayed, missing, filled (DMF index, sociodemographic and economic characteristics were registered in both groups, as well as characteristics of the primary disease of hospitalized patients with schizophrenia. Results. The value of DMF index (representing the sum of carious, extracted and filled teeth, in the hospitalized patients with schizophrenia was 18.57 ± 7.07 and 12.47 ± 5.64 in the healthy group (p = 0.000. The structure of the DMF index in the study group showed that caries and extracted teeth dominated with 88.1%; in the control group, filled teeth dominated with 55.6%, which was a statistically significant difference for all the three observed variables. Conclusion. Hospitalized patients with schizophrenia had twice as many caries and extracted teeth, and five time less filled teeth than healthy people. The patient’s age and taking antiparkinsonics were established as predictors of the increased DMF index in hospitalized patients with schizophrenia.

Insight and subjective measures of quality of life in chronic schizophrenia.

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Siu, Cynthia O; Harvey, Philip D; Agid, Ofer; Waye, Mary; Brambilla, Carla; Choi, Wing-Kit; Remington, Gary

2015-09-01

Lack of insight is a well-established phenomenon in schizophrenia, and has been associated with reduced rater-assessed functional performance but increased self-reported well-being in previous studies. The objective of this study was to examine factors that might influence insight (as assessed by the Insight and Treatment Attitudes Questionnaire [ITAQ] or PANSS item G12) and subjective quality-of-life (as assessed by Lehman QoL Interview [LQOLI]), using the large National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) dataset. Uncooperativeness was assessed by PANSS item G8 ("Uncooperativeness"). In the analysis, we found significant moderating effects for insight on the relationships of subjective life satisfaction assessment to symptom severity (as assessed by CGI-S score), objective everyday functioning (as assessed by rater-administered Heinrichs-Carpenter Quality of Life scale), clinically rated uncooperativeness (as assessed by PANSS G8), and discontinuation of treatment for all causes (all P > 0.05 for statistical interaction between insight and subject QoL). Patients with chronic schizophrenia who reported being "pleased" or "delighted" on LQOLI were found to have significantly lower neurocognitive reasoning performance and poorer insight (ITAQ total score). Our findings underscore the importance of reducing cognitive and insight impairments for both treatment compliance and improved functional outcomes.

Medication adherence and utilization in patients with schizophrenia or bipolar disorder receiving aripiprazole, quetiapine, or ziprasidone at hospital discharge: A retrospective cohort study

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Berger Ariel

2012-08-01

Full Text Available Abstract Background Schizophrenia and bipolar disorder are chronic debilitating disorders that are often treated with second-generation antipsychotic agents, such as aripiprazole, quetiapine, and ziprasidone. While patients who are hospitalized for schizophrenia and bipolar disorder often receive these agents at discharge, comparatively little information exists on subsequent patterns of pharmacotherapy. Methods Using a database linking hospital admission records to health insurance claims, we identified all patients hospitalized for schizophrenia (ICD-9-CM diagnosis code 295.XX or bipolar disorder (296.0, 296.1, 296.4-296.89 between January 1, 2001 and September 30, 2008 who received aripiprazole, quetiapine, or ziprasidone at discharge. Patients not continuously enrolled for 6 months before and after hospitalization (“pre-admission” and “follow-up”, respectively were excluded. We examined patterns of use of these agents during follow-up, including adherence with treatment (using medication possession ratios [MPRs] and cumulative medication gaps [CMGs] and therapy switching. Analyses were undertaken separately for patients with schizophrenia and bipolar disorder, respectively. Results We identified a total of 43 patients with schizophrenia, and 84 patients with bipolar disorder. During the 6-month period following hospitalization, patients with schizophrenia received an average of 101 therapy-days with the second-generation antipsychotic agent prescribed at discharge; for patients with bipolar disorder, the corresponding value was 68 therapy-days. Mean MPR at 6 months was 55.1% for schizophrenia patients, and 37.3% for those with bipolar disorder; approximately one-quarter of patients switched to another agent over this period. Conclusions Medication compliance is poor in patients with schizophrenia or bipolar disorder who initiate treatment with aripiprazole, quetiapine, or ziprasidone at hospital discharge.

Ziprasidone's effect on metabolic markers in patients with diabetes and chronic schizophrenia.

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Lindenmayer, Jean Pierre; Tedeschi, Frank; Yusim, Anna; Khan, Anzalee; Kaushik, Saurabh; Smith, Robert C; Parakadavil, Mohan

2012-01-01

Despite numerous studies of diabetes mellitus type II (DM-II) in schizophrenia and schizoaffective disorder, there have been no studies on the glycemic effects of switching patients with long-standing symptomatic DM-II from their current antipsychotic regimen to ziprasidone. An open-label, prospective inpatient study was conducted with 26 suboptimally responding inpatients with DSM-IV diagnoses of schizophrenia or schizoaffective disorder and comorbid DM-II who were switched to ziprasidone monotherapy and followed for 8 weeks. Outcome measures were fasting glucose, triglycerides, cholesterol, insulin levels, capillary blood glucose levels and weight. After a 3-week cross-titration period, patients were treated with ziprasidone up to a dose of 320 mg daily. Of the 26 study participants, 16 completed the entire study period of 63 days and 10 (38.46%) discontinued participation, primarily due to psychotic relapse. There was a statistically significant reduction in fasting glucose (F=4.43, p=0.05; 14.68 mg/dL mean reduction), capillary blood glucose levels (F=8.90, p=0.01; 25.36 mg/dL mean reduction), weight (F=4.46, p=0.05; 4.68 lb mean weight loss) and Body Mass Index (F=4.40, p=0.05; 3.62 kg/m(2) mean reduction). There was also a reduction in the use of antidiabetic medications after the switch to ziprasidone. Nine (34.62%) patients met criteria for metabolic syndrome (MetS) at baseline, as compared to 4 (15.38%) at endpoint. No change was observed in positive symptoms (F=0.62, p=0.44), negative symptoms (F=1.47, p=0.24) and in total PANSS score (F=0.12, p=0.74). This study suggests significant improvement in metabolic side effects and MetS in the subset of the patients who were able to tolerate switching from a polypharmacy regimen to ziprasidone. There was a large discontinuation rate, which limited the sustained beneficial effects of ziprasidone. The decision to switch to ziprasidone in patients with prior suboptimal response has to balance the potential

P50 suppression deficits and psychopathology in Han Chinese patients with schizophrenia.

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Zhu, Xiao Lin; Tan, Shu Ping; Wang, Zhi Ren; Zhang, Jin Guo; Li, Dong; Fan, Feng Mei; Zhao, Yan Li; Zou, Yi Zhuang; Tan, Yun Long; Yang, Fu De; Zhang, Xiang Yang

2017-07-13

Numerous studies have reported P50 gating deficits in schizophrenia, though with mixed results. Moreover, few studies have explored the association between P50 gating deficits and psychopathology in Chinese patients with schizophrenia. In the present study, we investigated the P50 auditory sensory gating patterns and their correlations with clinical symptoms in a large sample of Han Chinese patients with schizophrenia. We assessed P50 sensory gating with a 64-channel electroencephalography system in 133 patients with schizophrenia and 148 healthy controls. The schizophrenia symptomatology was assessed with the Positive and Negative Syndrome Scale (PANSS). Patients with schizophrenia had a significantly higher P50 gating ratio (pschizophrenia. These findings suggest that the P50 sensory gating deficits identified in Chinese patients with schizophrenia may not be involved in the psychopathology of the illness. Copyright © 2017 Elsevier B.V. All rights reserved.

The Role of Inflammation in Schizophrenia

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Norbert eMüller

2015-10-01

Full Text Available AbstractHigh levels of pro-inflammatory substances such as cytokines have been described in the blood and cerebrospinal fluid of schizophrenia patients. Animal models of schizophrenia show that under certain conditions an immune disturbance during early life, such as an infection-triggered immune activation, might trigger lifelong increased immune reactivity. A large epidemiological study clearly demonstrated that severe infections and autoimmune disorders are risk factors for schizophrenia. Genetic studies have shown a strong signal for schizophrenia on chromosome 6p22.1, in a region related to the human leucocyte antigen (HLA system and other immune functions. Another line of evidence demonstrates that chronic (disstress is associated with immune activation. The vulnerability-stress-inflammation model of schizophrenia includes the contribution of stress on the basis of increased genetic vulnerability for the pathogenesis

Antipsychotic use is a risk factor for hyponatremia in patients with schizophrenia: a 15-year follow-up study.

Science.gov (United States)

Yang, Hang-Ju; Cheng, Wan-Ju

2017-03-01

Hyponatremia affects 10% of patients with chronic schizophrenia and can lead to severe consequences. However, the role of antipsychotics and other risk factors in hyponatremia occurrence has remained inconsistent. This study examined the association between antipsychotic use and hyponatremia occurrence in patients with schizophrenia. We utilized the National Health Insurance Research Database to follow 2051 patients with schizophrenia from 1998 to 2013. Among them, 137 (6.7%) developed hyponatremia. Sociodemographic characteristics, physical comorbidities, and psychiatric treatment experiences were compared between those who had hyponatremia and those who did not. A Cox proportional hazards model was used to examine the hazard ratios (HRs) of these characteristics. In patients with hyponatremia, the mean age at first hyponatremia occurrence was 54.7 ± 13.9 years, an average of 9.5 ± 4.0 years after schizophrenia diagnosis, and 32.9% of them were off antipsychotics before hyponatremia occurrences. Age at schizophrenia diagnosis (HR = 1.1), low-income household (HR = 2.4), comorbidities (HR = 1.2), and psychiatric admissions (HR = 1.04) were associated with the risks of hyponatremia. Compared with no antipsychotic use, atypical (HR = 2.1) and typical antipsychotics (HR = 3.1) were associated with an elevated risk of hyponatremia, after adjustment for age, sex, and physical comorbidities. Carbamazepine use (HR = 2.9) was also a significant risk factor for hyponatremia (p schizophrenia with polypharmacy should be monitored for hyponatremia occurrences. Clinicians should pay attention to the impact of poor living conditions on hyponatremia occurrence.

Rethinking Schizophrenia

OpenAIRE

Insel, Thomas R.

2010-01-01

How will we view schizophrenia in 2030? Schizophrenia today is a chronic, frequently disabling mental disorder that affects about one per cent of the world's population. After a century of studying schizophrenia, the cause of the disorder remains unknown. Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia. These current uns...

Comparison of peripheral and central schizophrenia biomarker profiles.

Directory of Open Access Journals (Sweden)

Laura W Harris

Full Text Available We have recently shown that a molecular biomarker signature comprised of inflammatory, hormonal and growth factors occurs in the blood serum from first onset schizophrenia patients. Here, we use the same platform to investigate post mortem brain tissue (Brodmann area 10 from schizophrenia patients who were mainly chronically ill and drug treated. Twenty-one analytes are differentially expressed in post-mortem brain tissue. Comparison with our previous mRNA profiling studies of the same patient samples in another frontal cortical area showed that 9 of these molecules were also altered at the transcriptional level. Furthermore, 9 of the molecules were also altered in serum from living first onset schizophrenia patients compared to controls. We propose a model in which the brain and periphery are coordinated through hormones and other regulatory molecules released into the blood via the diffuse neuroendocrine system. These findings provide further evidence for the systemic nature of schizophrenia and give added validity to the concept that schizophrenia can be investigated through studies of blood-based biomarkers.

Suicidal behavior in the older patient with schizophrenia

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Kasckow, John; Montross, Lori; Prunty, Laurie; Fox, Lauren; Zisook, Sidney

2011-01-01

Little is known about treating elderly suicidal patients with schizophrenia. The purpose of this article is to review the literature dealing with this population and to discuss what is required to advance this field. Most available studies from middle-aged and older individuals suggest that risk factors include hopelessness, lower quality of life, past traumatic events, depressive symptoms, lifetime suicidal ideation and past attempts; it is not clear whether these findings are generalizable to geriatric populations. Although little treatment research has been performed in older suicidal patients with schizophrenia, an integrated psychosocial and pharmacologic approach is recommended. In addition, one recent study augmented antipsychotic treatment with an SSRI (i.e., citalopram) in a sample of middle-aged and older individuals with schizophrenia with subsyndromal depression; in that study, serotonin selective reuptake inhibitor augmentation reduced depressive symptoms and suicidal ideation. More research is required to better understand suicidal behavior in older patients with schizophrenia. PMID:22028735

Approaches to improve adherence to pharmacotherapy in patients with schizophrenia

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Shuler KM

2014-05-01

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

Indirect self-destructiveness in individuals with schizophrenia

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Konstantinos Tsirigotis

2017-06-01

Full Text Available Objective: To explore the indirect self-destructiveness syndrome in patients with schizophrenia. Methods: Two hundred individuals with paranoid schizophrenia (117 men and 83 women, mean age 37.15 years, all in remission, were examined using the Polish version of the Chronic Self-Destructiveness Scale. Two hundred well-matched healthy individuals served as a control group. Results: The intensity of indirect self-destructiveness was greater in the schizophrenia group than in controls. The intensity of each manifestation was as follows (in decreasing order: helplessness and passiveness in the face of difficulties (A5, personal and social neglects (A3, lack of planfulness (A4, poor health maintenance (A2, transgression and risk (A1. Conclusion: Patients with schizophrenia displayed more behaviors that were indirectly self-destructive than healthy controls; they scored better than healthy controls only on caring for their own health. The patients showed the lowest intensity of behaviors connected with the active form of indirect self-destructiveness, and the highest intensity of behaviors connected with the passive form. These findings may enable delivery of more effective forms of pharmacological and psychosocial help to patients with schizophrenia.

Approaches to improve adherence to pharmacotherapy in patients with schizophrenia.

Science.gov (United States)

Shuler, Kimberly M

2014-01-01

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

Schizophrenia patients differentiation based on MR vascular perfusion and volumetric imaging

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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.

The care needs of elderly patients with schizophrenia spectrum disorders

NARCIS (Netherlands)

Meesters, P.D.; Comijs, H.C.; Dröes, R.M.; de Haan, L.; Smit, J.H.; Eikelenboom, P.; Beekman, A.T.F.; Stek, M.L.

2013-01-01

Objective: Elderly patients constitute the fastest growing segment of the schizophrenia population. Still, their needs for care are poorly understood. This study aimed to gain insight into the care needs of older patients with schizophrenia spectrum disorders. Setting and Participants: Patients,

Amotivation is associated with smaller ventral striatum volumes in older patients with schizophrenia.

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Caravaggio, Fernando; Fervaha, Gagan; Iwata, Yusuke; Plitman, Eric; Chung, Jun Ku; Nakajima, Shinichiro; Mar, Wanna; Gerretsen, Philip; Kim, Julia; Chakravarty, M Mallar; Mulsant, Benoit; Pollock, Bruce; Mamo, David; Remington, Gary; Graff-Guerrero, Ariel

2018-03-01

Motivational deficits are prevalent in patients with schizophrenia, persist despite antipsychotic treatment, and predict long-term outcomes. Evidence suggests that patients with greater amotivation have smaller ventral striatum (VS) volumes. We wished to replicate this finding in a sample of older, chronically medicated patients with schizophrenia. Using structural imaging and positron emission tomography, we examined whether amotivation uniquely predicted VS volumes beyond the effects of striatal dopamine D 2/3 receptor (D 2/3 R) blockade by antipsychotics. Data from 41 older schizophrenia patients (mean age: 60.2 ± 6.7; 11 female) were reanalysed from previously published imaging data. We constructed multivariate linear stepwise regression models with VS volumes as the dependent variable and various sociodemographic and clinical variables as the initial predictors: age, gender, total brain volume, and antipsychotic striatal D 2/3 R occupancy. Amotivation was included as a subsequent step to determine any unique relationships with VS volumes beyond the contribution of the covariates. In a reduced sample (n = 36), general cognition was also included as a covariate. Amotivation uniquely explained 8% and 6% of the variance in right and left VS volumes, respectively (right: β = -.38, t = -2.48, P = .01; left: β = -.31, t = -2.17, P = .03). Considering cognition, amotivation levels uniquely explained 9% of the variance in right VS volumes (β = -.43, t = -0.26, P = .03). We replicate and extend the finding of reduced VS volumes with greater amotivation. We demonstrate this relationship uniquely beyond the potential contributions of striatal D 2/3 R blockade by antipsychotics. Elucidating the structural correlates of amotivation in schizophrenia may help develop treatments for this presently irremediable deficit. Copyright © 2017 John Wiley & Sons, Ltd.

Acupuncture treatment of a male patient suffering from long-term schizophrenia and sleep disorders

NARCIS (Netherlands)

Bosch, M.P.C.; Staudte, H.; Yeo, S.; Lee, S.H.; Lim, S.; Noort, M.W.M.L. van den

2017-01-01

Objective: To investigate the effectiveness of acupuncture in the treatment of chronic schizophrenia and co-morbid sleep disorders. Methods: A 42-year-old German male outpatient, suffering from long-term schizophrenia and sleep disorders, entered the study. Acupuncture was used as a

Caregiver burden among relatives of patients with schizophrenia in ...

African Journals Online (AJOL)

Background. Caring for patients with schizophrenia places an enormous burden on the caregivers. The magnitude of this problem remains largely unknown in sub-Saharan Africa. Objective. The objective of this study was to determine the nature of the burden reported by caregiving relatives of patients with schizophrenia.

[Schizophrenia and Liver Transplantation: Case Report].

Science.gov (United States)

Diana, Restrepo B; Marle, Duque G; Carlos, Cardeño C

2012-09-01

Liver transplantation is a treatment available for many patients with liver cirrhosis who find in this treatment a way to improve life expectancy and quality of life. Paranoid schizophrenia affects 1% of the general population, produces psychotic symptoms, and runs a chronic course in some cases with significant deterioration in all areas of life. To discuss the case of a patient with liver cirrhosis diagnosed with paranoid schizophrenia during the evaluation protocol for liver transplantation. Case report. We report the case of a 47-year-old woman with liver cirrhosis whose only alternative to improve life expectancy and quality of life was access to liver transplantation. During routine evaluations the liaison psychiatrist observed first-order psychotic symptoms and documented a life story that confirmed the presence of paranoid schizophrenia. Paranoid schizophrenia is a psychiatric disorder common in the general population that can be a part of the medical comorbidities of patients requiring liver transplantation and is not an absolute contraindication to its completion. We are unaware of similar cases of liver transplantation in patients with schizophrenia in our country. We believe this is a big step on the road to overcome the stigma that mental illness imposes on patients. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Schizophrenia, culture and neuropsychology: sensory deficits, language impairments and social functioning in Chinese-speaking schizophrenia patients.

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Yang, L; Chen, S; Chen, C-M; Khan, F; Forchelli, G; Javitt, D C

2012-07-01

While 20% of schizophrenia patients worldwide speak tonal languages (e.g. Mandarin), studies are limited to Western-language patients. Western-language patients show tonal deficits that are related to impaired emotional processing of speech. However, language processing is minimally affected. In contrast, in Mandarin, syllables are voiced in one of four tones, with word meaning varying accordingly. We hypothesized that Mandarin-speaking schizophrenia patients would show impairments in underlying basic auditory processing that, unlike in Western groups, would relate to deficits in word recognition and social outcomes. Altogether, 22 Mandarin-speaking schizophrenia patients and 44 matched healthy participants were recruited from New York City. The auditory tasks were: (1) tone matching; (2) distorted tunes; (3) Chinese word discrimination; (4) Chinese word identification. Social outcomes were measured by marital status, employment and most recent employment status. Patients showed deficits in tone-matching, distorted tunes, word discrimination and word identification versus controls (all pneuropsychology and language among Mandarin-speaking schizophrenia patients. As predicted, patients were highly impaired in both tone and auditory word processing, with these two measures significantly correlated. Tonally impaired patients showed significantly worse employment-status function than tonally intact patients, suggesting a link between sensory impairment and employment status outcome. While neuropsychological deficits appear similar cross-culturally, their consequences may be language- and culture-dependent.

[Prevention of schizophrenia: a review].

Science.gov (United States)

Balhara, Yatan Pal Singh

2013-01-01

Research over the years has introduced multiple interventions for schizophrenia. Notwithstanding the nature of intervention pharmacological or psychological a complete cure for the condition remains a much-desired, yet unachieved goal. What is required is an exploration of alternative intervention strategies for treating schizophrenia a preventive approach is such an option. The chronic nature of schizophrenia and its associated disabilities have a tremendously negative affect the quality of life of patients, their families, and communities. Among the preferred approaches to reducing the negative consequences associated with the disorder is the prevention of its emergence. This review aimed to present the available data on the prevention of schizophrenia data that suggest some pharmacological and non-pharmacological interventions have a potential role in the prevention of schizophrenia. Nonetheless, the findings are restricted to a few sites and are at best preliminary; as such, the findings must be replicated in new studies that include large samples and different settings.

The Role of Perceived Social Support in Explanation of Positive and Negative Syndrome in Patients with Schizophrenia

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akbar Atadokht

2014-12-01

Full Text Available Background & objectives: Chronic psychiatric patients not only become inactive members of community but also the heavy costs of their maintenance and rehabilitation burden on society and their family. According to importance of subject, this study aimed to investigate the role of percieved social support in predicting positive and negative syndrome in patients with schizophrenia.   Methods: In this descriptive-correlational study, 124 patients have been selected among patients with schizophrenia hospitalized in Issar Psychiatric Hospital and Rehabilitation Centers in first 3 mounths of 2014 in Ardabil, Iran and completed Positive and Negative Syndrome Scale (PANSS, Multidimensional Scale of Perceived Social Support (MSPSS and a researcher made demographic checklist. Data were analyzed by Pearson correlation coefficient and multivariate regression analysis on SPSS-16 software and P values less than 0.05 were considered statistically significant.   Results: The mean age of participants was 36.34±9.09 and their education level was mostly (58% primary or illiterate. Results showed that there is a negative relationship between patients positive symptoms index and their family, some others and total social support (p<0.01 and also between negative symptoms index and patients friends, some others and total social support (p<0.05. Results of multivariate regression analysis showed that 11% of positive and negative symptom syndrome are explained by percieved social support in patients with schizophrenia (p<0.01.   Conclusion: Percieved social support has relationship with positive and negative syndrome of patients with schizophrenia and measures to increase resources of social support and promotion of patients percieved social support can be used as an effective intervention by clinicians, patients and their family.

Risk for schizophrenia and schizophrenia-like psychosis among patients with epilepsy: population based cohort study

DEFF Research Database (Denmark)

Qin, Ping; Xu, Huylan; Laursen, Thomas Munk

2005-01-01

.20) in people with a history of epilepsy. The effect of epilepsy was the same in men and in women and increased with age. Family history of psychosis and a family history of epilepsy were significant risk factors for schizophrenia and schizophrenia-like psychosis, and the effect of epilepsy, both in cases......OBJECTIVES: To investigate whether age at onset of epilepsy, type of epilepsy, family history of psychosis, or family history of epilepsy affect the risk of schizophrenia or schizophrenia-like psychosis among patients with epilepsy. DESIGN: Comparison of population based data. SETTING: Danish...... and families, was greater among people with no family history of psychosis. In addition, the increased risk for schizophrenia or schizophrenia-like psychosis did not differ by type of epilepsy but increased with increasing number of admissions to hospital and, particularly, was significantly greater for people...

Are Cardiometabolic and Endocrine Abnormalities Linked to Sleep Difficulties in Schizophrenia? A Hypothesis Driven Review

Science.gov (United States)

Robillard, Rébecca; Rogers, Naomi L.; Whitwell, Bradley G.

2012-01-01

Schizophrenia is a psychiatric disorder that includes symptoms such as hallucinations, disordered thoughts, disorganized or catatonic behaviour, cognitive dysfunction and sleep-wake disturbance. In addition to these symptoms, cardiometabolic dysfunction is common in patients with schizophrenia. While previously it has been thought that cardiometabolic symptoms in patients with schizophrenia were associated with medications used to manage this disorder, more recently it has been demonstrated that these symptoms are present in drug naive and unmedicated patients. Sleep-wake disturbance, resulting in chronic sleep loss has also been demonstrated to induce changes in cardiometabolic function. Chronic sleep loss has been associated with an increased risk for weight gain, obesity and cardiac and metabolic disorders, independent of other potentially contributing factors, such as smoking and body mass index. We hypothesise that the sleep-wake disturbance comorbid with schizophrenia may play a significant role in the high prevalence of cardiometabolic dysfunction observed in this patient population. Here we present a critical review of the evidence that supports this hypothesis. PMID:23429436

Attitudes and beliefs about mental illness among relatives of patients with schizophrenia

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Ajak Manguak Agau

2017-08-01

Full Text Available Background: Schizophrenia is a mental disease with inability to differentiate real from unreal. In many African cultures a traditional view on mental disease results in stigma, negative attitudes, and ignorance of the patient and their symptoms. Objective: To explore the different attitudes and beliefs amongst relatives of patients having schizophrenia. Method: Cross-sectional survey among relatives of patients with schizophrenia treated at Butabika Mental Hospital, Kampala, Uganda. Results: A total of 44 were included. 30% believed schizophrenia to be a brain disease, 32% thought the cause was supernatural. The majority (80% thought that schizophrenia can be treated and preferably in hospitals (91%; 66% felt the best way to reduce schizophrenia was to pray to God, and many stated that being with the patients (73% or letting them be part of the community (80% was good ways of helping the patients. Conclusion: Beliefs about supernatural causes of schizophrenia and stigmatizing are still present in Uganda. However among participants many had positive attitude towards letting the patients be part of community. Education of the communities could be a way of improving the awareness of mental disorders and the role that the community play in recovery from mental illness.

Risk factors for violence among patients with schizophrenia

DEFF Research Database (Denmark)

Bo, Sune; Abu-Akel, Ahmad; Kongerslev, Mickey

2011-01-01

with schizophrenia. We identified two different trajectories for violent behavior in schizophrenia: one pertains to patients with no prior history of violence or criminal behavior and for whom positive symptoms appear to explain violent behavior, and another where personality pathology, including psychopathy...

Impaired coherence of life narratives of patients with schizophrenia.

Science.gov (United States)

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

2015-08-10

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

Neurological soft signs in the clinical course of schizophrenia

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Silke eBachmann

2014-12-01

Full Text Available Neurological soft signs (NSS comprise subtle deficits in sensory integration, motor coordination, and sequencing of complex motor acts which are typically observed in the majority of schizophrenia patients, including chronic cases and neuroleptic-naïve first-episode patients. However, recent studies clearly demonstrate that NSS are not a static feature of schizophrenia but vary in the clinical course of the disorder. This effect was investigated in a meta-analysis based on 17 longitudinal studies published between 1992 and 2012. Studies included between 10 and 93 patients with schizophrenia spectrum disorders (total number 787 with follow-up periods between 2 and 208 weeks. Beside the Neurological Examination Scale, the Cambridge Neurological Inventory and the Heidelberg NSS Scale were used to assess NSS. All but three studies found NSS to decrease in parallel with remission of psychopathological symptoms. This effect was more pronounced in patients with a remitting compared to a non-remitting, chronic course (Cohen´s d 0.81 vs. 0.15 and was significantly correlated with length of the follow-up period (r=-0.64 but not with age (r=0.28. NSS scores did not decrease to the level typically observed in healthy controls. From a clinical perspective, NSS may therefore be used to identify subjects at risk to develop schizophrenia and to monitor disease progression.

Left globus pallidus abnormality in never-medicated patients with schizophrenia

International Nuclear Information System (INIS)

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

1987-01-01

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

Do schizophrenia patients age early?

Science.gov (United States)

Shivakumar, Venkataram; Kalmady, Sunil V; Venkatasubramanian, Ganesan; Ravi, Vasanthapuram; Gangadhar, Bangalore N

2014-08-01

The etiopathogenesis of schizophrenia is poorly understood. Within the proposed "neurodegeneration paradigm", observations have been put forth for "accelerated aging" in this disorder. This proposition is largely based on the neuroscience research that demonstrates progressive changes in brain as well as other systemic abnormalities supportive of faster aging process in patients with this disorder. In this review, we have summarized the literature related to the concept of early aging in schizophrenia. These studies include P300 abnormalities & visual motion discrimination, neuroimaging findings, telomere dynamics as well as neuropathology of related brain regions. We also propose a role of vitamin D, neuroimmunological changes and elevated oxidative stress as well as mitochondrial dysfunction in addition to the above factors with 'vitamin-D deficiency' as the central paradox. Put together, the evidence supporting early aging in schizophrenia is compelling and this requires further systematic studies. Copyright © 2014 Elsevier B.V. All rights reserved.

Hyperglycemia and diabetes in patients with schizophrenia or schizoaffective disorders

NARCIS (Netherlands)

Cohen, D; Stolk, RP; Grobbee, DE; Gispen-De Wied, CC

OBJECTIVE - Pharmacoepidemiological studies have shown an increased prevalence of diabetes in patients with schizophrenia. To address this issue, we decided to assess glucose metabolism in a population of patients With schizophrenia or schizoaffective disorder. RESEARCH DESIGN AND METHODS - Oral

Effectiveness of high-intensity interval training on the mental and physical health of people with chronic schizophrenia

Directory of Open Access Journals (Sweden)

Wu MH

2015-05-01

Full Text Available Meng Hsiu Wu,1,2 Chin Pang Lee,1–3 Shih Chieh Hsu,1,3 Chia Ming Chang,1,3 Ching Yen Chen1–3 1Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; 2Men’s Health Center, Chang Gung Memorial Hospital, Linkou, Taiwan; 3School of Medicine, Chang Gung University, Taoyuan, Taiwan Background: Low-volume high-intensity interval training (HIIT is emerging as a time-efficient exercise strategy for improving cardiorespiratory fitness and for controlling blood sugar levels and hypertension. In addition, patient acceptance of HIIT may improve adherence to exercise programs. This study evaluated the effectiveness of HIIT for improving the mental and physical health of people with chronic schizophrenia. Methods: Twenty patients attending a psychiatric day care unit volunteered for an 8-week program of HIIT. Blood pressure, resting heart rate, body weight, body mass index, waist and hip circumference, and waist-to-hip ratio were measured weekly. The Positive and Negative Syndrome Scale score was recorded at baseline and at the end of the study. Beck Depression Inventory (BDI and Beck Anxiety Inventory (BAI scores were recorded every 2 weeks. Results: Statistically significant changes occurred in the physical and mental parameters measured in the 18 patients who completed the study. Body weight, body mass index, resting heart rate, and pulse pressure decreased significantly. Mean arterial pressure and diastolic blood pressure increased significantly. Mental health scores improved, with the Negative Scale score decreasing from 31.17±5.95 to 27.78±3.57 (P<0.01 and the General Psychopathology Scale score from 14.28±2.16 to 13.00±1.72 (P<0.01. Positive Scale scores changed, but not significantly, from 12.28±2.27 to 12.33±2.00 (P=0.729. Scores on the BDI (from 19.56±15.28 to 15.89±14.33, P<0.001 and BAI (from 13.67±13.83 to 10.06±11.18, P=0.003 both improved significantly. Conclusion: This study demonstrated that HIIT has positive

Schizophrenia causes significant burden to patients' and caregivers' lives.

Science.gov (United States)

Szkultecka-Dębek, Monika; Miernik, Katarzyna; Stelmachowski, Jarosław; Jakovljević, Miro; Jukić, Vlado; Aadamsoo, Kaire; Janno, Sven; Bitter, István; Tolna, Judit; Jarema, Marek; Jankovic, Slobodan; Pecenak, Jan; Vavrusova, Livia; Tavčar, Rok; Walczak, Jacek; Talbot, Darren; Augustyńska, Joanna

2016-06-01

Schizophrenia is a serious public health problem and is ranked among the most disabling diseases in the world. The sub-study presented here was part of a larger project to characterize the burden of schizophrenia on healthcare systems and on individuals living with the disease in Central and Eastern Europe (CEE). This sub-study aimed to assess and analyze the impact of schizophrenia on many aspects of the lives of patients and caregivers. Psychiatrists from selected centers in seven Central and Eastern European countries were asked to complete a questionnaire in order to collect information about the disease history, characteristics, treatment protocols and resources used for each randomly selected patient. All data were statistically analyzed and compared between countries. Data from 961 patients with schizophrenia (mean age 40.7 years, 45.1% female) were included in the analysis. The mean number of days spent in hospital per patient per year across all seven countries was 25.3 days. Hospitalization occurred on average once per year, with psychiatrist visits 9.4 times per year. Of the patients in the study, 61% were single, 12% divorced and 22% married or cohabiting. Almost 84% were living with relatives or a partner; only 17% lived alone and, on average, 25% of patients received support from social workers. Relatives provided care for approximately 60% of patients and 4% of them had to stop working in order to do so. Twenty-nine percent of the patients were unemployed, and 56% received a disability pension or were retired, with only 19% in full-time employment or education. Schizophrenia has a significant effect on the lives of patients and caregivers and impacts their social integration.

Biosocial characteristics of patients with paranoid schizophrenia

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Gergana K. Panayotova

2016-04-01

Full Text Available Schizophrenia is known as a complex disorder that combines both genetic and environmental factors. Different genes have been tested as candidates for association with schizophrenia and different environmental factors have been examined in many studies on epidemiology of schizophrenia. Specific environmental factors, such as nonspecific stress, mental and physical abuse, maternal diet during pregnancy, drug use, living in an urban setting, migration, seasonal effects on birth and exposure to infections, have been discussed as possible risk for schizophrenia. The present preliminary study is focused on the relations between biological and social characteristics of patients with paranoid schizophrenia with different cognitive levels, emotional and creative styles. Descriptive statistics, the Student's t-test and SPSS software, were used to analyse the relations mentioned. Differences between sexes and these concerning age of individuals (risk level of inheritance, ABO blood group distribution, triggering factors, aggressive behavior, single or multiple suicide attempts, levels of education and creative talents were indicated and discussed. The study identifies important trends and discuses essential biosocial relations in context of the knowledge for schizophrenia in Bulgaria. Future comparative investigations, including genetic markers and psychogenetic approaches, should be used in complex, in order to characterize the reasons for developing paranoid schizophrenia and the possible relations between biological, psychological and social factors better.

Clinical and epidemiological aspects of suicide in patients with schizophrenia.

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Gómez-Durán, Esperanza L; Martin-Fumadó, Carles; Hurtado-Ruíz, Gemma

2012-01-01

Suicide is a major cause of death among patients with schizophrenia. Suicide phenomenon's characterization is the best available approach for improved prediction and prevention of suicide. Patients at high risk for suicide need a more intensive monitoring and intervention. The aim of this review is to characterize, from a clinical-epidemiological point of view, the phenomenon of completed suicide in schizophrenia. We performed a systematic review to identify the most relevant studies published between 1994 and 2009, by searching on the international database Medline and among previous reviews references. Patients with schizophrenia experience higher mortality rates than the general population, especially due to the suicide. Most patients with schizophrenia who commit suicide are likely to be young and males, with a higher risk around illness onset and hospitalization periods. Previous suicide attempts are an important risk factor for completed suicide. Suicide risk is associated to psychotic positive symptoms, affective symptoms, depression and substance abuse. Treatment adherence is as protective factor. Patients with schizophrenia are likely to commit suicide by violent means. Suicide prevention should focus on treating affective symptoms and syndromes, improving treatment compliance and providing intensive monitoring to those patients at high risk of suicide, specially around hospitalization periods. Further studies are needed to clarify differential characteristics between suicide behaviour and completed suicide.

An intervention study to prevent relapse in patients with schizophrenia

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van Meijel, B.; Kruitwagen, C.; van der Gaag, M.; Kahn, R.S.; Grypdonck, M.H.E.

2006-01-01

Purpose: To determine whether the use of relapse prevention plans (RPPs) in nursing practice is an effective intervention in reducing relapse rates among patients with schizophrenia. Design and Methods: Experimental design. Patients with schizophrenia (or a related psychotic disorder) and nurses

5-HT3 antagonist for cognition improvement in schizophrenia: a double blind, placebo-controlled trial

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Neyousha Mohammadi

2010-01-01

Full Text Available   Abstract   Introduction: Patients with schizophrenia characteristically exhibit cognitive deficits. The level of cognitive impairment is found to predict the functional outcome of the illness more strongly than the severity of positive or negative symptoms. The purpose of this study was to assess the efficacy of ondansetron, a 5-HT3 receptor antagonist as an adjuvant agent in the treatment of chronic schizophrenia in particular for cognitive impairments.   Methods: This investigation was a 12-week, double blind study of parallel groups of patients with stable chronic schizophrenia. Thirty patients were recruited from inpatient and outpatient departments. All participants met Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision (DSM-IV-TR criteria for schizophrenia. To be eligible, patients were required to have been treated with a stable dose of risperidone as their primary antipsychotic treatment for a minimum period of 8 weeks. The subjects were randomized to receive ondansetron (8 mg/day or the placebo in addition to risperidone. Cognition was measured by a cognitive battery. Patients were assessed at baseline and after 8, and 12 weeks after the medication started.   Results: Administration of ondansetron significantly improved visual memory based on improvement on visual reproduction, visual paired associate and figural memory sub tests of Wechsler Memory Scale Revised.  Discussion: The present study indicates ondansetron as potential adjunctive treatment strategy for chronic schizophrenia particularly for cognitive impairments.

Word and nonword repetition in patients with Schizophrenia

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Alireza Farnam

2015-08-01

Full Text Available Introduction: The assessment of the verbal repetition is important in the study of acquired language disorders and neuropsychology. It is helpful in differential diagnosis of aphasia subtypes, auditory breakdowns, and working memory (WM performance. Though different linguistic disorders have been identified in patients with schizophrenia, very little is known about their verbal repetition ability. Methods: The present study was conducted in the inpatient ward of Razi Psychiatric Hospital, Tabriz University of Medical Sciences, Iran, during the year 2013. Participants were: 30 patients diagnosed with schizophrenia during the maintenance phase of treatment and 30 healthy people as control group. They were asked to repeat 15 words and 15 nonwords immediately. The stimuli were 1, 2, and 3 syllabic in Turkish language. Any incorrect repetition scored 1 and correct repetitions scored 0. Lexicalization errors were compared between groups too. Results: Both groups repeated words better than nonwords. Patients showed lower ability to repeat nonwords than controls, especially in 3 syllabics. There was no significant difference in the repetition of words between groups though it was better in controls. Patients with schizophrenia made more errors in both words and nonwords and lexicalization errors were twice more. Conclusion: Lower ability to repeat nonwords (than words in patients with schizophrenia may show the involvement of phonological loop of WM. More lexicalization errors may take place because of dis-inhibition.

Isochromosome 13 in a patient with childhood-onset schizophrenia, ADHD, and motor tic disorder

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Graw Sharon L

2012-01-01

Full Text Available Abstract Background A small percentage of all cases of schizophrenia have a childhood onset. The impact on the individual and family can be devastating. We report the results of genetic analyses from a patient with onset of visual hallucinations at 5 years, and a subsequent diagnosis at 9 years of schizophrenia, attention deficit hyperactivity disorder (ADHD with hyperactivity and impulsivity, and chronic motor tic disorder. Results Karyotypic analysis found 45,XX,i(13(q10 in all cells examined. Alpha satellite FISH of isochromosome 13 revealed a large unsplit centromeric region, interpreted as two centromeres separated by minimal or undetectable short-arm material or as a single monocentric centromere, indicating that the isochromosome likely formed post-zygotically by a short arm U-type or centromeric exchange. Characterization of chromosome 13 simple tandem repeats and Affymetrix whole-genome 6.0 SNP array hybridization found homozygosity for all markers, and the presence of only a single paternal allele in informative markers, consistent with an isodisomic isochromosome of paternal origin. Analysis of two chromosome 13 schizophrenia candidate genes, D-amino acid oxidase activator (DAOA and 5-hydroxytryptamine (serotonin receptor 2A (5-HTR2A, failed to identify non-synonymous coding mutations but did identify homozygous risk polymorphisms. Conclusions We report a female patient with childhood-onset schizophrenia, ADHD, and motor tic disorder associated with an isodisomic isochromosome 13 of paternal origin and a 45,XX,i(13(q10q10 karyotype. We examined two potential mechanisms to explain chromosome 13 involvement in the patient's pathology, including reduction to homozygosity of a paternal mutation and reduction to homozygosity of a paternal copy number variation, but were unable to identify any overtly pathogenic abnormality. Future studies may consider whether epigenetic mechanisms resulting from uniparental disomy (UPD and the lack of

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

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

2016-01-01

Schizophrenia is thought to be associated with impairments of executive functions, among which conflict control functions play an important role. The available evidence, however, suggests that conflict control is intact in schizophrenia, despite being based on methods that have successfully unveiled conflict control problems in other disorders. Differences between schizophrenia patients and healthy controls in stimulus perception, selective attention, alertness, processing speed and reaction time variability may have been previously overlooked. By controlling for these potential confounders, the present experiments were aimed to be more rigorous tests of the hypothesis that psychosis and schizophrenia are associated with impairments of conflict control. To that end, 27 healthy controls and 53 recent-onset psychosis patients with (n = 27) and without schizophrenia (n = 26) with comparable age, intelligence, and education level, performed three iconic conflict control tasks: the Simon task, the Eriksen flanker task, and the Stroop task, all equipped with neutral trials, and analyzed for various potential confounders. They further performed a battery of standard neuropsychological tests. Schizophrenia patients showed no increased conflict effects in any of the 3 tasks for any alternative measures used. Nonschizophrenia patients only showed abnormally increased response competition in the Simon task. All patients nevertheless demonstrated impaired control of attention and verbal memory. These findings indicate that the type of conflict control engaged by conflict tasks is intact in recent-onset schizophrenia, suggesting that a major component of executive function is spared in schizophrenia. We discuss these findings in terms of proactive and reactive control. (c) 2016 APA, all rights reserved.

S175. AMOTIVATION IS ASSOCIATED WITH SMALLER VENTRAL STRIATUM VOLUMES IN OLDER PATIENTS WITH SCHIZOPHRENIA

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Caravaggio, Fernando; Fervaha, Gagan; Iwata, Yusuke; Plitman, Eric; Chung, Jun Ku; Nakajima, Shinichiro; Mar, Wanna; Gerretsen, Philip; Kim, Julia; Chakravarty, Mallar; Mulsant, Benoit; Pollock, Bruce; Mamo, David; Remington, Gary; Graff-Guerrero, Ariel

2018-01-01

Abstract Background Motivational deficits are prevalent in patients with schizophrenia, persist despite antipsychotic treatment, and predict long‐term outcomes. Evidence suggests that patients with greater amotivation have smaller ventral striatum (VS) volumes. We wished to replicate this finding in a sample of older, chronically medicated patients with schizophrenia. Using structural imaging and positron emission tomography, we examined whether amotivation uniquely predicted VS volumes beyond the effects of striatal dopamine D2/3 receptor (D2/3R) blockade by antipsychotics. Methods Data from 41 older schizophrenia patients (mean age: 60.2 ± 6.7; 11 female) were reanalysed from previously published imaging data. We constructed multivariate linear stepwise regression models with VS volumes as the dependent variable and various sociodemographic and clinical variables as the initial predictors: age, gender, total brain volume, and antipsychotic striatal D2/3R occupancy. Amotivation was included as a subsequent step to determine any unique relationships with VS volumes beyond the contribution of the covariates. In a reduced sample (n = 36), general cognition was also included as a covariate. Results Amotivation uniquely explained 8% and 6% of the variance in right and left VS volumes, respectively (right: β = -.38, t = -2.48, P = .01; left: β = -.31, t = -2.17, P = .03). Considering cognition, amotivation levels uniquely explained 9% of the variance in right VS volumes (β = -.43, t = -0.26, P = .03). Discussion We replicate and extend the finding of reduced VS volumes with greater amotivation. We demonstrate this relationship uniquely beyond the potential contributions of striatal D2/3R blockade by antipsychotics. Elucidating the structural correlates of amotivation in schizophrenia may help develop treatments for this presently irremediable deficit.

Effects of gamma-aminobutyric acid-modulating drugs on working memory and brain function in patients with schizophrenia.

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Menzies, Lara; Ooi, Cinly; Kamath, Shri; Suckling, John; McKenna, Peter; Fletcher, Paul; Bullmore, Ed; Stephenson, Caroline

2007-02-01

Cognitive impairment causes morbidity in schizophrenia and could be due to abnormalities of cortical interneurons using the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). To test the predictions that cognitive and brain functional responses to GABA-modulating drugs are correlated and abnormal in schizophrenia. Pharmacological functional magnetic resonance imaging study of 2 groups, each undergoing scanning 3 times, using an N-back working memory task, after placebo, lorazepam, or flumazenil administration. Eleven patients with chronic schizophrenia were recruited from a rehabilitation service, and 11 healthy volunteers matched for age, sex, and premorbid IQ were recruited from the local community. Intervention Participants received 2 mg of oral lorazepam, a 0.9-mg intravenous flumazenil bolus followed by a flumazenil infusion of 0.0102 mg/min, or oral and intravenous placebo. Working memory performance was summarized by the target discrimination index at several levels of difficulty. Increasing (or decreasing) brain functional activation in response to increasing task difficulty was summarized by the positive (or negative) load response. Lorazepam impaired performance and flumazenil enhanced it; these cognitive effects were more salient in schizophrenic patients. Functional magnetic resonance imaging demonstrated positive load response in a frontoparietal system and negative load response in the temporal and posterior cingulate regions; activation of the frontoparietal cortex was positively correlated with deactivation of the temporocingulate cortex. After placebo administration, schizophrenic patients had abnormally attenuated activation of the frontoparietal cortex and deactivation of the temporocingulate cortex; this pattern was mimicked in healthy volunteers and exacerbated in schizophrenic patients by lorazepam. However, in schizophrenic patients, flumazenil enhanced deactivation of the temporocingulate and activation of the anterior cingulate

Memory profiles in parents of patients with schizophrenia.

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Sitskoorn, Margriet M; Ebisch, Sjoerd J H; Appels, Melanie; Nuyen, Jasper; Kahn, René S

2004-08-30

Recent research shows that categorizing patients with schizophrenia based on frontal-striatal and frontal-temporal memory profiles may yield neurobiologically meaningful disease subtypes. We hypothesize that parents of patients exhibit similar memory profiles. Both parents of 36 patients with schizophrenia (N = 72) and 26 healthy married control couples (N = 52) participated in this study. All subjects were physically healthy and had no history of neurological illness or alcohol/drug abuse. The presence of a psychiatric and/or personality disorder was assessed with the Comprehensive Assessment of Symptoms and History (CASH) interview, the Schedule for Affective Disorders and Schizophrenia-lifetime (SADS-L) interview and the Structured Interview for DSM-IV Personality Disorders (SIDP-IV), respectively. Cluster analysis of selected measures from the Dutch version of the California Verbal Learning Test (CVLT) delineated parents into two subgroups with distinct memory deficits and a third subgroup without impairments. Specific frontal-striatal and frontal-temporal subgroups, however, were not found. In addition, our results indicated that mothers seem to be more protected against the negative effects of genetic liability to schizophrenia than fathers. Furthermore, relatives with a higher level of intelligence may have more cognitive reserve to compensate for the negative impact of implied brain dysfunction on verbal memory than relatives with a low level of intelligence. Although the parents of patients with schizophrenia could be delineated into subgroups with primary memory deficits, frontal-striatal and frontal-temporal subgroups could not be unambiguously identified. The association that emerged between level of intelligence, gender and severity of memory impairment deserves further exploration.

Marital adjustment of patients with substance dependence, schizophrenia and bipolar affective disorder

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Shital S Muke

2014-01-01

Full Text Available Background: Marital adjustment is considered as a part of social well-being. Disturbed marital relationship can directly affect the disease adjustment and the way they face disease outcomes and complications. It may adversely affect physical health, mental health, the quality-of-life and even economic status of individuals. Aim: The aim of this study was to compare the marital adjustment among patients with substance dependence, schizophrenia and bipolar affective disorder. Materials and Methods: The sample consisted of each 30 patients with substance dependence, bipolar affective disorder and schizophrenia, diagnosed as per international classification of diseases-10 diagnostic criteria for research with a minimum duration of illness of 1 year were evaluated using marital adjustment questionnaire. The data was analyzed using parametric and non-parametric statistics. Results: Prevalence of poor marital adjustment in patients with schizophrenia, bipolar affective disorder and substance dependence was 60%, 70% and 50% respectively. There was a significant difference on overall marital adjustment among substance dependence and bipolar affective disorder patients. There was no significant difference on overall marital adjustment among patients with substance dependence and schizophrenia as well as among patients with schizophrenia and bipolar affective disorder. On marital adjustment domains, schizophrenia patients had significantly poor sexual adjustment than substance dependence patients while bipolar affective disorder patients had significantly poor sexual and social adjustment compared with substance dependence patients. Conclusion: Patients with substance dependence have significant better overall marital adjustment compared with bipolar affective disorder patients. Patients with substance dependence have significantly better social and sexual adjustment than patients with bipolar affective disorder as well as significantly better sexual

Predictors of resocialization of patients with schizophrenia: medico-sociological analysis

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Zhukova О.A.

2012-03-01

Full Text Available Processes of urbanization, stressful events and other social trends of the modern world are considered as the social predictors determining the growth of frequency of mental illness. They are directly associated with manifestations of mental disorders, including schizophrenia. The majority of people is subjected to mental disorders living in unfavorable conditions. According to severe social consequences schizophrenia takes the leading position in psychiatry. Course of schizophrenia is one of the main clinical predictors of clinical and social prognosis. The research has established that the clinical predictors determining the severity of non-cancerous condition of patients with schizophrenia are not obligate in the socialization of the patients.

High-functioning autism patients share similar but more severe impairments in verbal theory of mind than schizophrenia patients.

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Tin, L N W; Lui, S S Y; Ho, K K Y; Hung, K S Y; Wang, Y; Yeung, H K H; Wong, T Y; Lam, S M; Chan, R C K; Cheung, E F C

2018-06-01

Evidence suggests that autism and schizophrenia share similarities in genetic, neuropsychological and behavioural aspects. Although both disorders are associated with theory of mind (ToM) impairments, a few studies have directly compared ToM between autism patients and schizophrenia patients. This study aimed to investigate to what extent high-functioning autism patients and schizophrenia patients share and differ in ToM performance. Thirty high-functioning autism patients, 30 schizophrenia patients and 30 healthy individuals were recruited. Participants were matched in age, gender and estimated intelligence quotient. The verbal-based Faux Pas Task and the visual-based Yoni Task were utilised to examine first- and higher-order, affective and cognitive ToM. The task/item difficulty of two paradigms was examined using mixed model analyses of variance (ANOVAs). Multiple ANOVAs and mixed model ANOVAs were used to examine group differences in ToM. The Faux Pas Task was more difficult than the Yoni Task. High-functioning autism patients showed more severely impaired verbal-based ToM in the Faux Pas Task, but shared similar visual-based ToM impairments in the Yoni Task with schizophrenia patients. The findings that individuals with high-functioning autism shared similar but more severe impairments in verbal ToM than individuals with schizophrenia support the autism-schizophrenia continuum. The finding that verbal-based but not visual-based ToM was more impaired in high-functioning autism patients than schizophrenia patients could be attributable to the varied task/item difficulty between the two paradigms.

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

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

2015-05-01

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

[Religiousness of patients with diagnosis of schizophrenia. Wide-ranging studies].

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Tomczak, Piotr

2006-01-01

(1) The correlations between: (1.1) various aspects of religiousness and (1.2) age, anxiety-state, anxiety-trait, locus of control, and, in the group of patients with shizophrenia: span of treatment, rate of therapy, ego psychopathology, paranoid and depression dimensions, self-rating of state of self-feeling, state of feeling of illness, and quality of life and (2) the comparison of various aspects of religiousness of patients with schizophrenia and healthy people were studied. The Scale of Christian Religiousness, Individual Religiousness Scale, Intrinsic, Extrinsic and Quest Religious Orientation Scales, Scale of Fundamentalism, State-Trait Anxiety Inventory, Rotter's questionnaire of locus of control, Scharfetter's questionnaire of ego psychopathology, Paranoid-Depresivity Scale-abridgment, Frankfurt Self-feeling Scale-abridgment, visual analogy of self-feeling, visual analogy of feeling of illness, and questionnaire of quality of life (WHOQOL-BREF) were used in the study. 91 adults both of sexes, 60 patients with a diagnosis of schizophrenia according to ICD-10 and DCR-10 in the diagnostic group and 31 healthy persons were studied. It was noticed that: (1) various correlations are manifested between religiousness and psychopathology of patients with schizophrenia; (2) patients diagnosed as having schizophrenia have a significantly higher level of extrinsic religiousness and fundamentalism than healthy individuals; (3) many results pointed out in the bibliography had no verification in these studies. Intrinsic, extrinsic, quest, and orthodox religiousness and fundamentalism realize significant functions in psychopathology of schizophrenia disorder. The knowledge about religiousness of schizophrenia patients can be important for diagnostic and therapeutic processes of the disorder.

A family affair: brain abnormalities in siblings of patients with schizophrenia

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Hulshoff Pol, Hilleke; Gogtay, Nitin

2013-01-01

Schizophrenia is a severe mental disorder that has a strong genetic basis. Converging evidence suggests that schizophrenia is a progressive neurodevelopmental disorder, with earlier onset cases resulting in more profound brain abnormalities. Siblings of patients with schizophrenia provide an invaluable resource for differentiating between trait and state markers, thus highlighting possible endophenotypes for ongoing research. However, findings from sibling studies have not been systematically put together in a coherent story across the broader age span. We review here the cortical grey matter abnormalities in siblings of patients with schizophrenia from childhood to adulthood, by reviewing sibling studies from both childhood-onset schizophrenia, and the more common adult-onset schizophrenia. When reviewed together, studies suggest that siblings of patients with schizophrenia display significant brain abnormalities that highlight both similarities and differences between the adult and childhood populations, with shared developmental risk patterns, and segregating trajectories. Based on current research it appears that the cortical grey matter abnormalities in siblings are likely to be an age-dependent endophenotype, which normalize by the typical age of onset of schizophrenia unless there has been more genetic or symptom burdening. With increased genetic burdening (e.g. discordant twins of patients) the grey matter abnormalities in (twin) siblings are progressive in adulthood. This synthesis of the literature clarifies the importance of brain plasticity in the pathophysiology of the illness, indicating that probands may lack protective factors critical for healthy development. PMID:23698280

Treatment with Ziprasidone for schizophrenia patients with OCD.

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

2014-09-01

Comorbidity of obsessive-compulsive disorder (OCD) has been observed in about 15% of schizophrenic patients and has been associated with poor prognosis. Therefore, there is a need for specific treatment options for these patients (schizo-obsessive, ScOCD). This is an open, prospective study, aiming to test the efficacy of Ziprasidone (80-200mg/d) in ScOCD patients and comparing the response to the treatment between stable schizophrenic (N=16) and stable ScOCD (N=29) patients. Treatment effect with Ziprasidone was different in schizophrenic patients when stratified based on OCD comorbidity. Overall, the effect on OCD symptoms (as measured by the Yale Brown Obsessive Compulsive Scale, YBOCS) was found to be bimodal-either no response or exacerbation (for 45% of the patients, n=13) or significant improvement of symptoms (55%, n=16). Those who improved in OCD symptoms, improved also in negative and general schizophrenia symptoms, while ScOCD-unimproved group worsened in all symptoms. Whereas schizophrenic patients without OCD responded in a modest Gaussian distribution, they improved in schizophrenia negative symptoms and in general anxiety. This data suggests that schizo-obsessive disorder is a distinct and complex condition with more than one underlying pathogenesis. Definition of these ScOCD subgroups defined by their response to Ziprasidone might contribute to personalized medicine within the OCD-schizophrenia spectrum. Moreover, this finding suggests that ScOCD may be considered as a special schizophrenic subtype and its inclusion in schizophrenia treatment studies need to be further explored due to its divergent response. Copyright © 2014. Published by Elsevier B.V.

Body composition in patients with schizophrenia: Comparison with healthy controls

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Sugawara Norio

2012-05-01

Full Text Available Abstract Background Recently, a relationship between obesity and schizophrenia has been reported. Although fat- mass and fat free mass have been shown to be more predictive of health risk than body mass index, there are limited findings about body composition among patients suffering from schizophrenia. The aim of this study is to compare the body composition of schizophrenia patients with that of healthy subjects in Japan. Methods We recruited patients (n = 204, aged 41.3 ± 13.8 (mean ± SD years old with the DSM-IV diagnosis of schizophrenia who were admitted to psychiatric hospital using a cross-sectional design. Subjects' anthropometric measurements including weight, height, body mass index (BMI, and medications were also collected. Body fat, percent (% body fat, fat- free mass, muscle mass, and body water were measured using the bioelectrical impedance analysis (BIA method. Comparative analysis was performed with schizophrenic subjects and 204 healthy control individuals. Results In a multiple regression model with age, body mass index, and dose in chlorpromazine equivalents, schizophrenia was a significantly linked with more body fat, higher % body fat, lower fat- free mass, lower muscle mass, and lower body water among males. In females, schizophrenia had a significant association with lower % body fat, higher fat- free mass, higher muscle mass, and higher body water. Conclusions Our data demonstrate gender differences with regard to changes in body composition in association with schizophrenia. These results indicate that intervention programs designed to fight obesity among schizophrenic patients should be individualized according to gender.

Mismatch Negativity in Patients with Schizophrenia

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Aleš Urban

2007-01-01

Full Text Available Cognitive deficit is considered to be a part of core dysfuncions in schizophrenia. It is associated with social impairment and influences the long-term course of the disorder. In addition to neuropsychological methods, event-related potentials can be used to study cognitive functions. In patients with schizophrenia an association was found between amplitude changes in slow negative component of evoked responses and infrequent deviations in a series of uniform stimuli. This amplitude change is known as „mismatch negativity“ (MMN. It is supposed to be independent of the focused attention and effort that otherwise interfere with neuropsychological testing. Recently accumulated knowledge on MMN as a possible preattentive measure of cognition supports its potential significance for neuropsychological assessment. It may be helpful in more precise diagnosis and functional evaluation of schizophrenia.

Village doctor-assisted case management of rural patients with schizophrenia: protocol for a cluster randomized control trial.

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Gong, Wenjie; Xu, Dong; Zhou, Liang; Brown, Henry Shelton; Smith, Kirk L; Xiao, Shuiyuan

2014-01-16

Strict compliance with prescribed medication is the key to reducing relapses in schizophrenia. As villagers in China lack regular access to psychiatrists to supervise compliance, we propose to train village 'doctors' (i.e., villagers with basic medical training and currently operating in villages across China delivering basic clinical and preventive care) to manage rural patients with schizophrenia with respect to compliance and monitoring symptoms. We hypothesize that with the necessary training and proper oversight, village doctors can significantly improve drug compliance of villagers with schizophrenia. We will conduct a cluster randomized controlled trial in 40 villages in Liuyang, Hunan Province, China, home to approximately 400 patients with schizophrenia. Half of the villages will be randomized into the treatment group (village doctor, or VD model) wherein village doctors who have received training in a schizophrenia case management protocol will manage case records, supervise drug taking, educate patients and families on schizophrenia and its treatment, and monitor patients for signs of relapse in order to arrange prompt referral. The other 20 villages will be assigned to the control group (case as usual, or CAU model) wherein patients will be visited by psychiatrists every two months and receive free antipsychotic medications under an on-going government program, Project 686. These control patients will receive no other management or follow up from health workers. A baseline survey will be conducted before the intervention to gather data on patient's socio-economic status, drug compliance history, and clinical and health outcome measures. Data will be re-collected 6 and 12 months into the intervention. A difference-in-difference regression model will be used to detect the program effect on drug compliance and other outcome measures. A cost-effectiveness analysis will also be conducted to compare the value of the VD model to that of the CAU group. Lack of

Differential impairment on measures of attention in patients with paranoid and nonparanoid schizophrenia.

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Chan, Michelle W C; Yip, James T H; Lee, Tatia M C

2004-01-01

The purpose of the present study is to investigate whether patients with different subtypes of schizophrenia are differentially impaired on measures of attention. Forty-eight patients with schizophrenia (19 paranoid and 29 nonparanoid) and 48 healthy controls (matched on chronological age, sex, and years of education) were administered five measures of attention including the Stroop Color-Word Test (SCWT; Stroop, 1935), the Digit Vigilance Test (DVT; Lewis, 1992), the Symbol Digit Modalities Test (SDMT; Smith, 1982), the Backward Digit Span Test (BDST; Wechsler, 1987), and the Color Trails Test (CTT; D'Elia et al., 1996) to assess selective attention, sustained attention, switching attention, and attentional control processing by the latter two tests respectively. Results from the present study showed that patients with schizophrenia performed poorer on the SCWT, the DVT, and the SDMT, relative to their healthy counterparts. Furthermore, patients with different subtypes of schizophrenia also had different degrees of attentional impairment. While patients with paranoid schizophrenia performed worse on the SCWT, those with nonparanoid schizophrenia performed worse on the SDMT. Nevertheless, these findings may suggest that patients with paranoid and nonparanoid schizophrenia may have different profiles with respect to their performances on measures of attention.

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

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Arango, Celso

2014-01-01

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

Rethinking schizophrenia.

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Insel, Thomas R

2010-11-11

How will we view schizophrenia in 2030? Schizophrenia today is a chronic, frequently disabling mental disorder that affects about one per cent of the world's population. After a century of studying schizophrenia, the cause of the disorder remains unknown. Treatments, especially pharmacological treatments, have been in wide use for nearly half a century, yet there is little evidence that these treatments have substantially improved outcomes for most people with schizophrenia. These current unsatisfactory outcomes may change as we approach schizophrenia as a neurodevelopmental disorder with psychosis as a late, potentially preventable stage of the illness. This 'rethinking' of schizophrenia as a neurodevelopmental disorder, which is profoundly different from the way we have seen this illness for the past century, yields new hope for prevention and cure over the next two decades.

Relationship between abstract thinking and eye gaze pattern in patients with schizophrenia

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2014-01-01

Background Effective integration of visual information is necessary to utilize abstract thinking, but patients with schizophrenia have slow eye movement and usually explore limited visual information. This study examines the relationship between abstract thinking ability and the pattern of eye gaze in patients with schizophrenia using a novel theme identification task. Methods Twenty patients with schizophrenia and 22 healthy controls completed the theme identification task, in which subjects selected which word, out of a set of provided words, best described the theme of a picture. Eye gaze while performing the task was recorded by the eye tracker. Results Patients exhibited a significantly lower correct rate for theme identification and lesser fixation and saccade counts than controls. The correct rate was significantly correlated with the fixation count in patients, but not in controls. Conclusions Patients with schizophrenia showed impaired abstract thinking and decreased quality of gaze, which were positively associated with each other. Theme identification and eye gaze appear to be useful as tools for the objective measurement of abstract thinking in patients with schizophrenia. PMID:24739356

Plasma HVA, tardive dyskinesia and psychotic symptoms in long-term drug-free inpatients with schizophrenia.

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Muscettola, G; Barbato, G; de Bartolomeis, A; Monteleone, P; Pickar, D

1990-09-01

Plasma homovanillic acid (pHVA) levels were measured in 16 chronically ill patients with schizophrenia who also suffered from tardive dyskinesia, and in a group of 14 chronically ill patients with schizophrenia who did not have tardive dyskinesia. All patients were studied following an extensive drug-free period (mean = 32.9 months). Patients with orofacial dyskinesia had significantly lower levels of pHVA than did controls. In patients without tardive dyskinesia, pHVA levels were significantly correlated with both positive and negative symptomatology. In contrast, pHVA levels from patients with tardive dyskinesia bore neither a significant nor a nearly significant relationship to symptomatology. The implications of these findings for dopaminergic models of tardive dyskinesia are discussed.

Relative risk of probabilistic category learning deficits in patients with schizophrenia and their siblings

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Weickert, Thomas W.; Goldberg, Terry E.; Egan, Michael F.; Apud, Jose A.; Meeter, Martijn; Myers, Catherine E.; Gluck, Mark A; Weinberger, Daniel R.

2010-01-01

Background While patients with schizophrenia display an overall probabilistic category learning performance deficit, the extent to which this deficit occurs in unaffected siblings of patients with schizophrenia is unknown. There are also discrepant findings regarding probabilistic category learning acquisition rate and performance in patients with schizophrenia. Methods A probabilistic category learning test was administered to 108 patients with schizophrenia, 82 unaffected siblings, and 121 healthy participants. Results Patients with schizophrenia displayed significant differences from their unaffected siblings and healthy participants with respect to probabilistic category learning acquisition rates. Although siblings on the whole failed to differ from healthy participants on strategy and quantitative indices of overall performance and learning acquisition, application of a revised learning criterion enabling classification into good and poor learners based on individual learning curves revealed significant differences between percentages of sibling and healthy poor learners: healthy (13.2%), siblings (34.1%), patients (48.1%), yielding a moderate relative risk. Conclusions These results clarify previous discrepant findings pertaining to probabilistic category learning acquisition rate in schizophrenia and provide the first evidence for the relative risk of probabilistic category learning abnormalities in unaffected siblings of patients with schizophrenia, supporting genetic underpinnings of probabilistic category learning deficits in schizophrenia. These findings also raise questions regarding the contribution of antipsychotic medication to the probabilistic category learning deficit in schizophrenia. The distinction between good and poor learning may be used to inform genetic studies designed to detect schizophrenia risk alleles. PMID:20172502

Cognitive Assessment Interview (CAI): Validity as a co-primary measure of cognition across phases of schizophrenia.

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Ventura, Joseph; Subotnik, Kenneth L; Ered, Arielle; Hellemann, Gerhard S; Nuechterlein, Keith H

2016-04-01

Progress has been made in developing interview-based measures for the assessment of cognitive functioning, such as the Cognitive Assessment Interview (CAI), as co-primary measures that compliment objective neurocognitive assessments and daily functioning. However, a few questions remain, including whether the relationships with objective cognitive measures and daily functioning are high enough to justify the CAI as an co-primary measure and whether patient-only assessments are valid. Participants were first-episode schizophrenia patients (n=60) and demographically-similar healthy controls (n=35), chronic schizophrenia patients (n=38) and demographically similar healthy controls (n=19). Participants were assessed at baseline with an interview-based measure of cognitive functioning (CAI), a test of objective cognitive functioning, functional capacity, and role functioning at baseline, and in the first episode patients again 6 months later (n=28). CAI ratings were correlated with objective cognitive functioning, functional capacity, and functional outcomes in first-episode schizophrenia patients at similar magnitudes as in chronic patients. Comparisons of first-episode and chronic patients with healthy controls indicated that the CAI sensitively detected deficits in schizophrenia. The relationship of CAI Patient-Only ratings with objective cognitive functioning, functional capacity, and daily functioning were comparable to CAI Rater scores that included informant information. These results confirm in an independent sample the relationship of the CAI ratings with objectively measured cognition, functional capacity, and role functioning. Comparison of schizophrenia patients with healthy controls further validates the CAI as an co-primary measure of cognitive deficits. Also, CAI change scores were strongly related to objective cognitive change indicating sensitivity to change. Copyright © 2016 Elsevier B.V. All rights reserved.

[Chronical care of schizophrenia].

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Lustygier, V

2010-09-01

Schizophrenia is a complex mental disease leading to many deficits that needs a broad range of therapeutic interventions. The recent data raises the importance of the cognitive revalidation even though other interventions are also necessary in the treatment. The asylums of the former century have experienced a slow and continuous process of patient's deinstitutionalization. The global knowledge of the disorder having progressed, new multidisciplinary and multidimensional models of managing are now proposed. The psychiatric rehabilitation is one of those models having as goal the global taking charge of the disease, from the managing of the symptoms to the return to a life with good quality. The great specificity of this rehabilitation work is that it's multidisciplinary and involves a strong collaboration between the medical and the psychosocial intervening party's around a common therapeutic project. This model brings up the notion of recovery witch is, not the cure but, the experience that a patient acquires as he accepts the situation and as he recovers the feeling of being able to get going again.

Quality of Care and Outcomes of Heart Failure Among Patients With Schizophrenia in Denmark

DEFF Research Database (Denmark)

Jorgensen, Mette; Mainz, Jan; Egstrup, Kenneth

2017-01-01

care among patients with schizophrenia included patient-specific factors (age, gender, Global Assessment of Functioning [GAF] score, alcohol or drug abuse, duration of schizophrenia); provider-specific factors (quality of schizophrenia care); and system-specific factors (patient-volume defined......Research on the association between schizophrenia and the quality of care and clinical outcomes of heart failure (HF) remains sparse. This nationwide study compared the quality of care and clinical outcomes of HF among Danish patients with and without schizophrenia. In a population-based cohort...... study, we identified 36,718 patients with incident HF with hospital contacts, including 108 with schizophrenia, using Danish registries between 2004 and 2013. High quality of HF care was defined as receiving ≥ 80% guideline-recommended process-performance measures of care. Potential predictors of HF...

The Correlates of Quality of Life Among Jordanian Patients With Schizophrenia.

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Rayan, Ahmad; Obiedate, Khaldoon

Addressing the quality of life (QOL) of patients with schizophrenia is of special importance in the Arab world, where little knowledge is available about their well-being, and most of them experience stigma and living in poverty. The purpose of this study was to examine the association of sociodemographic characteristics, severity of depressive symptoms, and various aspects of public stigma against mental illness, with QOL among Jordanian patients with schizophrenia. In this descriptive correlational study, 160 Jordanian outpatients diagnosed with schizophrenia completed measures of demographic characteristics, perceived public stigma against mental illness, severity of depression, and QOL. Participants had poor QOL. Age, marital status, relapse, education level, stigma against mental illness, and severity of depression were significantly associated with QOL among Jordanian patients with schizophrenia. Data analysis revealed that the severity of depression accounted for an additional 27% of the variance above and beyond the 36.7% accounted for by age of the participants and perceived public stigma against mental illness. Health care professionals should develop culturally competent nursing practice considering the specific factors associated with QOL among Arab patients with schizophrenia.

The Basis of Feeling-of-Knowing Judgments in Patients with Schizophrenia

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Bacon, Elisabeth; Pillot, Mathieu; Izaute, Marie; Schwartz, Bennett L.

2018-01-01

We examined the basis of feeling-of-knowing judgments (FOK) in patients with schizophrenia. Such patients typically have impaired memory and awareness, but not metamemory-accuracy deficits. The magnitude of FOKs are lower for patients with schizophrenia than for healthy participants, but judgments equally predict memory performance. In healthy…

Brain volumes in relatives of patients with schizophrenia - A meta-analysis

NARCIS (Netherlands)

Boos, Heleen B. M.; Aleman, Andre; Cahn, Wiepke; Pol, Hilleke Hulshoff; Kahn, Rene S.

Context: Smaller brain volumes have consistently been found in patients with schizophrenia, particularly in gray matter and medial temporal lobe structures. Although several studies have investigated brain volumes in nonpsychotic relatives of patients with schizophrenia, results have been

Effects of behavioral therapy on weight loss in overweight and obese patients with schizophrenia or schizoaffective disorder.

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Brar, Jaspreet S; Ganguli, Rohan; Pandina, Gahan; Turkoz, Ibrahim; Berry, Sally; Mahmoud, Ramy

2005-02-01

Obesity is common in persons with schizophrenia. Besides its adverse health effects, obesity reduces quality of life and contributes to the social stigma of schizophrenia. This 14-week, multicenter, open-label, rater-blinded, randomized study evaluated the effects of a group-based behavioral treatment (BT) for weight loss in overweight and obese stable patients with DSM-IV schizophrenia or schizoaffective disorder who had been switched from olanzapine to risperidone. Participants were randomly assigned to receive BT or usual clinical care (UC). BT included 20 sessions during which patients were taught to reduce caloric intake. In UC, patients were encouraged to lose weight but received no special advice about weight reduction. The primary outcome measure was change in body weight. Seventy-two patients were enrolled. The mean +/- SD weight loss at endpoint was significant in both groups (p or = 5% of their body weight at endpoint (26.5% [9/34] and 10.8% [4/37], respectively; p = .082). A post hoc analysis of patients attending at least 1 BT session showed that significantly more patients in the BT than the UC group had lost > or = 5% of their body weight at endpoint (32.1% [9/28] vs. 10.8% [4/37], respectively, p = .038) and at week 14 (complete population; 40.9% [9/22] and 14.3% [4/28], respectively, p = .027). BT may be an effective method for weight reduction in patients with chronic psychotic illness.

A COMPARATIVE STUDY OF ORAL OLANZAPINE AND ORAL HALOPERIDOL ON GLUCOSE TOLERANCE LEVELS IN PATIENTS WITH SCHIZOPHRENIA

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G N S Sangeetha Lakshmi

2015-08-01

Full Text Available Background: Schizophrenia is a mental disorder characterized by persistent defects in the perception, thinking or the expression of reality. The term “schizophrenia” translates roughly as “shattered mind,” and comes from the Greek (schizo, “to split” or “to divide” and (phrēn, “mind”. Material and Methods: The study was designed to be a prospective control study. Schizophrenic patients taking Olanzapine and Haloperidol were selected and follow up at three weeks and six weeks was done. Results: In this prospective control study, Olanzapine and Haloperidol were associated with an increase in Blood Glucose Levels. The mean changes in Glucose remained within clinically normal range in this six week study. Conclusion: Antipsychotic treatmemt leads to the development of Diabetes mellitus in a significant 10.1% of patients within 6 weeks. Given the serious implications for morbidity and mortality attributable to diabetes mellitus, clinicians need to be aware of these risk factors when treating patients with chronic schizophrenia

An interactive sports video game as an intervention for rehabilitation of community-living patients with schizophrenia: A controlled, single-blind, crossover study.

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Shimizu, Nobuko; Umemura, Tomohiro; Matsunaga, Masahiro; Hirai, Takayoshi

2017-01-01

Hypofrontality is a state of decreased cerebral blood flow in the prefrontal cortex during executive function performance; it is commonly observed in patients with schizophrenia. Cognitive dysfunction, as well as the psychological symptoms of schizophrenia, influences the ability of patients to reintegrate into society. The current study investigated the effects of an interactive sports video game (IVG; Nintendo Wii™ Sports Resort) on frontal lobe function of patients with schizophrenia. A sample of eight patients (6 male and 2 female; mean age = 46.7 years, standard deviation (SD) = 13.7) engaged in an IVG every week for 3 months in a controlled, single-blind, crossover study. Before and after the intervention we examined frontal lobe blood-flow volume using functional near-infrared spectroscopy (fNIRS), and assessed functional changes using the Frontal Assessment Battery, Health-Related Quality of Life scale, and behaviorally-assessed physical function tests. fNIRS revealed that prefrontal activity during IVG performance significantly increased in the IVG period compared with the control period. Furthermore, significant correlations between cerebral blood flow changes in different channels were observed during IVG performance. In addition, we observed intervention-related improvement in health-related quality of life following IVG. IVG intervention was associated with increased prefrontal cortex activation and improved health-related quality of life performance in patients with schizophrenia. Patients with chronic schizophrenia are characterized by withdrawal and a lack of social responsiveness or interest in others. Interventions using IVG may provide a useful low-cost rehabilitation method for such patients, without the need for specialized equipment.

An interactive sports video game as an intervention for rehabilitation of community-living patients with schizophrenia: A controlled, single-blind, crossover study.

Directory of Open Access Journals (Sweden)

Nobuko Shimizu

Full Text Available Hypofrontality is a state of decreased cerebral blood flow in the prefrontal cortex during executive function performance; it is commonly observed in patients with schizophrenia. Cognitive dysfunction, as well as the psychological symptoms of schizophrenia, influences the ability of patients to reintegrate into society. The current study investigated the effects of an interactive sports video game (IVG; Nintendo Wii™ Sports Resort on frontal lobe function of patients with schizophrenia. A sample of eight patients (6 male and 2 female; mean age = 46.7 years, standard deviation (SD = 13.7 engaged in an IVG every week for 3 months in a controlled, single-blind, crossover study. Before and after the intervention we examined frontal lobe blood-flow volume using functional near-infrared spectroscopy (fNIRS, and assessed functional changes using the Frontal Assessment Battery, Health-Related Quality of Life scale, and behaviorally-assessed physical function tests. fNIRS revealed that prefrontal activity during IVG performance significantly increased in the IVG period compared with the control period. Furthermore, significant correlations between cerebral blood flow changes in different channels were observed during IVG performance. In addition, we observed intervention-related improvement in health-related quality of life following IVG. IVG intervention was associated with increased prefrontal cortex activation and improved health-related quality of life performance in patients with schizophrenia. Patients with chronic schizophrenia are characterized by withdrawal and a lack of social responsiveness or interest in others. Interventions using IVG may provide a useful low-cost rehabilitation method for such patients, without the need for specialized equipment.

Differential cardiac effects of aerobic interval training versus moderate continuous training in a patient with schizophrenia: a case report.

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Marco eHerbsleb

2014-08-01

Full Text Available Increased cardiovascular morbidity and mortality rates for patients with schizophrenia are reported to contribute to their reduced life expectancy. Common reasons for increased cardiac mortality rates include cigarette smoking, obesity, dyslipidemia, diabetes and poorer health behavior in general. The majority of excess mortality among people with schizophrenia is caused by cardiovascular complications. Reduced vagal activity might be one important mechanism leading to this increased cardiac mortality and has been consistently described in patients and their healthy first-degree relatives.In this case study, we compared two different aerobic exercise regimes in one patient with chronic schizophrenia to investigate their effects on cardiovascular regulation. The patient completed a 6-week period of moderate continuous training followed by a 6-week period of interval training, each regime 2 times per week, on a stationary bicycle. This was followed by a 6-week period of detraining. Primary outcome measures examined heart rate (HR and heart rate variability (HRV at rest while secondary measures assessed fitness parameters such as the ventilatory threshold 1 (VT1. We observed that interval training was far more effective than moderate continuous training in increasing HRV, as indicated by RMSSD (improvement to baseline 27% vs. 18%, and reducing resting heart rate (-14% vs. 0%. Improvement in VT1 (21% vs. -1% was only observed after interval training. Our study provides preliminary data that the type of intervention is highly influential for improving cardiac function in patients with schizophrenia. While cardiovascular function might be influenced by continuous training to some degree, no such effect was present in this patient with schizophrenia. In addition, the beneficial effect of interval training on heart rate regulation vanished completely after a very short period of detraining after the intervention.

Brain structural changes associated with chronicity and antipsychotic treatment in schizophrenia.

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Tomelleri, Luisa; Jogia, Jigar; Perlini, Cinzia; Bellani, Marcella; Ferro, Adele; Rambaldelli, Gianluca; Tansella, Michele; Frangou, Sophia; Brambilla, Paolo

2009-12-01

Accumulating evidence suggest a life-long impact of disease related mechanisms on brain structure in schizophrenia which may be modified by antipsychotic treatment. The aim of the present study was to investigate in a large sample of patients with schizophrenia the effect of illness duration and antipsychotic treatment on brain structure. Seventy-one schizophrenic patients and 79 age and gender matched healthy participants underwent brain magnetic resonance imaging (MRI). All images were processed with voxel based morphometry, using SPM5. Compared to healthy participants, patients showed decrements in gray matter volume in the left medial and left inferior frontal gyrus. In addition, duration of illness was negatively associated with gray matter volume in prefrontal regions bilaterally, in the temporal pole on the left and the caudal superior temporal gyrus on the right. Cumulative exposure to antipsychotics correlated positively with gray matter volumes in the cingulate gyrus for typical agents and in the thalamus for atypical drugs. These findings (a) indicate that structural abnormalities in prefrontal and temporal cortices in schizophrenia are progressive and, (b) suggest that antipsychotic medication has a significant impact on brain morphology.

Association between the scores of the Japanese version of the Brief Assessment of Cognition in Schizophrenia and whole-brain structure in patients with chronic schizophrenia: A voxel-based morphometry and diffusion tensor imaging study.

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Hidese, Shinsuke; Ota, Miho; Matsuo, Junko; Ishida, Ikki; Hiraishi, Moeko; Teraishi, Toshiya; Hattori, Kotaro; Kunugi, Hiroshi

2017-12-01

The Brief Assessment of Cognition in Schizophrenia (BACS) is a concise tool designed to evaluate cognitive deficits in schizophrenia. We examined the possible association between BACS scores and whole-brain structure, as observed using magnetic resonance imaging with a relatively large sample. The study sample comprised 116 patients with schizophrenia (mean age, 39.3 ± 11.1 years; 66 men) and 118 healthy controls (HC; mean age, 40.0 ± 13.6 years; 58 men) who completed the Japanese version of the BACS (BACS-J). All participants were of Japanese ethnicity. The magnetic resonance imaging volume and diffusion tensor imaging data were processed with voxel-based morphometry and tract-based spatial statistics, respectively. There were significant reductions in the regional gray matter volumes and white matter fractional anisotropy values in patients with schizophrenia compared to HC. For the gray matter areas, the working memory score had a significant positive correlation with the anterior cingulate and medial frontal cortices volumes in the patients. For the white matter areas, the motor speed score had a significant positive correlation with fractional anisotropy values in the corpus callosum, internal capsule, superior corona radiata, and superior longitudinal fasciculus in the patients. However, there was no significant correlation among either the gray or white matter areas in the HC. Our results suggest that among the BACS-J measures, the working memory and motor speed scores are associated with several structural alterations in the brains of patients with schizophrenia. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

The Associations between Visual Attention and Facial Expression Identification in Patients with Schizophrenia.

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Lin, I-Mei; Fan, Sheng-Yu; Huang, Tiao-Lai; Wu, Wan-Ting; Li, Shi-Ming

2013-12-01

Visual search is an important attention process that precedes the information processing. Visual search also mediates the relationship between cognition function (attention) and social cognition (such as facial expression identification). However, the association between visual attention and social cognition in patients with schizophrenia remains unknown. The purposes of this study were to examine the differences in visual search performance and facial expression identification between patients with schizophrenia and normal controls, and to explore the relationship between visual search performance and facial expression identification in patients with schizophrenia. Fourteen patients with schizophrenia (mean age=46.36±6.74) and 15 normal controls (mean age=40.87±9.33) participated this study. The visual search task, including feature search and conjunction search, and Japanese and Caucasian Facial Expression of Emotion were administered. Patients with schizophrenia had worse visual search performance both in feature search and conjunction search than normal controls, as well as had worse facial expression identification, especially in surprised and sadness. In addition, there were negative associations between visual search performance and facial expression identification in patients with schizophrenia, especially in surprised and sadness. However, this phenomenon was not showed in normal controls. Patients with schizophrenia who had visual search deficits had the impairment on facial expression identification. Increasing ability of visual search and facial expression identification may improve their social function and interpersonal relationship.

Symptom structure and severity: a comparison of responses to the positive and negative syndrome scale (PANSS) between patients with PTSD or schizophrenia.

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Stefanovics, Elina A; Krystal, John H; Rosenheck, Robert A

2014-05-01

To describe and compare the structure and relative severity of symptoms in clinical trial patients diagnosed with Post Traumatic Stress Disorder (PTSD) or schizophrenia using the Positive and Negative Syndrome Scale (PANSS), developed originally to evaluate symptoms of schizophrenia. This secondary data analysis used baseline PANSS symptom ratings (n=267) from a six-month multicenter randomized placebo-controlled trial of adjunctive risperidone in patients with chronic military-related PTSD. First, using a split-half design, Exploratory Factor Analysis (EFA) was employed to identify independent factors which were then compared to published factor structures for schizophrenia. Next, Confirmatory Factor Analysis (CFA) was applied to the second half of the sample to compare the results of the EFA and published factor structures. Finally, T-tests were used to compare the severity of factor scores between the PTSD sample and the baseline PANSS ratings from the Clinical Antipsychotic Trial for Intervention Effectiveness (CATIE) schizophrenia sample (n=1460). EFA suggested five factors similar to those identified in a summary of 29 schizophrenia studies by Wallwork (Schizophrenia Research, 137:246-250). CFA showed that the five factor Wallwork model fit the data better than the EFA, although both had relatively high goodness of fit. T-tests showed that the PTSD sample had more severe symptoms on the Depressive factor, and the schizophrenia sample on the Positive, Negative, and Disorganized factors, with no significant difference on the Excited factor. Veterans with PTSD had similar symptom structure to patients with schizophrenia on the PANSS, but were less symptomatic on psychosis-related factors and more symptomatic on depression. Dimensional symptom factors can be virtually the same across diagnoses. Published by Elsevier Inc.

Magnetic resonance imaging in schizophrenia: a morphometric study

International Nuclear Information System (INIS)

Castro, Claudio Campi de

2001-01-01

Thirty-three patients with chronic schizophrenia and 21 normal subjects were submitted to magnetic resonance imaging studies using a 1.5 T scanner. Axial and coronal T 2-weighted images were obtained. The volumes of the brain, intracranial, supratentorial, infratentorial and the total, ventricular and subarachnoid cerebrospinal fluid volumes were measured using semi-automated morphometric methods. The volumes of the amygdala-hippocampus complex, para hippocampal gyrus cortex, putamen, globus pallidus, temporal lobe, gray and white matter of temporal lobe were also measured. These volumes were normalized using the intracranial volume as reference. The most relevant findings observed were reduced brain volume and increased total, ventricular and subarachnoid cerebrospinal fluid volumes in patients with schizophrenia when compared to the controls. Patients with schizophrenia had also smaller amygdala-hippocampus complexes, temporal lobes and temporal lobe white matter than the controls, as well as increased putamen volumes. (author)

Acute and chronic effects of NMDA receptor antagonists in rodents, relevance to negative symptoms of schizophrenia: a translational link to humans.

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Neill, Joanna C; Harte, Michael K; Haddad, Peter M; Lydall, Emma S; Dwyer, Dominic M

2014-05-01

Negative symptoms of schizophrenia remain an unmet clinical need as they are common, persistent, respond poorly to existing treatments and lead to disability. Blunted affect, alogia, asociality, anhedonia and avolition are regarded as key negative symptoms despite DSM-IV-TR specifying a more limited range. The key to development of improved therapies is improved animal models that mimic the human condition in terms of behaviour and pathology and that predict efficacy of novel treatments in patients. Accumulating evidence shows that NMDA receptor (NMDAR) antagonists mimic cognitive deficits of relevance to schizophrenia in animals, along with associated pathological changes. This review examines evidence for the ability of NMDAR antagonists to mimic anhedonia and asociality, two negative symptoms of schizophrenia, in animals. The use of various species, paradigms and treatment regimens are reviewed. We conclude that sub-chronic treatment with NMDAR antagonists, typically PCP, induces social withdrawal in animals but not anhedonia. NMDAR antagonists have further effects in paradigms such as motivational salience that may be useful for mimicking other aspects of negative symptoms but these require further development. Sub-chronic treatment regimens of NMDAR antagonists also have some neurobiological effects of relevance to negative symptoms. It is our view that a sub-chronic treatment regime with NMDAR antagonists, particularly PCP, with animals tested following a wash-out period and in a battery of tests to assess certain behaviours of relevance to negative symptoms and social withdrawal (the animal equivalent of asociality) is valuable. This will enhance our understanding of the psycho and neuropathology of specific negative symptom domains and allow early detection of novel pharmacological targets. © 2013 Elsevier B.V. and ECNP All rights reserved.

Approaches to improve adherence to pharmacotherapy in patients with schizophrenia

OpenAIRE

Shuler, Kimberly M

2014-01-01

Kimberly M Shuler Shuler Counseling and Consulting, Fayetteville, AR, USA Purpose: In patients with schizophrenia, nonadherence to prescribed medications increases the risk of patient relapse and hospitalization, key contributors to the costs associated with treatment. The objectives of this review were to evaluate the impact of nonadherence to pharmacotherapy in patients with schizophrenia as it relates to health care professionals, particularly social workers, and to identify effective tea...

Comprehension of metaphors in patients with schizophrenia-spectrum disorders.

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Mossaheb, Nilufar; Aschauer, Harald N; Stoettner, Susanne; Schmoeger, Michaela; Pils, Nicole; Raab, Monika; Willinger, Ulrike

2014-05-01

Metaphors, mainly proverbs and idiomatic expressions of ordinary life are commonly used as a model for concretism. Previous studies have shown impaired metaphor comprehension in patients with schizophrenia-spectrum disorders compared to either psychiatric or non-psychiatric control subject. The aim of this study was to detect possible quantitative differences in figurative processing between patients with schizophrenia-spectrum disorders and healthy controls. In order to analyse possible dissociations of different aspects of figurative speech, a range of metaphor tasks was used to distinguish between recognition of familiar metaphors, paraphrasing the meaning of the latter and generating novel metaphors: we used a standard proverb test for conventional metaphors consisting of a multiple-choice and a paraphrasing task, and the Metaphoric Triads Test for the assessment of novel metaphors. We included 40 patients with schizophrenia-spectrum disorders and 43 healthy control subjects. Our results showed that patients had impaired figurative speech processing regarding novel and conventional metaphors. Associations with cognitive functions were detected. Performance on the paraphrasing task was associated with the severity of negative symptoms. We conclude that patients with schizophrenia-spectrum disorders do exhibit impairments in the recognition and paraphrasing of conventional and the generation of novel metaphors and that some cognitive domains as well the extent of negative symptoms might be associated with these deficits. Copyright © 2014 Elsevier Inc. All rights reserved.

Left prefrontal repetitive transcranial magnetic stimulation in schizophrenia.

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Holi, Matti M; Eronen, Markku; Toivonen, Kari; Toivonen, Päivi; Marttunen, Mauri; Naukkarinen, Hannu

2004-01-01

In a double-blind, controlled study, we examined the therapeutic effects of high-frequency left prefrontal repetitive transcranial magnetic stimulation (rTMS) on schizophrenia symptoms. A total of 22 chronic hospitalized schizophrenia patients were randomly assigned to 2 weeks (10 sessions) of real or sham rTMS. rTMS was given with the following parameters: 20 trains of 5-second 10-Hz stimulation at 100 percent motor threshold, 30 seconds apart. Effects on positive and negative symptoms, self-reported symptoms, rough neuropsychological functioning, and hormones were assessed. Although there was a significant improvement in both groups in most of the symptom measures, no real differences were found between the groups. A decrease of more than 20 percent in the total PANSS score was found in 7 control subjects but only 1 subject from the real rTMS group. There was no change in hormone levels or neuropsychological functioning, measured by the MMSE, in either group. Left prefrontal rTMS (with the used parameters) seems to produce a significant nonspecific effect of the treatment procedure but no therapeutic effect in the most chronic and severely ill schizophrenia patients.

An Exploratory Study of Intensive Neurofeedback Training for Schizophrenia

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Wenya Nan

2017-01-01

Full Text Available Schizophrenia is a chronic and devastating brain disorder with ongoing cognitive, behavioral, and emotional deteriorated functions. Neurofeedback training, which enables the individuals to regulate their brain activity using a real-time feedback loop, is increasingly investigated as a potential alternative intervention for schizophrenia. This study aimed to explore the effect of short but intensive neurofeedback training for schizophrenic patients with difficulty for long-time training. A middle-aged woman with chronic schizophrenia completed the intensive training of alpha/beta2 (20–30 Hz in four consecutive days with a total training duration of 13.5 hours. The results showed that her alpha/beta2 increased over sessions, and her behavior performance including short-term memory, mood, and speech pattern was improved at the end of neurofeedback training. Importantly, a 22-month follow-up found a dramatic improvement in both positive and negative symptoms. These positive outcomes suggest that such intensive neurofeedback training may provide new insight into the treatment of schizophrenia and thus deserves further study to fully examine its scope.

Symptom profiles and parental bonding in homicidal versus non-violent male schizophrenia patients.

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Halmai, Tamás; Tényi, Tamás; Gonda, Xénia

2017-01-30

To compare the intensity and the profile of psychotic symptoms and the characteristics of parental bonding of male schizophrenia patients with a history of homicide and those without a history of violent behaviour. Clinical question - We hypothesized more intense psychotic symptoms, especially positive symptoms as signs of a more severe psychopathology in the background of homicidal behaviour. We also hypothesized a more negatively perceived pattern (less Care more Overprotection) of parental bonding in the case of homicidal schizophrenia patients than in non-violent patients and non-violent healthy controls. Symptom severity and symptom profiles were assessed with the Positive and Negative Syndrome Scale in a group of male schizophrenia patients (n=22) with the history of committed or attempted homicide, and another group (n=19) of male schizophrenia patients without a history of violent behaviour. Care- and Overprotection were assessed using the Parental Bonding Instrument (PBI) in a third group of non-violent healthy controls (n=20), too. Positive, negative and general psychopathology symptoms in the homicidal schizophrenia group were significantly (pOverprotection than violent patients and healthy controls. Homicidal schizophrenia patients showed a pattern similar to the one in the healthy control group. It seems imperative to register intense positive psychotic symptoms as predictive markers for later violent behaviour. In the subgroup of male homicidal schizophrenia patients negatively experienced parental bonding does not appear to be major contributing factor to later homicidal behaviour.

Estimating 10-year cardiovascular disease risk in Asian patients with schizophrenia.

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Rekhi, Gurpreet; Khyne, Toe Toe; Lee, Jimmy

This study aims to describe the cardiovascular risk profile of Asian patients with schizophrenia. Data was extracted from the databases of 139 patients with schizophrenia and 206 controls from two previous studies conducted at the Institute for Mental Health (IMH), Singapore. Their medical and smoking histories were obtained, and anthropometric parameters measured. Framingham risk score (FRS) calculator using body mass index was used to compute the 10-year cardiovascular disease risk (FRS BMI ) and the vascular age (VA BMI ) for each participant. Data on fasting lipids were available for 80 patients and all the controls; hence the FRS for lipids (FRS lipids ) and VA (VA lipids ) were also computed. The difference between VA and actual age was computed as VA diff . The 10-year CVD risk and VA diff based on lipids as well as BMI were significantly higher for patients compared to controls (all prisk of CVD in patients with schizophrenia as compared to controls; and conclude that patients with schizophrenia need regular physical health monitoring, especially for cardiovascular risk factors. Copyright © 2016 Elsevier Inc. All rights reserved.

Cognitive function in schizophrenia and its association with socio-demographics factors

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Bharti T Talreja

2013-01-01

Full Text Available Background: Schizophrenia is a chronic and debilitating psychiatric illness consisting primarily of positive and negative symptoms. However, cognitive deficits in various domains have been consistently replicated in patients with schizophrenia. Therefore, the present study was designed to assess cognitive impairment in schizophrenia and to correlate the same with sociodemographic factors. Materials and Methods: Cognitive function in 100 patients with schizophrenia as per Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR criteria attending the psychiatry outpatient department (OPD of Department of Psychiatry, SBKS MIRC was assessed using Addenbrooke′s Cognitive Examination Revised (ACER rating scale and Mini Mental State Examination (MMSE and sociodemographic details was obtained using semistructured proforma. Data was analyzed by Chi-square and t-test. Results: About 70% patients of schizophrenia were found to have cognitive dysfunction for attention, concentration, memory, language, and executive function. Positive symptoms were associated with memory (P2 years and belonging to urban habitat showed more cognitive dysfunction. Male patients were associated with impairment in two domains of ACER: Language and memory. Conclusion: The study findings depict that persistent cognitive deficits are seen in patients with schizophrenia. Its correlation with sociodemographic factors showed that patients with >2 years of illness and belonging to urban habitat showed more cognitive dysfunction. Male patients were associated with language and memory impairment. Our study recommends that the neurocognitive impairment should be included in the DSM-V diagnostic criteria for schizophrenia.

Association between forkhead-box P2 gene polymorphism and clinical symptoms in chronic schizophrenia in a Chinese population.

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Rao, Wenwang; Du, Xiangdong; Zhang, Yingyang; Yu, Qiong; Hui, Li; Yu, Yaqin; Kou, Changgui; Yin, Guangzhong; Zhu, Xiaomin; Man, Lijuan; Soares, Jair C; Zhang, Xiang Yang

2017-07-01

The forkhead-box P2 (FOXP2) gene polymorphism has been reported to be involved in the susceptibility to schizophrenia; however, few studies have investigated the association between FOXP2 gene polymorphism and clinical symptoms in schizophrenia. This study investigated whether the FOXP2 gene was associated with the development and symptoms of schizophrenia in relatively genetically homogeneous Chinese population. The FOXP2 rs10447760 polymorphism was genotyped in 1069 schizophrenia inpatients and 410 healthy controls using a case-control design. The patients' psychopathology was assessed by the Positive and Negative Syndrome Scale (PANSS). We found no significant differences in the genotype and allele distributions between the patient and control groups. Interestingly, we found significant differences in PANSS total, positive symptom, and general psychopathology scores between genotypic subgroups in patients, with the higher score in patients with CC genotype than those with CT genotype (all p schizophrenia, but may contribute to the clinical symptoms of schizophrenia among Han Chinese.

[Predictors of medication non-adherence among a Moroccan sample of patients with schizophrenia: A cross sectional study].

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El Ammouri, A; Kisra, H

2017-12-01

Schizophrenia is a chronic, relapsing, mental disorder, and lack of adherence is a common and severe problem in such patients leadingto global and heavy consequences for patients (relapses, hospitalizations, impaired quality of life…), for the family and for society. Improved understanding of the underlying reasons will help to form intervention strategies relevant to the context. We aimed to assess medication adherence among stable patients suffering from schizophrenia and to identify factors associated with non-adherence. This is a retrospective cohort study of outpatients with schizophrenia at the psychiatric hospital Ar-razi of Salé (Maroc). The patients were aged over 18, clinically stabilized under the same treatment during the three months prior to inclusion. Data (demographic, clinical and therapeutic) was collected by a questionnaire developed for this purpose. Assessment of adherence and awareness of the disorder (insight) were performed respectively by two validated scales: Medication Adherence Rating Scale the (MARS) and scale Q8. Fourty percent of schizophrenic patients included in our study were not compliant to treatment. Compared to adherent patients, non-adherent patients had history of substance use (57.6 % vs. 42.4 %, P<0.05), were less aware of their disorder (77.8 % vs. 22.2 %, P<0.01), had significantly more drug intake per day (2.4 vs. 1.9, P<0.01), took significantly more tablets per day (2.8 vs. 2.2; P<0.05) and complained of significantly more side effects (43.2 vs. 56.8, P<0.05). A logistic regression model had shown that only side effects, lack of insight, and a history of substances use are significant predictors of poor adherence in patients with schizophrenia. The results of this work should guide our efforts to improve adherence in patients with schizophrenia. Waiting for new drugs with fewer side effects and better benefit/risk, some strategies would help to improve adherence to treatment. For example: implementation of

Vitamin D in schizophrenia: a clinical review.

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Chiang, Mathew; Natarajan, Radhika; Fan, Xiaoduo

2016-02-01

Vitamin D (vitD) is known for its essential role in calcium homeostasis and bone health. VitD is made endogenously in the skin from UVB radiation from sunlight. VitD is now considered as a potent neurosteroid hormone, critical to brain development and normal brain function, and is known for its anti-inflammatory property affecting various aspects of human health. VitD ligand-receptor, a receptor that mediates much of vitD's biological actions, has been found throughout the body including the central nervous system. VitD deficiency is common in patients with severe mental illness such as schizophrenia. Schizophrenia is a debilitating chronic mental illness characterised by positive symptoms, such as hallucinations and delusions, and negative symptoms including flat affect and lack of motivation. Several environmental risk factors for schizophrenia, such as season of birth, latitude and migration, have been linked to vitD deficiency. Recent studies have suggested a potential role of vitD in the development of schizophrenia. For example, neonatal vitD status is associated with the risk of developing schizophrenia in later life obesity, insulin resistance, diabetes, hyperlipidaemia and cardiovascular disease, which are commonly seen in patients with schizophrenia. It has been well established that vitD deficiency is related to these metabolic problems. The biological mechanism is most likely related to vitD's action on the regulation of inflammatory and immunological processes, consequently affecting the manifestation of clinical symptoms and treatment response of schizophrenia. Potential benefits of vitD supplementation to improve schizophrenia symptoms as well as physical health in patients with schizophrenia should be further explored in future studies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A Survey of the Tardive Dyskinesia Induced by Antipsychotic Drugs in Patients with Schizophrenia

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Naser tabibi

2010-11-01

Full Text Available "nObjective: Tardive Dyskinesia (TD, is one of the important problems of the patients with schizophrenia. The emergence of these side effects depends on so many factors such as the patients' age and the duration of antipsychotic treatment. By discovering new drugs (Atypical, there has been an outstanding decrease in the emergence of these side effects. The present study investigates the symptoms of TD in the Patients with schizophrenia who were under  treatments for more than 6 months. "nMethod: The sample of this study was 200 Patients with schizophrenia of four wards in Razi hospital (two acute and two chronic wards who were hospitalized in the winter of 2006 and were qualified for this study. The subjects were 101 males and 99 females who were younger than 60 and had received antipsychotic drugs for at least 6 months. After psychiatric interview and filling the demographic questionnaire by the patients, the required information about the drugs and the intensity of the symptoms was acquired. Then clinical and physical examinations of tardive dyskinesia were done. Next, the tardive dyskinesia disorders' check list (AIMS was used. Findings of this cross-sectional, descriptive study were analyzed by SPSS. "nResults: There was a high ratio of 95% between TD and the age factor (P=0.05. There was no relationship between symptoms frequency and duration of treatment (P=0.68. Facial muscles and oral zones were mostly involved in T.D disorder (72%. "nConclusion: No significant difference was observed between nine fold symptoms of T.D in patients who were using traditional drugs and those who were using the new ones (typical and atypical. Findings showed that in the intensity of the symptoms, gender does not play a major role.

Schizophrenia: management and family burden.

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Sebit, M B

2007-01-01

To explore schizophrenia with respect to its management, causes, risk factors as well as the impact it has in families regarding the burden and social networks support. Desk literature reviews. The findings are that patients with schizophrenia typically have great difficulty following a medication regimen, but they also have the greatest potential for benefiting from adherence. As with other chronic diseases that lack a definitive cure, the individual's service/recovery plan must include treatment interventions directed towards decreasing manifestations of the illness, rehabilitative services, enhancing adaptive skills, and social support mobilization aimed at optimizing function and quality of life. Finally, this paper is not exhaustive, but a pointer for further readings.

[Microcirculation in patients with paranoid schizophrenia].

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Sakharov, A V; Ozornin, A S; Golygina, S E; Vinogradova, A O; Shvets, M S

2018-01-01

To study microcirculation in patients with paranoid schizophrenia by laser Doppler flowmetry. Fifty-three patients at the age from 18 to 38 years with a diagnosis of 'paranoid schizophrenia' (F20.0) were examined in the acute psychotic state and after 3 weeks of therapy. The control group consisted of 20 healthy volunteers. To assess microcirculation, the noninvasive technique of laser Doppler flowmetry using a laser blood flow analyzer was used. Significant changes in the microcirculation persisting even over three weeks of therapy in patients were identified. The total microcirculation index was increased by 1.4 times which indicated the acceleration of blood flow. An increase in the average fluctuations of perfusion by 3.7 times and in the coefficient of variation by 1.9 times, which reflect the excessive strengthening of local mechanisms of regulation of microcirculation, were found. There were an increase in the myogenic tone and neurogenic tone of metarteriole and precapillary sphincters as well as bypass index.

Exploratory RCT of art therapy as an adjunctive treatment in schizophrenia

OpenAIRE

Richardson, Phil; Jones, Kevin; Evans, Chris; Stevens, Peter; Rowe, Anna; HASH(0x7f4d76f6c120)

2007-01-01

Background\\ud There is no high quality controlled trial evidence for the effectiveness of art therapy in the adjunctive treatment of schizophrenia.\\ud \\ud Aims\\ud To conduct the first exploratory RCT of group interactive art therapy (AT) as an adjunctive treatment in chronic schizophrenia.\\ud \\ud Method\\ud The outcomes of 43 patients randomised to 12 sessions of AT were compared with those of 47 who received standard psychiatric care. Patients were assessed on a range of measures of symptoms,...

Differences in Clinical Features of Methamphetamine Users with Persistent Psychosis and Patients with Schizophrenia.

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Wang, Liang-Jen; Lin, Shih-Ku; Chen, Yi-Chih; Huang, Ming-Chyi; Chen, Tzu-Ting; Ree, Shao-Chun; Chen, Chih-Ken

Methamphetamine exerts neurotoxic effects and elicits psychotic symptoms. This study attempted to compare clinical differences between methamphetamine users with persistent psychosis (MAP) and patients with schizophrenia. In addition, we examined the discrimination validity by using symptom clusters to differentiate between MAP and schizophrenia. We enrolled 53 MAP patients and 53 patients with schizophrenia. The psychopathology of participants was assessed using the Chinese version of the Diagnostic Interview for Genetic Studies and the 18-item Brief Psychiatric Rating Scale. Logistic regression was used to examine the predicted probability scores of different symptom combinations on discriminating between MAP and schizophrenia. The receiver operating characteristic (ROC) analyses and area under the curve (AUC) were further applied to examine the discrimination validity of the predicted probability scores on differentiating between MAP and schizophrenia. We found that MAP and schizophrenia demonstrated similar patterns of delusions. Compared to patients with schizophrenia, MAP experienced significantly higher proportions of visual hallucinations and of somatic or tactile hallucinations. However, MAP exhibited significantly lower severity in conceptual disorganization, mannerism/posturing, blunted affect, emotional withdrawal, and motor retardation compared to patients with schizophrenia. The ROC analysis showed that a predicted probability score combining the aforementioned 7 items of symptoms could significantly differentiate between MAP and schizophrenia (AUC = 0.77). Findings in the current study suggest that nuanced differences might exist in the clinical presentation of secondary psychosis (MAP) and primary psychosis (schizophrenia). Combining the symptoms as a whole may help with differential diagnosis for MAP and schizophrenia. © 2016 S. Karger AG, Basel.

A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia

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Sandeep Grover

2011-01-01

Full Text Available Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia and 20 healthy controls. All three groups were matched on age, sex, and level of education. The two patient groups were also matched on duration of illness. Results: In general, patients with delusional disorder performed worst than healthy controls and patients with paranoid schizophrenia performed in between the other two groups. Compared with healthy controls, both patients with delusional disorder and patients with paranoid schizophrenia were significantly impaired on different tests of attention and visual learning and memory. Compared with patients with paranoid schizophrenia, patients with delusional disorder had more impairment different tests of attention, visual learning and memory, verbal working memory, and executive functions. Conclusion: Patients with delusional disorder exhibit cognitive dysfunctions that are very similar to schizophrenia, but are more severe in intensity. The resemblance of cognitive profiles suggests that the two disorders may have similar etiological basis.

Attentional dysfunction in abstinent long-term cannabis users with and without schizophrenia.

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Rentzsch, Johannes; Stadtmann, Ada; Montag, Christiane; Kunte, Hagen; Plöckl, Doris; Hellweg, Rainer; Gallinat, Jürgen; Kronenberg, Golo; Jockers-Scherübl, Maria Christiane

2016-08-01

Long-term cannabis use may confer cognitive deficits and increased risk of psychosis. However, the relationship between cannabis use and schizophrenia is complex. In particular, little is known about the effects of chronic cannabis use on the attention-related electric brain response in schizophrenia. We investigated auditory novelty and oddball P300 evoked potentials in a mixed sample of first-episode and chronic schizophrenic patients and healthy controls with (SZCA, n = 20; COCA, n = 20, abstinence ≥28 days) or without (SZ, n = 20; CO, n = 20) chronic cannabis use. Duration of regular cannabis use was 8.3 ± 5.6 (SZCA) and 9.1 ± 7.1 (COCA) years. In general, schizophrenic patients showed reduced P300 amplitudes. Cannabis use was associated with both a reduced early and late left-hemispheric novelty P300. There was a significant 'diagnosis × cannabis' interaction for the left-hemispheric late novelty P300 in that cannabis use was associated with a reduced amplitude in the otherwise healthy but not in the schizophrenic group compared with their relative control groups (corrected p  0.9, respectively). The left-hemispheric late novelty P300 in the otherwise healthy cannabis group correlated inversely with amount and duration of cannabis use (r = -0.50, p = 0.024; r = -0.57, p = 0.009, respectively). Our study confirms attentional deficits with chronic cannabis use. However, cannabis use may lead to different cognitive sequelae in patients with schizophrenia and in healthy controls, possibly reflecting preexisting alterations in the endocannabinoid system in schizophrenia.

Increased breath ethane levels in medicated patients with schizophrenia and bipolar disorder are unrelated to erythrocyte omega-3 fatty acid abundance.

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Ross, Brian M; Maxwell, Ross; Glen, Iain

2011-03-30

Oxidative stress has been reported to be elevated in mental illness. Preliminary evidence suggests this phenomenon can be assessed non-invasively by determining breath levels of the omega-3 polyunsaturated fatty acid (PUFA) oxidation product ethane. This study compares alkane levels in chronic, medicated, patients with schizophrenia or bipolar disorder with those in healthy controls. Both ethane and butane levels were significantly increased in patients with schizophrenia or bipolar disorder, although elevated butane levels were likely due to increased ambient gas concentrations. Ethane levels were not correlated with symptom severity or with erythrocyte omega-3 PUFA levels. Our results support the hypothesis that oxidative stress is elevated in patients with schizophrenia and bipolar disorder leading to increased breath ethane abundance. This does not appear to be caused by increased abundance of omega-3 PUFA, but rather is likely due to enhanced oxidative damage of these lipids. As such, breath hydrocarbon analysis may represent a simple, non-invasive means to monitor the metabolic processes occurring in these disorders. Copyright © 2010 Elsevier Inc. All rights reserved.

Diffusion Tensor MR Imaging Evaluation of Callosal Abnormalities in Schizophrenia: A Meta-Analysis.

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Chuanjun Zhuo

Full Text Available Widespread white matter (WM abnormalities have been found in patients with schizophrenia. Corpus callosum (CC is the key area that connects the left and right brain hemispheres. However, the results of studies considering different subregions of the CC as regions of interest in patients with schizophrenia have been inconsistent. To obtain a more consistent evaluation of the diffusion characteristics change of the corpus callosum (CC related to schizophrenia. A meta-analysis involving fractional anisotropy (FA values in the CC of 729 schizophrenic subjects and 682 healthy controls from 22 studies was conducted. Overall FA values in the CC of the schizophrenic group were less than that of the healthy control group [weighted mean difference (WMD = -0.021,P< 0.001]. So were the FA values in the genus region (WMD = -0.019, P< 0.001 and the splenium region (WMD = -0.020, P< 0.001 of the CC respectively. The FA reduction was also significant in subjects with chronic schizophrenia (WMD = -0.032, P< 0.001 and first-episode schizophrenia (WMD = -0.014, P = 0.001. In present study, we demonstrated an overall FA decrease in the CC of schizophrenic patients. In the two subgroup analyses of the genu vs splenium region and chronic vs first-episode schizophrenia, the decrease of all groups was significant. Further studies with more homogenous populations and standardized DTI protocols are needed to confirm and extend these findings.

Facilitating recruitment of patients with schizophrenia to a clinical trial

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Grønbech, Bettina Ellen; Aagaard, Jørgen; Jensen, Svend Eggert

People with severe mental illness, such as schizophrenia have higher rates of mortality especially due to cardiovascular disease. We have established a clinical trial named “Coronary artery disease and schizophrenia”. However, patients with schizophrenia have cognitive disturbances, which make re...... recruitment of patients challenging. The purpose of this study is to understand which type of recruitment strategy is needed in clinical trials....

INSIGHT AND SELF-STIGMA IN PATIENTS WITH SCHIZOPHRENIA.

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

2016-03-01

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

Validation of the Persian version of the Schizophrenia Cognition Rating Scale (SCoRS) in patients with schizophrenia.

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Mazhari, Shahrzad; Ghafaree-Nejad, Ali R; Soleymani-Zade, Somayeh; Keefe, Richard S E

2017-06-01

The Schizophrenia Cognition Rating Scale (SCoRS) is an interview-based assessment of cognition that involves interviews with patients and informants. The SCoRS has shown good reliability, validity, and sensitivity to cognitive impairment in schizophrenia, with the advantage of brief administration and scoring time. The present study aimed to test the concurrent validity of the Persian version of the SCoRS. A group of 35 patients with schizophrenia and a group of 35 healthy controls received the Persian-SCoRS in the first session, and a standardized performance-based cognitive battery, the Brief Assessment of Cognition in Schizophrenia (BACS), in the second session.Our results indicated that the Persian version of the SCoRS was sensitive to cognitive impairment in the patients. The Persian SCoRS global rating was significantly associated with the composite score generated from the Persian version of the BACS and predicted functional outcomes as measured by Global Assessment of Functioning (GAF) and World Health Organization Quality of Life (WHO QOL). A Persian version of the SCoRS, an interview based measure of cognition that included informants, is related to cognitive performance and global functioning. Copyright © 2017 Elsevier B.V. All rights reserved.

Heart rate variability response to mental arithmetic stress in patients with schizophrenia Autonomic response to stress in schizophrenia

NARCIS (Netherlands)

Castro, Mariana N.; Vigo, Daniel E.; Weidema, Hylke; Fahrer, Rodolfo D.; Chu, Elvina M.; De Achaval, Delfina; Nogues, Martin; Leiguarda, Ramon C.; Cardinali, Daniel P.; Guinjoan, Salvador N.

Background: The vulnerability-stress hypothesis is an established model of schizophrenia symptom formation. We sought to characterise the pattern of the cardiac autonomic response to mental arithmetic stress in patients with stable schizophrenia. Methods: We performed heart rate variability (HRV)

[Theory of mind in schizophrenia].

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Bonshtein, Udi

2006-12-01

The term "theory of mind" (ToM) refers to the capacity to infer one's own and other persons' mental states (e.g. their beliefs, feelings, intentions or knowledge). It was found that children in the autistic spectrum have deficits in ToM. One of the suggestions was that unlike autistic people, ToM skills are normally developed in schizophrenia patients, but "lost" in the first psychotic episode. The deficit may disappear on remission from the acute phase, as described in some studies. A substantial body of research has highlighted the impaired ToM in schizophrenia. There is good empirical evidence that ToM is specifically impaired in schizophrenia and that many psychotic symptoms--for instance, delusions of alien control and persecution, the presence of thought and language disorganization, and other behavioral symptoms--may best be understood in light of a disturbed capacity in patients to relate their own intentions to executing behavior, and to monitor others' intentions. However, it is still under debate how an impaired ToM in schizophrenia is associated with other aspects of cognition, how the impairment fluctuates with acuity or chronicity of the schizophrenic disorder, and if it is a state or trate marker. The paper reviews the current literature and suggests potential implications and future research areas.

Effect of Community-Based Social Skills Training and Tai-Chi Exercise on Outcomes in Patients with Chronic Schizophrenia: A Randomized, One-Year Study.

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Kang, Ruiying; Wu, Yeqing; Li, Zhiwu; Jiang, Jun; Gao, Qi; Yu, Yuncui; Gao, Keming; Yan, Yuxiang; He, Yan

Antipsychotic drugs are limited in their ability to improve negative symptoms, quality of life, and medication adherence in patients with schizophrenia. The addition of nonpharmacological interventions like social skills training has a positive effect on medication adherence and decreases rehospitalization rates but is limited in improving patients' symptoms, aggressive behaviors, and quality of life. Aerobic exercise, especially Tai-chi, can potentially reduce psychopathological and negative symptoms, decrease aggressive behaviors, and improve quality of life. It is an ideal rehabilitation intervention for patients with schizophrenia. However, no study has investigated the effects of social skills training plus Tai-chi on outcomes among outpatients with schizophrenia. This study analyzes the effect of antipsychotics combined with community-based integrated interventions on outcomes of schizophrenia. In this study, a 24-session social skills training plus Tai-chi was used in community settings among patients with schizophrenia. A total of 244 patients were randomly assigned to medication treatment alone (MTA group) or community-based integrated intervention (CBII group), which accepted social skills training plus Tai-chi in addition to medication treatment. Generalized linear mixed models were used to evaluate the intervention effect (group effect), intervention effect over time (time effect), and interaction effect (group × time effect). t tests were used to evaluate between-group differences on clinical variables. Multiple linear regression analysis was used to analyze the differences between the intervention at 12 months and baseline for the Positive and Negative Syndrome Scale (PANSS) negative symptoms and quality of life-social domain. Compared with the MTA group, the CBII group had lower scores on PANSS (F = 17.312, p social domain of the World Health Organization Quality of Life Scale-Brief version (WHOQOL-BREF) from baseline to 12 months were significant

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

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...... not change in patients or controls. The present results show that PPI in drug-naive, first-episode schizophrenia patients can improve significantly over time. As PPI increased in patients over the same period that it decreased in controls, it is likely that the increase was caused by disease-related factors......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...

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

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Wen-Yu Hsu

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

Normal brain activation in schizophrenia patients during associative emotional learning

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Swart, Marte; Liemburg, Edith Jantine; Kortekaas, Rudie; Wiersma, Durk; Bruggeman, Richard; Aleman, Andre

2013-01-01

Emotional deficits are among the core features of schizophrenia and both associative emotional learning and the related ability to verbalize emotions can be reduced. We investigated whether schizophrenia patients demonstrated impaired function of limbic and prefrontal areas during associative

Association of IQ Changes and Progressive Brain Changes in Patients With Schizophrenia.

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Kubota, Manabu; van Haren, Neeltje E M; Haijma, Sander V; Schnack, Hugo G; Cahn, Wiepke; Hulshoff Pol, Hilleke E; Kahn, René S

2015-08-01

Although schizophrenia is characterized by impairments in intelligence and the loss of brain volume, the relationship between changes in IQ and brain measures is not clear. To investigate the association between IQ and brain measures in patients with schizophrenia across time. Case-control longitudinal study at the Department of Psychiatry at the University Medical Center Utrecht, Utrecht, the Netherlands, comparing patients with schizophrenia and healthy control participants between September 22, 2004, and April 17, 2008. Magnetic resonance imaging of the brain and IQ scores were obtained at baseline and the 3-year follow-up. Participants included 84 patients with schizophrenia (mean illness duration, 4.35 years) and 116 age-matched healthy control participants. Associations between changes in IQ and the total brain, cerebral gray matter, cerebral white matter, lateral ventricular, third ventricles, cortical, and subcortical volumes; cortical thickness; and cortical surface area. Cerebral gray matter volume (P = .006) and cortical volume (P = .03) and thickness (P = .02) decreased more in patients with schizophrenia across time compared with control participants. Patients showed additional loss in cortical volume and thickness of the right supramarginal, posterior superior temporal, left supramarginal, left postcentral, and occipital regions (P values were between IQ increased similarly in patients with schizophrenia and control participants, changes in IQ were negatively correlated with changes in lateral ventricular volume (P = .05) and positively correlated with changes in cortical volume (P = .007) and thickness (P = .004) only in patients with schizophrenia. Positive correlations between changes in IQ and cortical volume and thickness were found globally and in widespread regions across frontal, temporal, and parietal cortices (P values were between <.001 and .03 after clusterwise correction). These findings were independent of symptom

Beliefs about the cause of schizophrenia among caregivers in Midwestern Nigeria

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Osayi Igberase

2017-07-01

Full Text Available Schizophrenia is a devastating illness with a chronic and relapsing course. While Western countries may endorse, biological and psychosocial causes more commonly than supernatural causes, non-western cultures like Nigeria in contrast, tend to endorse supernatural causes. Belief in supernatural causes has been reported to have consequences for treatment seeking behavior. This study aimed to examine the causes of schizophrenia reported by family members of outpatients with schizophrenia in a neuropsychiatric hospital in Midwestern Nigeria. In this study, we recruited a convenient sample of 200 consecutive caregivers of patients visiting the outpatient department of the Psychiatric Hospital, Benin City, Nigeria. These primary caregivers were unpaid relatives who provided support to patients. The patients were service users who fulfilled the diagnostic criteria of the International Classification of Disease [ICD-10; World Health Organization 1993] for schizophrenia and had been on treatment for at least two years. Majority (72.0% of caregivers endorsed supernatural causes as most important in the etiology of schizophrenia, while 28.0% endorsed natural causes. Every participant without formal education endorsed supernatural attribution. In our study, it was evident that participants embraced multiple causal attributions for schizophrenia.

Abnormal neural hierarchy in processing of verbal information in patients with schizophrenia.

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Lerner, Yulia; Bleich-Cohen, Maya; Solnik-Knirsh, Shimrit; Yogev-Seligmann, Galit; Eisenstein, Tamir; Madah, Waheed; Shamir, Alon; Hendler, Talma; Kremer, Ilana

2018-01-01

Previous research indicates abnormal comprehension of verbal information in patients with schizophrenia. Yet the neural mechanism underlying the breakdown of verbal information processing in schizophrenia is poorly understood. Imaging studies in healthy populations have shown a network of brain areas involved in hierarchical processing of verbal information over time. Here, we identified critical aspects of this hierarchy, examining patients with schizophrenia. Using functional magnetic resonance imaging, we examined various levels of information comprehension elicited by naturally presented verbal stimuli; from a set of randomly shuffled words to an intact story. Specifically, patients with first episode schizophrenia ( N  = 15), their non-manifesting siblings ( N  = 14) and healthy controls ( N  = 15) listened to a narrated story and randomly scrambled versions of it. To quantify the degree of dissimilarity between the groups, we adopted an inter-subject correlation (inter-SC) approach, which estimates differences in synchronization of neural responses within and between groups. The temporal topography found in healthy and siblings groups were consistent with our previous findings - high synchronization in responses from early sensory toward high order perceptual and cognitive areas. In patients with schizophrenia, stimuli with short and intermediate temporal scales evoked a typical pattern of reliable responses, whereas story condition (long temporal scale) revealed robust and widespread disruption of the inter-SCs. In addition, the more similar the neural activity of patients with schizophrenia was to the average response in the healthy group, the less severe the positive symptoms of the patients. Our findings suggest that system-level neural indication of abnormal verbal information processing in schizophrenia reflects disease manifestations.

Abnormal neural hierarchy in processing of verbal information in patients with schizophrenia

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Yulia Lerner

2018-01-01

Full Text Available Previous research indicates abnormal comprehension of verbal information in patients with schizophrenia. Yet the neural mechanism underlying the breakdown of verbal information processing in schizophrenia is poorly understood. Imaging studies in healthy populations have shown a network of brain areas involved in hierarchical processing of verbal information over time. Here, we identified critical aspects of this hierarchy, examining patients with schizophrenia. Using functional magnetic resonance imaging, we examined various levels of information comprehension elicited by naturally presented verbal stimuli; from a set of randomly shuffled words to an intact story. Specifically, patients with first episode schizophrenia (N = 15, their non-manifesting siblings (N = 14 and healthy controls (N = 15 listened to a narrated story and randomly scrambled versions of it. To quantify the degree of dissimilarity between the groups, we adopted an inter-subject correlation (inter-SC approach, which estimates differences in synchronization of neural responses within and between groups. The temporal topography found in healthy and siblings groups were consistent with our previous findings – high synchronization in responses from early sensory toward high order perceptual and cognitive areas. In patients with schizophrenia, stimuli with short and intermediate temporal scales evoked a typical pattern of reliable responses, whereas story condition (long temporal scale revealed robust and widespread disruption of the inter-SCs. In addition, the more similar the neural activity of patients with schizophrenia was to the average response in the healthy group, the less severe the positive symptoms of the patients. Our findings suggest that system-level neural indication of abnormal verbal information processing in schizophrenia reflects disease manifestations.

Object versus spatial visual mental imagery in patients with schizophrenia

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Aleman, André; de Haan, Edward H.F.; Kahn, René S.

2005-01-01

Objective Recent research has revealed a larger impairment of object perceptual discrimination than of spatial perceptual discrimination in patients with schizophrenia. It has been suggested that mental imagery may share processing systems with perception. We investigated whether patients with schizophrenia would show greater impairment regarding object imagery than spatial imagery. Methods Forty-four patients with schizophrenia and 20 healthy control subjects were tested on a task of object visual mental imagery and on a task of spatial visual mental imagery. Both tasks included a condition in which no imagery was needed for adequate performance, but which was in other respects identical to the imagery condition. This allowed us to adjust for nonspecific differences in individual performance. Results The results revealed a significant difference between patients and controls on the object imagery task (F1,63 = 11.8, p = 0.001) but not on the spatial imagery task (F1,63 = 0.14, p = 0.71). To test for a differential effect, we conducted a 2 (patients v. controls) х 2 (object task v. spatial task) analysis of variance. The interaction term was statistically significant (F1,62 = 5.2, p = 0.026). Conclusions Our findings suggest a differential dysfunction of systems mediating object and spatial visual mental imagery in schizophrenia. PMID:15644999

Behavioral therapy for weight loss in patients with schizophrenia.

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Ganguli, Rohan

2007-01-01

Compared with the general population, individuals with schizophrenia demonstrate an increased prevalence of obesity. While most antipsychotics are associated with weight gain, certain second-generation antipsychotics (SGAs) appear to be especially problematic. Weight gain and obesity are highly distressing to these patients, can reduce treatment adherence, and may increase the relative risk of serious medical conditions and all-cause premature mortality. The selection of an antipsychotic on the basis of its effectiveness and relative side effect profile is recognized as an important initial consideration in the treatment of schizophrenia. However, less is known regarding the efficacy of dietary, pharmacologic, and behavioral therapy in reducing antipsychotic-related weight gain and obesity. Behavioral therapy, in particular, is understudied, and there are relatively few controlled trials of its effectiveness in reducing SGA-induced weight gain. Although weight loss resulting from behavioral therapy has been observed mostly as a result of effective short-term interventions, controlled behavioral studies do exist to suggest that weight can be controlled long term. In addition, a small pilot study in patients with schizophrenia or schizoaffective disorder recently demonstrated that behavioral therapy that utilizes stepped interventions, involving body weight self-monitoring, diet, and exercise, can prevent weight gain in patients initiating treatment with SGAs. Additional studies of behavioral therapy for long-term weight control in patients with schizophrenia and other forms of severe mental illness are warranted.

Cerebral perfusion inhomogeneities in schizophrenia demonstrated with single photon emission computed tomography and Tc99m-hexamethylpropyleneamineoxim

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Bajc, M.; Basic, M.; Topuzovic, N.; Babic, C.; Medved, V.

1989-01-01

Cerebral blood flow was measured in relative terms with Tc99m-hexamethylpropyleneamineoxim (HMPAO) and single photon emission computed tomography (SPECT) in 28 female schizophrenic patients (20 acute and 8 chronic) classified according to DSM-III. Eleven normals served as controls. The acute patients were classified according to positive and negative symptoms. Patients with predominantly positive symptoms showed by and large normal and homogeneous cerebral isotope uptake. Those with negative symptoms, and the chronic patients, showed inhomogeneous tracer uptake with multiple regions of hypoperfusion in slices 4-6 cm above the orbitomeatal line. The findings support in principle the notion that schizophrenia with negative or chronic symptoms does not affect the whole brain homogeneously. Brain imaging with Tc99m-HMPAO and SPECT might be used to distinguish various types of schizophrenia. (author)

Neurocognitive recovery of patients with paranoid schizophrenia

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Olena Molchanova

2017-11-01

Full Text Available Background. At present neurocognitive impairment is considered a core feature of schizophrenia. This statement is grounded on cognitive impairment stability, the persistence of cognitive impairment independently of the disease stage and other symptoms of schizophrenia. The relevance of the search for cognitive remediation methods is determined by the influence of cognitive functioning on the functional outcome in patients with schizophrenia. In order to solve this problem, scientists are actively investigating such direction in the treatment of patients with this psychopathology as «neurocognitive therapy» or neurocognitive training. Objective.To evaluate the effectiveness of neurocognitive training in patients with paranoid schizophrenia. Methods and materials. The patients who matched inclusion criteria were assessed on Positive and Negative Syndrome Scale (PANSS, Personal and Social Performance scale (PSP, neuropsychological tests (Trail Making Test part A and B, Wisconsin Card Sorting Test, Luria test at the baseline, 1st and 6th month. All patients who were included in the study were randomly assigned into two groups. The intervention group (n=40 underwent a standard supportive treatment and neurocognitive training. The control group (n=31 received supportive medication treatment alone. Results. After 1st month, a statistically significant difference between the intervention and control groups was found both for the overall PANSS score improvement and improvement in several items, which represented the cognitive decline. Total PSP score increased significantly in the intervention group from 41-50 to 51-60 (р=0.0001. In Wisconsin Card Sorting Test the proportion of incorrect answers decreased by 31.4% (р=0.0001, perseverative errors by 20.1% (р=0.042, the number of completed categories increased by 33.5% (р=0.002. Conclusion. The proposed neurocognitive training program showed positive results, which was reflected in a statistically

Remission and recovery in schizophrenia: practitioner and patient perspectives.

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Davidson, Larry; Schmutte, Timothy; Dinzeo, Thomas; Andres-Hyman, Raquel

2008-01-01

Schizophrenia remains a complex, dynamic, multi-dimensional, and poorly understood condition. Although the concept of heterogeneity in outcome has conceptually overturned the post Kraepelinian legacy of progressive deterioration, a number of factors appear to contribute to perpetuating a pessimistic attitude toward outcome within the field. These include the limited access people with schizophrenia have to effective interventions and the phenomenon of the "clinician's illusion," which refers to the tendency of practitioners to assume that patients remain seriously ill when outside of the clinical care settings in which they are typically seen. Longitudinal studies, however, continue to point to a large number of people who experience improvements in their condition over time. Pressure from patients and their families, who experience periods of symptomatic relief and enhanced functioning first-hand, has led to the introduction of such concepts as "remission" and being "in" recovery with schizophrenia, in addition to the conventional notion of recovering "from" schizophrenia. These developments are consistent with recent policy initiatives by the U.S. and other governments around the world and aim to re-orient research and clinical practice from a traditional focus on effecting cure to exploring ways to encourage and assist people with schizophrenia to live meaningful lives in the face of an enduring illness.

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

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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.

Association of gliadin antibodies, HLA alleles, and schizophrenia in Cuban population patients

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José A. Galván

2016-05-01

Full Text Available Introduction: Several lines of evidence have suggested an interesting link between gluten ingestion and schizophrenia. For example, increased levels of gliadin and transglutaminase antibodies have been observed in patients with schizophrenia. Methods: To verify these observations we compared the prevalence of gliadin and transglutaminse antibodies, as well as the presence of the HLA alleles, HLA DQA1*0501-DQB1*02 (DQ2 and HLA-DQA1*0301-DQB1*0302 (DQ8, among patients with schizophrenia and healthy controls. A total of 108 patients with schizophrenia and 60 healthy controls were evaluated. Gliadin antibodies were determined by a visual semiquantitative assay and tissue transglutaminase antibodies were determined both by one-step immunochromatografic assay and ELISA. HLA typing was performed by PCR amplification using sequence-specific primers for each allele. Results: We found a strong association between the presence of gliadin antibodies and schizophrenia (OR 3.488; 95% CI, 1.43-8.44. However, tissue transglutaminase antibodies were not detected in either group neither by immunochromatograpic or ELISA. No significant association was found for the DQ2 or DQ8 heterodimer and the disease, but a significant positive association between schizophrenia and HLA alleles DQA1*0301 and DQB1*02 was present (OR = 2.80; 95% CI, 1.27-6.17, and OR = 2.37, 95% CI, 1.24-4.53, respectively. Conclusions: The present study showed that the presence of gliadin antibodies was not correlated with the presence of HLA DQA1*0301 or DQB1*02 alleles within the group of patients with schizophrenia. Our study replicates the findings that anti-gliadin antibodies are associated with schizophrenia but also suggests that the presence of these antibodies and the HLA alleles DQB1*02 and DQA1*0301 are independently associated with susceptibility to schizophrenia.

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

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

2015-01-01

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

Is dietary pattern of schizophrenia patients different from healthy subjects?

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Amani Reza

2007-05-01

Full Text Available Abstract Background There are limited findings about dietary patterns and food preferences among patients suffering from schizophrenia. The main objective of this study was therefore to compare the nutritional pattern of schizophrenia patients with that of matched healthy subjects. Methods The dietary pattern of 30 hospitalized 16–67 years old schizophrenic patients (11 female was compared with that of 30 healthy age and sex matched individuals as control group. Subjects' anthropometric measurements including weight, height and body mass index (BMI, semi-quantitative food frequency (FFQ, medical and food history questionnaires were also collected and FFQs were then scored using Food Guide Pyramid to obtain the dietary scores. Percent body fat (%BF was measured using bioelectrical impedance analysis (BIA method. Results Female patients had more %BF and lower dietary pattern scores than that of their controls (32 ± 3.6 vs 27.7 ± 4.6 percent and 43.2 ± 11.9 vs 54.5 ± 10.7 points; respectively, p Conclusion Schizophrenia patients have poor nutritional patterns. In particular, female patients have more percent body fat and lower dietary pattern scores compared with their healthy controls. All patients used to consume more fats and sweet drinks frequently. The findings of this study suggest that schizophrenia patients need specific medical nutrition therapies through limiting dietary fats and sugars intakes and weight control. Whether obesity is the consequence of disease, dietary preference or medications used remains to be cleared.

Effect of organizational strategy on visual memory in patients with schizophrenia.

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Kim, Myung-Sun; Namgoong, Yoon; Youn, Tak

2008-08-01

The aim of the present study was to examine how copy organization mediated immediate recall among patients with schizophrenia using the Rey-Osterrieth Complex Figure Test (ROCF). The Boston Qualitative Scoring System (BQSS) was applied for qualitative and quantitative analyses of ROCF performances. Subjects included 20 patients with schizophrenia and 20 age- and gender-matched healthy controls. During the copy condition, the schizophrenia group and the control group differed in fragmentation; during the immediate recall condition, the two groups differed in configural presence and planning; and during the delayed recall condition, they differed in several qualitative measurements, including configural presence, cluster presence/placement, detail presence/placement, fragmentation, planning, and neatness. The two groups also differed in several quantitative measurements, including immediate presence and accuracy, immediate retention, delayed retention, and organization. Although organizational strategies used during the copy condition mediated the difference between the two groups during the immediate recall condition, group also had a significant direct effect on immediate recall. Schizophrenia patients are deficient in visual memory, and a piecemeal approach to the figure and organizational deficit seem to be related to the visual memory deficit. But schizophrenia patients also appeared to have some memory problems, including retention and/or retrieval deficits.

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

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

2010-03-17

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

[Face recognition in patients with schizophrenia].

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Doi, Hirokazu; Shinohara, Kazuyuki

2012-07-01

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

Regional cerebral blood flow in schizophrenia

International Nuclear Information System (INIS)

Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

1982-01-01

Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions

Regional cerebral blood flow in schizophrenia

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Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

1982-10-01

Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions.

Schizophrenia patients demonstrate a dissociation on declarative and non-declarative memory tests.

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Perry, W; Light, G A; Davis, H; Braff, D L

2000-12-15

Declarative memory refers to the recall and recognition of factual information. In contrast, non-declarative memory entails a facilitation of memory based on prior exposure and is typically assessed with priming and perceptual-motor sequencing tasks. In this study, schizophrenia patients were compared to normal comparison subjects on two computerized memory tasks: the Word-stem Priming Test (n=30) and the Pattern Sequence Learning Test (n=20). Word-stem Priming includes recall, recognition (declarative) and priming (non-declarative) components of memory. The schizophrenia patients demonstrated an impaired performance on recall of words with relative improvement during the recognition portion of the test. Furthermore, they performed normally on the priming portion of the test. Thus, on tests of declarative memory, the patients had retrieval deficits with intact performance on the non-declarative memory component. The Pattern Sequence Learning Test utilizes a serial reaction time paradigm to assess non-declarative memory. The schizophrenia patients' serial reaction time was significantly slower than that of comparison subjects. However, the patients' rate of acquisition was not different from the normal comparison group. The data suggest that patients with schizophrenia process more slowly than normal, but have an intact non-declarative memory. The schizophrenia patients' dissociation on declarative vs. non-declarative memory tests is discussed in terms of possible underlying structural impairment.

Deficient gaze pattern during virtual multiparty conversation in patients with schizophrenia.

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Han, Kiwan; Shin, Jungeun; Yoon, Sang Young; Jang, Dong-Pyo; Kim, Jae-Jin

2014-06-01

Virtual reality has been used to measure abnormal social characteristics, particularly in one-to-one situations. In real life, however, conversations with multiple companions are common and more complicated than two-party conversations. In this study, we explored the features of social behaviors in patients with schizophrenia during virtual multiparty conversations. Twenty-three patients with schizophrenia and 22 healthy controls performed the virtual three-party conversation task, which included leading and aiding avatars, positive- and negative-emotion-laden situations, and listening and speaking phases. Patients showed a significant negative correlation in the listening phase between the amount of gaze on the between-avatar space and reasoning ability, and demonstrated increased gaze on the between-avatar space in the speaking phase that was uncorrelated with attentional ability. These results suggest that patients with schizophrenia have active avoidance of eye contact during three-party conversations. Virtual reality may provide a useful way to measure abnormal social characteristics during multiparty conversations in schizophrenia. Copyright © 2014 Elsevier Ltd. All rights reserved.

Caregiver burden among relatives of patients with schizophrenia in Katsina, Nigeria

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Abdulkareem Jika Yusuf

2009-06-01

Full Text Available Objective: Caring for patients’ with schizophrenia leads to an enormous burden on the caregivers. However, the magnitude of this problem remains largely unknown in Sub-Saharan Africa. The objective of this study was to determine the burden of care giving among relatives of patients with schizophrenia. Materials and method: A total of 129 primary care-givers of patients with schizophrenia attending out-patient clinic of Katsina state Psychiatric Hospital were interviewed using a socio-demographic data collection sheet and Zarith Burden Interview (ZBI. Data obtained was analysed using Statistical Package for Social Sciences version 13. Results: The mean age of the respondents was 45.07±8.91. Majority of the caregivers are females. High level of burden was found in 47.3% of the respondents. The level of burden experienced was significantly associated with place of residence and family size. Conclusion: Schizophrenia is associated with high level of caregiver burden and effort should be made at alleviating this burden for better out come in both the patients and caregivers.

Intellectual factors in false memories of patients with schizophrenia.

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Zhu, Bi; Chen, Chuansheng; Loftus, Elizabeth F; Dong, Qi; Lin, Chongde; Li, Jun

2018-07-01

The current study explored the intellectual factors in false memories of 139 patients with schizophrenia, using a recognition task and an IQ test. The full-scale IQ score of the participants ranged from 57 to 144 (M = 100, SD = 14). The full IQ score had a negative correlation with false recognition in patients with schizophrenia, and positive correlations with high-confidence true recognition and discrimination rates. Further analyses with the subtests' scores revealed that false recognition was negatively correlated with scores of performance IQ (and one of its subtests: picture arrangement), whereas true recognition was positively correlated with scores of verbal IQ (and two of its subtests: information and digit span). High-IQ patients had less false recognition (overall or high-confidence false recognition), more high-confidence true recognition, and higher discrimination abilities than those with low IQ. These findings contribute to a better understanding of the cognitive mechanism in false memory of patients with schizophrenia, and are of practical relevance to the evaluation of memory reliability in patients with different intellectual levels. Copyright © 2018 Elsevier B.V. All rights reserved.

An association between autumn birth and clozapine treatment in patients with schizophrenia

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Sørensen, Holger J; Foldager, Leslie; Røge, Rasmus

2014-01-01

BACKGROUND: Numerous studies on seasonality of birth and schizophrenia risk have been published but it is uncertain whether, among those with schizophrenia, refractory illness exhibits any predilection for birth month. We hypothesized and examined whether a season of birth effect was present in p...... investigated but might be partially explained by early exposures such as winter flu season and low vitamin D levels.......BACKGROUND: Numerous studies on seasonality of birth and schizophrenia risk have been published but it is uncertain whether, among those with schizophrenia, refractory illness exhibits any predilection for birth month. We hypothesized and examined whether a season of birth effect was present...... in patients with schizophrenia with a history of clozapine treatment. METHOD: Using record linkage with Danish registers, we examined patients with schizophrenia born between 1950 and 1970, and between 1995 and 2009 and Cox regression analysis was used to examine season of birth in relation to history...

Preliminary analysis of positive and negative syndrome scale in ketamine-associated psychosis in comparison with schizophrenia.

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Xu, Ke; Krystal, John H; Ning, Yuping; Chen, Da Chun; He, Hongbo; Wang, Daping; Ke, Xiaoyin; Zhang, Xifan; Ding, Yi; Liu, Yuping; Gueorguieva, Ralitza; Wang, Zuoheng; Limoncelli, Diana; Pietrzak, Robert H; Petrakis, Ismene L; Zhang, Xiangyang; Fan, Ni

2015-02-01

Studies of the effects of the N-methyl-d-aspartate (NMDA) glutamate receptor antagonist, ketamine, have suggested similarities to the symptoms of schizophrenia. Our primary goal was to evaluate the dimensions of the Positive and Negative Syndrome Scale (PANSS) in ketamine users (acute and chronic) compared to schizophrenia patients (early and chronic stages). We conducted exploratory factor analysis for the PANSS from four groups: 135 healthy subject administrated ketamine or saline, 187 inpatients of ketamine abuse; 154 inpatients of early course schizophrenia and 522 inpatients of chronic schizophrenia. Principal component factor analyses were conducted to identify the factor structure of the PANSS. Factor analysis yielded five factors for each group: positive, negative, cognitive, depressed, excitement or dissociation symptoms. The symptom dimensions in two schizophrenia groups were consistent with the established five-factor model (Wallwork et al., 2012). The factor structures across four groups were similar, with 19 of 30 symptoms loading on the same factor in at least 3 of 4 groups. The factors in the chronic ketamine group were more similar to the factors in the two schizophrenia groups rather than to the factors in the acute ketamine group. Symptom severities were significantly different across the groups (Kruskal-Wallis χ(2)(4) = 540.6, p Symptoms in the two ketamine groups were milder than in the two schizophrenia groups (Cohen's d = 0.7). Our results provide the evidence of similarity in symptom dimensions between ketamine psychosis and schizophrenia psychosis. The interpretations should be cautious because of potential confounding factors. Copyright © 2014 Elsevier Ltd. All rights reserved.

Insight and white matter fractional anisotropy in first-episode schizophrenia.

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Asmal, Laila; du Plessis, Stefan; Vink, Matthijs; Fouche, Jean-Paul; Chiliza, Bonginkosi; Emsley, Robin

2017-05-01

Impaired insight is a hallmark feature of schizophrenia. Structural studies implicate predominantly prefrontal, cingulate, cuneus/precuneus, and inferior temporal brain regions. The cortical midline structures (CMS) are also implicated in functional studies primarily through self-reflective processing tasks. However, few studies have explored the relationship between white matter tracts and insight in schizophrenia, and none in first-episode schizophrenia (FES). Here, we examined for fractional anisotropy (FA) differences in 89 minimally treated FES patients and 98 matched controls, and identified those FA differences associated with impaired clinical insight in patients. We found widespread FA reduction in FES patients compared to controls. Poorer insight in patients was predicted by lower FA values in a number of white matter tracts with a predilection for tracts associated with cortical midline structures (fronto-occipital, cingulate, cingulate hippocampus, uncinate, anterior corona radiata), and more severe depressive symptoms. The association between FA abnormalities and insight was most robust for the awareness of symptoms and illness awareness domains. Our study implicates a network of tracts involved in impaired insight in schizophrenia with a predilection for the CMS. This study is a first step in delineating the white matter tracts involved in insight impairment in schizophrenia prior to chronicity. Copyright © 2016. Published by Elsevier B.V.

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

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

2014-12-01

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

A case study on acupuncture in the treatment of schizophrenia

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Bosch, M.P.C.; Staudte, H.; Noort, M.W.M.L. van den; Lim, S.

2014-01-01

This report describes the use of acupuncture as an add on treatment for a patient with chronic schizophrenia. The 63-year-old woman suffered from persistent hallucinations and even physical pain as a result of the hallucination of a black bird that kept pecking her back. The patient received 12

Low dietary intake of n-3 fatty acids, niacin, folate, and vitamin C in Korean patients with schizophrenia and the development of dietary guidelines for schizophrenia.

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Kim, Eun Jin; Lim, So Young; Lee, Hee Jae; Lee, Ju-Yeon; Choi, Seunggi; Kim, Seon-Young; Kim, Jae-Min; Shin, Il-Seon; Yoon, Jin-Sang; Yang, Soo Jin; Kim, Sung-Wan

2017-09-01

Inappropriate dietary intake and poor nutritional status are reported to be associated with metabolic syndrome and psychopathology in patients with schizophrenia. We hypothesized that inappropriate dietary habits and insufficient dietary intake of specific nutrients are associated with schizophrenia. To test the hypothesis, we assessed the dietary habits and nutritional intake of patients with schizophrenia and then developed suitable dietary guidelines. In total, 140 subjects (73 controls and 67 patients with schizophrenia from community mental health centers) were included, and dietary intakes were analyzed using a semi-quantitative food frequency questionnaire. As a result, the proportion of overweight or obese patients was significantly higher in schizophrenia subjects (64.2%) compared with control subjects (39.7%) (P=.004). The male schizophrenia patients had significantly lower dietary intakes of protein, polyunsaturated fatty acids (PUFAs), vitamin K, niacin, folate, and vitamin C than the male control subjects. In all multiple logistic regression models, subjects with the "low" dietary intake of protein, n-3 PUFAs, niacin, folate, and vitamin C had a significantly higher odds ratios for schizophrenia compared with those with the "high" dietary intake category of each nutrient. Therefore, maintenance of a healthy body weight and sufficient dietary intake of protein, PUFAs, niacin, folate, and vitamin C are recommended for Korean patients with schizophrenia. Copyright © 2017 Elsevier Inc. All rights reserved.

The relationship between obesity and neurocognitive function in Chinese patients with schizophrenia.

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Guo, Xiaofeng; Zhang, Zhanchou; Wei, Qinling; Lv, Hailong; Wu, Renrong; Zhao, Jingping

2013-04-09

Studies have reported that up to 60% of individuals with schizophrenia are overweight or obese. This study explored the relationship between obesity and cognitive performance in Chinese patients with schizophrenia. Outpatients with schizophrenia aged 18-50 years were recruited from 10 study sites across China. Demographic and clinical information was collected. A neuropsychological battery including tests of attention, processing speed, learning/memory, and executive functioning was used to assess cognitive function, and these 4 individual domains were transformed into a neurocognitive composite z score. In addition, height and weight were measured to calculate body mass index (BMI). Patients were categorized into 4 groups (underweight, normal weight, overweight and obese) based on BMI cutoff values for Asian populations recommended by the World Health Organization. A total number of 896 patients were enrolled into the study. Fifty-four percent of participants were overweight or obese. A higher BMI was significantly associated with lower scores on the Wechsler Memory Scale-Revised (WMS-R) Visual Reproduction subscale, the Wechsler Adult Intelligence Scale-Revised (WAIS-R) Digit Symbol subscale, and the composite z score (p's ≤ 0.024). Obese patients with schizophrenia had significantly lower scores than normal weight patients on the Trail Making Test B, the WMS-R Visual Reproduction subscale, the WAIS Digit Symbol subscale, and the composite z score (p's ≤ 0.004). Our study suggests that, in addition to its well established risk for various cardiometabolic conditions, obesity is also associated with decreased cognitive function in Chinese patients with schizophrenia. Future studies should explore if weight loss and management can improve cognitive function in obese patients who suffer from schizophrenia.

Characteristics of patients diagnosed with schizoaffective disorder compared with schizophrenia and bipolar disorder.

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Pagel, Tobias; Baldessarini, Ross J; Franklin, Jeremy; Baethge, Christopher

2013-05-01

Information on basic demographic and clinical characteristics of schizoaffective disorder is sparse and subject to sampling bias and low diagnostic reliability. In the present study we aimed to: (i) estimate the demographic and clinical descriptors in schizoaffective disorder patients and (ii) compare the findings with those with schizophrenia and bipolar disorder. To minimize sampling bias and low reliability, we systematically reviewed studies that simultaneously compared schizoaffective, schizophrenia, and bipolar disorder patients. We estimated demographic, clinical, and psychometric characteristics based on weighted pooling, and compared disorders by meta-analysis. We also estimated whether schizoaffective disorder is closer to schizophrenia or to bipolar disorder. We identified 50 studies that included 18312 patients. Most characteristics of the 2684 schizoaffective disorder patients fell between those of 4814 diagnosed with bipolar disorder and 10814 with schizophrenia. However, the schizoaffective group had the highest proportion of women (52%), had the youngest age at illness onset (23.3 ± 3.8 years), and had the highest standardized ratings of psychosis and depression. Differences in pooled parameters between schizoaffective versus schizophrenia and versus bipolar disorder subjects were similar. Values for patients with schizoaffective disorders mostly were intermediate between schizophrenia and bipolar disorder. However, the majority of studies showed schizoaffective patients to be more like schizophrenia than bipolar disorder patients in seven out of nine demographic and clinical categories as well as in five out of eight psychometric measures. These results remained similar when we restricted the analyses to studies with psychotic bipolar disorder patients only or to studies using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IIIR and DSM-IV only. The present study provided estimates of important characteristics of schizoaffective

Hemispheric dominance during the mental rotation task in patients with schizophrenia.

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Chen, Jiu; Yang, Laiqi; Zhao, Jin; Li, Lanlan; Liu, Guangxiong; Ma, Wentao; Zhang, Yan; Wu, Xingqu; Deng, Zihe; Tuo, Ran

2012-04-01

Mental rotation is a spatial representation conversion capability using an imagined object and either object or self-rotation. This capability is impaired in schizophrenia. To provide a more detailed assessment of impaired cognitive functioning in schizophrenia by comparing the electrophysiological profiles of patients with schizophrenia and controls while completing a mental rotation task using both normally-oriented images and mirror images. This electroencephalographic study compared error rates, reaction times and the topographic map of event-related potentials in 32 participants with schizophrenia and 29 healthy controls during mental rotation tasks involving both normal images and mirror images. Among controls the mean error rate and the mean reaction time for normal images and mirror images were not significantly different but in the patient group the mean (sd) error rate was higher for mirror images than for normal images (42% [6%] vs. 32% [9%], t=2.64, p=0.031) and the mean reaction time was longer for mirror images than for normal images (587 [11] ms vs. 571 [18] ms, t=2.83, p=0.028). The amplitude of the P500 component at Pz (parietal area), Cz (central area), P3 (left parietal area) and P4 (right parietal area) were significantly lower in the patient group than in the control group for both normal images and mirror images. In both groups the P500 for both the normal and mirror images was significantly higher in the right parietal area (P4) compared with left parietal area (P3). The mental rotation abilities of patients with schizophrenia for both normally-oriented images and mirror images are impaired. Patients with schizophrenia show a diminished left cerebral contribution to the mental rotation task, a more rapid response time, and a differential response to normal images versus mirror images not seen in healthy controls. Specific topographic characteristics of the EEG during mental rotation tasks are potential biomarkers for schizophrenia.

Overconfidence in incorrect perceptual judgments in patients with schizophrenia

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Steffen Moritz

2014-12-01

Discussion: To the best of our knowledge, this is the first study to demonstrate overconfidence in errors among individuals with psychosis using a visual perception task. Speaking to the specificity of this abnormality for schizophrenia and its pathogenetic relevance, overconfidence in errors and knowledge corruption were elevated in patients with schizophrenia relative to both control groups and were correlated with paranoia.

Self-harm in patients with schizophrenia spectrum disorders.

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Mork, Erlend; Mehlum, Lars; Barrett, Elizabeth A; Agartz, Ingrid; Harkavy-Friedman, Jill M; Lorentzen, Steinar; Melle, Ingrid; Andreassen, Ole A; Walby, Fredrik A

2012-01-01

This study describes the prevalence, clinical characteristics, and gender profile of self-harm in a cross-sectional sample of 388 patients with schizophrenia spectrum disorders. All patients were interviewed and assessed with respect to lifetime self-harm and relevant clinical variables. An overall of 49% of the patients reported self-harm which was associated with female gender, having had a depressive episode, younger age at psychosis onset, alcohol abuse or dependence, current suicidality, awareness of illness, and low adherence to prescribed medication. Higher awareness of having a mental disorder was associated with self-harm in men only, while emotional dysregulation was associated with self-harm in women only. We conclude that while self-harm in patients with schizophrenia spectrum disorders is highly prevalent in both genders, risk factors in men and women differ in several important ways.

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

in the left rostral dorsal premotor cortex, the right presupplementary motor area and the anterior medial superior frontal gyrus bilaterally. Follow-up analyses suggested that the rostral dorsal premotor cortex and presupplementary motor area correlations were driven predominantly by the controls. Limitations......Background: Prepulse inhibition (PPI) of the startle reflex is modulated by a complex neural network. Prepulse inhibition impairments are found at all stages of schizophrenia. Previous magnetic resonance imaging (MRI) studies suggest that brain correlates of PPI differ between patients...... with schizophrenia and healthy controls; however, these studies included only patients with chronic illness and medicated patients. Our aim was to examine the structural brain correlates of PPI in antipsychotic-naive patients with first-episode schizophrenia. Methods: We performed acoustic PPI assessment...

CANTAB Explicit Memory Is Less Impaired in Addicted Schizophrenia Patients

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

2005-01-01

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

Impulsivity, aggression and suicide risk among male schizophrenia patients.

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Iancu, Iulian; Bodner, Ehud; Roitman, Suzana; Piccone Sapir, Anna; Poreh, Amir; Kotler, Moshe

2010-01-01

Impulsivity has been shown to be a major variable in the etiology of suicide and aggression, but has not been researched as much in the schizophrenic population, which is characterized by serious suicide and aggression risks. 68 male schizophrenia patients responded to a battery of measures including the Positive and Negative Syndrome Scale (PANSS), the impulsivity control scale (IS), the Suicide Risk Scale (SRS) and the Overt Aggression Scale. We divided our subjects into those who received scores above and below the median on the IS. The high-impulsivity group had higher present and past rates of suicidal ideation and showed a trend for more lifetime suicidal attempts than the low-impulsivity group. The impulsivity score correlated positively with the SRS score and with some of the scores of the PANSS (the positive symptoms score, the general psychopathology score and the total score). A multiple regression analysis revealed that an older age, higher levels of aggression, high impulsivity and an elevated score on the general psychopathology subscale of the PANSS contributed positively and significantly to the explained variance of the SRS. Our study supports the contention that high impulsivity in schizophrenia patients is significant in the etiology of suicide in schizophrenia. However, the relationship between impulsivity and aggression in schizophrenia patients, and also the amelioration of impulsivity by pharmacological interventions, require further study. Copyright (c) 2010 S. Karger AG, Basel.

Genetic underpinnings of left superior temporal gyrus thickness in patients with schizophrenia.

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Wolthusen, Rick P F; Hass, Johanna; Walton, Esther; Turner, Jessica A; Rössner, Veit; Sponheim, Scott R; Ho, Beng-Choon; Holt, Daphne J; Gollub, Randy L; Calhoun, Vince; Ehrlich, Stefan

2015-08-07

Schizophrenia is a highly disabling psychiatric disorder with a heterogeneous phenotypic appearance. We aimed to further the understanding of some of the underlying genetics of schizophrenia, using left superior temporal gyrus (STG) grey matter thickness reduction as an endophenoptype in a genome-wide association (GWA) study. Structural magnetic resonance imaging (MRI) and genetic data of the Mind Clinical Imaging Consortium (MCIC) study of schizophrenia were used to analyse the interaction effects between 1,067,955 single nucleotide polymorphisms (SNPs) and disease status on left STG thickness in 126 healthy controls and 113 patients with schizophrenia. We next used a pathway approach to detect underlying pathophysiological pathways that may be related to schizophrenia. No SNP by diagnosis interaction effect reached genome-wide significance (5 × 10 -8 ) in our GWA study, but 10 SNPs reached P-values less than 10 -6 . The most prominent pathways included those involved in insulin, calcium, PI3K-Akt and MAPK signalling. Our strongest findings in the GWA study and pathway analysis point towards an involvement of glucose metabolism in left STG thickness reduction in patients with schizophrenia only. These results are in line with recently published studies, which showed an increased prevalence of psychosis among patients with metabolic syndrome-related illnesses including diabetes.

Cardiovascular Pharmacogenomics and Cognitive Function in Patients with Schizophrenia.

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Ward, Kristen M; Kraal, A Zarina; Flowers, Stephanie A; Ellingrod, Vicki L

2017-09-01

The authors sought to examine the impact of multiple risk alleles for cognitive dysfunction and cardiovascular disease risk on cognitive function and to determine if these relationships varied by cognitive reserve (CR) or concomitant medication use in patients with schizophrenia. They conducted a cross-sectional study in ambulatory mental health centers. A total of 122 adults with a schizophrenia spectrum diagnosis who were maintained on a stable antipsychotic regimen for at least 6 months before study enrollment were included. Patients were divided into three CR groups based on years of formal education: no high school completion or equivalent (low-education group [18 patients]), completion of high school or equivalent (moderate-education group [36 patients], or any degree of post-high school education (high-education group [68 patients]). The following pharmacogenomic variants were genotyped for each patient: AGT M268T (rs699), ACE insertion/deletion (or ACE I/D, rs1799752), and APOE ε2, ε3, and ε4 (rs429358 and rs7412). Risk allele carrier status (identified per gene as AGT M268 T carriers, ACE D carriers, and APOE ε4 carriers) was not significantly different among CR groups. The Brief Assessment of Cognition in Schizophrenia (BACS) scale was used to assess cognitive function. The mean ± SD patient age was 43.9 ± 11.6 years. Cardiovascular risk factors such as hypertension and hyperlipidemia diagnoses, and use of antihypertensive and lipid-lowering agents, did not significantly differ among CR groups. Mixed modeling revealed that risk allele carrier status was significantly associated with lower verbal memory scores for ACE D and APOE ε4 carriers, but AGT T carrier status was significantly associated with higher verbal memory scores (p=0.0188, p=0.0055, and p=0.0058, respectively). These results were only significant in the low-education group. In addition, medication-gene interactions were not significant predictors of BACS scores. ACE D and APOE ε4

Glucoregulation in normal weight schizophrenia patients treated by first generation antipsychotics

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Marić Nađa

2008-01-01

Full Text Available Introduction Schizophrenia patients are at greater risk of obesity, diabetes mellitus (DM, lipid abnormalities and cardiovascular disorders. The metabolic complications in patients are associated with several risk factors: family history of DM, lifestyle, smoking, dietary habits, physical inactivity, but also with antipsychotic medication. In literature, most publications have been focused on the effects of the second generation antipsychotics (SGA on glucose metabolism. However, less attention has been paid to abnormality in glucoregulation, patients with schizophrenia treated with the first generation antipsychotics (FGA. Objective The present study evaluated glucose metabolism in normal weight schizophrenia patients treated with FGA. METHOD The cross-sectional study included 18 patients (FGA treated and 20 healthy controls with neither group differences in sex distribution, age, nor in BMI. Inclusion criteria were normal BMI (20-25 kg/m2. The glucose levels, insulin levels and growth hormone levels during oral glucose tolerance test (OGTT were measured. Results Fasting glucose and insulin levels did not differ significantly between groups. Groups differed in OGTT glucose and insulin peak and area under curve (AUC, level of significance p<0.05 (patients vs. controls: glucose peak 8.3±0.4 vs.6.9±0.5 mmol/l, glucose AUC 758±28 vs. 640±36 mU/l/120 min; insulin peak in patients 92.7±15.6 mU/l; insulin AUC 6060±1016 mU/l/120 min, insulin peak in controls 47.9±6.5 mU/l; insulin AUC 2597±256 mU/l/120 min. Conclusion Patients with schizophrenia, although with normal body mass index, are at high risk of abnormal glucose regulation. Not only SGA increase the risk of impaired glucoregulation and metabolic syndrome, but this may also be due to FGA or schizophrenia per se. .

Differentiation of schizophrenia patients from healthy subjects by mismatch negativity and neuropsychological tests.

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Yi-Ting Lin

Full Text Available BACKGROUND: Schizophrenia is a heterogeneous disorder with diverse presentations. The current and the proposed DSM-V diagnostic system remains phenomenologically based, despite the fact that several neurobiological and neuropsychological markers have been identified. A multivariate approach has better diagnostic utility than a single marker method. In this study, the mismatch negativity (MMN deficit of schizophrenia was first replicated in a Han Chinese population, and then the MMN was combined with several neuropsychological measurements to differentiate schizophrenia patients from healthy subjects. METHODOLOGY/PRINCIPAL FINDINGS: 120 schizophrenia patients and 76 healthy controls were recruited. Each subject received examinations for duration MMN, Continuous Performance Test, Wisconsin Card Sorting Test, and Wechsler Adult Intelligence Scale Third Edition (WAIS-III. The MMN was compared between cases and controls, and important covariates were investigated. Schizophrenia patients had significantly reduced MMN amplitudes, and MMN decreased with increasing age in both patient and control groups. None of the neuropsychological indices correlated with MMN. Predictive multivariate logistic regression models using the MMN and neuropsychological measurements as predictors were developed. Four predictors, including MMN at electrode FCz and three scores from the WAIS-III (Arithmetic, Block Design, and Performance IQ were retained in the final predictive model. The model performed well in differentiating patients from healthy subjects (percentage of concordant pairs: 90.5%. CONCLUSIONS/SIGNIFICANCE: MMN deficits were found in Han Chinese schizophrenia patients. The multivariate approach combining biomarkers from different modalities such as electrophysiology and neuropsychology had a better diagnostic utility.

Decreased resting-state interhemispheric functional connectivity in unaffected siblings of schizophrenia patients.

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Guo, Wenbin; Jiang, Jiajing; Xiao, Changqing; Zhang, Zhikun; Zhang, Jian; Yu, Liuyu; Liu, Jianrong; Liu, Guiying

2014-01-01

Neuroimaging studies in unaffected siblings of schizophrenia patients can provide clues to the pathophysiology for the development of schizophrenia. However, little is known about the alterations of the interhemispheric resting-state functional connectivity (FC) in siblings, although the dysconnectivity hypothesis is prevailing in schizophrenia for years. In the present study, we used a newly validated voxel-mirrored homotopic connectivity (VMHC) method to identify whether aberrant interhemispheric FC was present in unaffected siblings at increased risk of developing schizophrenia at rest. Forty-six unaffected siblings of schizophrenia patients and 50 age-, sex-, and education-matched healthy controls underwent a resting-state functional magnetic resonance imaging (fMRI). Automated VMHC was used to analyze the data. The sibling group had lower VMHC than the control group in the angular gyrus (AG) and the lingual gyrus/cerebellum lobule VI. No region exhibited higher VMHC in the sibling group than in the control group. There was no significant sex difference of the VMHC values between male siblings and female siblings or between male controls and female controls, although evidence has been accumulated that size and shape of the corpus callosum, and functional homotopy differ between men and women. Our results first suggest that interhemispheric resting-state FC of VMHC is disrupted in unaffected siblings of schizophrenia patients, and add a new clue of abnormal interhemispheric resting-state FC to the pathophysiology for the development of schizophrenia. Copyright © 2013 Elsevier B.V. All rights reserved.

Visual integration dysfunction in schizophrenia arises by the first psychotic episode and worsens with illness duration

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Keane, Brian P.; Paterno, Danielle; Kastner, Sabine; Silverstein, Steven M.

2016-01-01

Visual integration dysfunction characterizes schizophrenia, but prior studies have not yet established whether the problem arises by the first psychotic episode or worsens with illness duration. To investigate the issue, we compared chronic schizophrenia patients (SZs), first episode psychosis patients (FEs), and well-matched healthy controls on a brief but sensitive psychophysical task in which subjects attempted to locate an integrated shape embedded in noise. Task difficulty depended on th...

Chronic mild stress impairs latent inhibition and induces region-specific neural activation in CHL1-deficient mice, a mouse model of schizophrenia.

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Buhusi, Mona; Obray, Daniel; Guercio, Bret; Bartlett, Mitchell J; Buhusi, Catalin V

2017-08-30

Schizophrenia is a neurodevelopmental disorder characterized by abnormal processing of information and attentional deficits. Schizophrenia has a high genetic component but is precipitated by environmental factors, as proposed by the 'two-hit' theory of schizophrenia. Here we compared latent inhibition as a measure of learning and attention, in CHL1-deficient mice, an animal model of schizophrenia, and their wild-type littermates, under no-stress and chronic mild stress conditions. All unstressed mice as well as the stressed wild-type mice showed latent inhibition. In contrast, CHL1-deficient mice did not show latent inhibition after exposure to chronic stress. Differences in neuronal activation (c-Fos-positive cell counts) were noted in brain regions associated with latent inhibition: Neuronal activation in the prelimbic/infralimbic cortices and the nucleus accumbens shell was affected solely by stress. Neuronal activation in basolateral amygdala and ventral hippocampus was affected independently by stress and genotype. Most importantly, neural activation in nucleus accumbens core was affected by the interaction between stress and genotype. These results provide strong support for a 'two-hit' (genes x environment) effect on latent inhibition in CHL1-deficient mice, and identify CHL1-deficient mice as a model of schizophrenia-like learning and attention impairments. Copyright © 2017 Elsevier B.V. All rights reserved.

Theory of Mind differences in older patients with early-onset and late-onset paranoid schizophrenia.

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Smeets-Janssen, M M J; Meesters, P D; Comijs, H C; Eikelenboom, P; Smit, J H; de Haan, L; Beekman, A T F; Stek, M L

2013-11-01

Theory of Mind (ToM) is considered an essential element of social cognition. In younger schizophrenia patients, ToM impairments have extensively been demonstrated. It is not clear whether similar impairments can be found in older schizophrenia patients and if these impairments differ between older patients with early-onset and late-onset schizophrenia. Theory of Mind abilities were assessed using the Hinting Task in 15 older patients (age 60 years and older) with early-onset paranoid schizophrenia, 15 older patients with late-onset paranoid schizophrenia and 30 healthy controls. ANCOVA was performed to test differences between groups. Analyses were adjusted for level of education. Effect sizes, partial eta squared (ε(2) ), were computed as an indication of the clinical relevance of the findings. Patients with early-onset schizophrenia scored significantly lower on the Hinting Task (mean 16.1; SD 4.3) compared with patients with late-onset schizophrenia (mean 18.6; SD 1.5) and with healthy controls (mean 19.0; SD 1.4). The effect size of this difference was large (ε(2)  = 0.2). These results suggest that ToM functioning may be a protective factor modulating the age at onset of psychosis. Further studies into the relationship between social cognition and onset age of psychosis are warranted. Copyright © 2013 John Wiley & Sons, Ltd.

Change in Prolactin Levels in Pediatric Patients Given Antipsychotics for Schizophrenia and Schizophrenia Spectrum Disorders: A Network Meta-Analysis

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Chakrapani Balijepalli

2018-01-01

Full Text Available Background. Treatment of schizophrenia with first- and second-generation antipsychotics has been associated with elevated prolactin levels, which may increase the risk for prolactin-related adverse events. Methods. Randomized controlled trials (RCTs included in a recent systematic review were considered for this analysis. A Bayesian network meta-analysis was used to compare changes in prolactin levels in pediatric patients diagnosed with schizophrenia or schizophrenia spectrum disorders treated with second-generation antipsychotics (SGAs. Results. Five RCTs, including 989 patients combined, have evaluated the changes in prolactin for pediatric patients after 6 weeks of treatment with risperidone, quetiapine, aripiprazole, olanzapine, and paliperidone. In the overall study population, treatment with risperidone was associated with the highest increase in mean prolactin levels compared to other SGAs. Patients treated with risperidone 4–6 mg/day were found to experience the greatest increases (55.06 ng/ml [95% CrI: 40.53–69.58] in prolactin levels, followed by risperidone 1–3 mg/day, paliperidone 3–6 mg/day, and paliperidone 6–12 mg/day. Conclusions. This study shows that there are differences in SGAs ability to cause hyperprolactinemia. Further, there is clear evidence of safety concerns with risperidone and paliperidone treatment in adolescent schizophrenia patients. Registration. PROSPERO CRD42014009506.

Intrinsic motivation and metacognition as predictors of learning potential in patients with remitted schizophrenia.

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Tas, Cumhur; Brown, Elliot C; Esen-Danaci, Aysen; Lysaker, Paul H; Brüne, Martin

2012-08-01

Previous research has suggested that neurocognitive functioning predicts best the potential of patients with schizophrenia to acquire newly learned material, which, in turn may impact patients' social functioning. Recent studies have also shown that intrinsic motivation and metacognitive abilities play a decisive role in social functioning in schizophrenia. Accordingly, the present study sought to examine the relationship between intelligence, motivation, metacognition, and learning during a cognitive remediation experimental training. We hypothesized that metacognition and intrinsic motivation would have a strong relationship and independently predict learning potential. Thirty-two patients with schizophrenia who fulfilled the criteria of functional remission were recruited. In a pre-training-post experimental design, patients' learning potential was assessed using previously defined cognitive remediation training for WCST. Intrinsic motivation was examined using Intrinsic Motivation Inventory for schizophrenia; mastery, a domain of metacognition, was measured using the Metacognitive Assessment Scale. Metacognition significantly correlated with subdomains of intrinsic motivation. Patients with higher intrinsic motivation and preserved metacognition improved more in the learning paradigm compared to poorly motivated patients and patients with reduced metacognitive abilities. In particular, "mastery" was determined as an independent predictor of learning potential. Motivation and metacognition are important predictors of learning in schizophrenia. Psychological interventions in schizophrenia may therefore consider incorporating techniques to stimulate metacognitive and motivational abilities as well as developing individualized training programs. Copyright © 2012 Elsevier Ltd. All rights reserved.

The impact of insight on social functioning in patients with schizophrenia.

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Erol, Almila; Delibas, Hakan; Bora, Ozlem; Mete, Levent

2015-06-01

It is still unclear whether insight has a direct association with social functioning in schizophrenia, independent of its association with symptoms. This study aimed to investigate the relationship of insight and its dimensions with social functioning in schizophrenia. A total of 170 outpatients with schizophrenia were included in this study. All patients were evaluated with the Scale to Assess Unawareness of Mental Disorder (SUMD), Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance Scale (PSP). Patients with impaired insight and patients with unimpaired insight were compared for PSP score through independent samples t test. Pearson's correlation analysis was used to determine the correlations between study variables. Multiple stepwise linear regression analysis was used in order to determine the variables that predict social performance. The PSP score of patients with impaired insight was significantly lower than that of patients with unimpaired insight. There were significant correlations between insight dimensions and PSP score. PANSS negative scale score, awareness of achieved effects of medication and awareness of anhedonia/asociality were significant predictors of social performance. Insight has a significant impact on social functioning in schizophrenia, and some, but not all, insight dimensions have direct impact on social performance, independent of their association with symptoms. © The Author(s) 2014.

Targeting anxiety to improve quality of life in patients with schizophrenia.

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Buonocore, M; Bosia, M; Bechi, M; Spangaro, M; Cavedoni, S; Cocchi, F; Bianchi, L; Guglielmino, C; Mastromatteo, A R; Cavallaro, R

2017-09-01

Several studies suggested that anxiety can significantly affect the outcome of schizophrenia. Despite this evidence, non-pharmacological interventions targeting anxiety are still heterogenous. This study aims to test the efficacy of a novel training specifically designed to target anxiety in patients with schizophrenia. Innovatively, this training, beyond psychoeducation and problem solving, also targets Theory of Mind, as it provides coping strategies. Twenty-seven outpatients with schizophrenia received a novel rehabilitative training targeting anxiety (Anxiety Management Group [AMG]) combined with a Computer-Assisted Cognitive Remediation (CACR), and twenty received CACR plus a control intervention (Control Newspaper discussion Group [CNG]). All patients were assessed at baseline and after treatment for quality of life, neurocognition and anxiety. After training, patients treated with AMG+CACR showed significantly greater improvements on anxiety. A significant increase in quality of life was observed only for AMG+CACR group. Moreover, the participants' appraisal showed a significant difference between treatment groups with higher ratings among patients who received the AMG+CACR. This study thus suggests feasibility and efficacy of the proposed intervention, that could be implemented in rehabilitative programs for patients with schizophrenia with potential benefits also on disease course and outcome. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Alterations in theory of mind in patients with schizophrenia and non-psychotic relatives.

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Janssen, I; Krabbendam, L; Jolles, J; van Os, Jim

2003-08-01

It has been proposed that alterations in theory of mind underlie specific symptoms of psychosis. The present study examined whether alterations in theory of mind reflect a trait that can be detected in non-psychotic relatives of patients with schizophrenia. Participants were 43 patients with schizophrenia or schizoaffective disorder, 41 first-degree non-psychotic relatives and 43 controls from the general population. Theory of mind was assessed using a hinting task and a false-belief task. There was a significant association between schizophrenia risk and failure on the hinting task (OR linear trend = 2.01, 95% CI: 1.22-3.31), with relatives having intermediate values between patients and controls. Adjustment for IQ and neuropsychological factors reduced the association by small amounts. The association between schizophrenia risk and failure on the false-belief tasks was not significant. Changes in theory of mind are associated with schizophrenia liability. General cognitive ability and neuropsychological measures seem to mediate only part of this association.

Cognitive deficit in patients with paranoid schizophrenia: Its clinical and laboratory correlates.

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Dorofeikova, Mariia; Neznanov, Nikolay; Petrova, Nataliia

2018-04-01

The aim of this study was to search for correlates of cognitive impairment in patients with paranoid schizophrenia among clinical, demographic, anamnestic and biochemical markers (NSE, S100B protein, BDNF, hs-CRP). Patients with paranoid schizophrenia (n=125) were examined using the Brief Assessment of Cognitive Function in Schizophrenia, the Rey-Osterrieth Complex Figure task, and a number of clinical scales including the Positive and Negative Syndrome Scale. The majority of patients demonstrated cognitive impairment. The type of impairment was highly heterogeneous and individual. Relationships were found between the degree of executive functioning and family history of mental illness; working memory and age of onset of schizophrenia; and visual memory and psychopathological symptomatology. Negative and affective symptoms were not significantly associated with cognitive functioning. Treatment with first generation antipsychotics was associated with a more frequent impairment of motor skills, and concomitant anticholinergic drugs, with reduced accuracy. Use of second-generation antipsychotics only was associated with better accuracy, working memory and speech fluency. Among the patients, 21.4% had signs of a systemic inflammatory response, indicating a possible role of inflammatory response in the development of schizophrenia. CRP, S100B and NSE levels reflected features of the course of illness and therapeutic response. Patients with lower concentrations of BDNF were characterized by lower processing speeds. Copyright © 2017 Elsevier B.V. All rights reserved.

Emotion regulation strategies in Patients with schizophrenia

NARCIS (Netherlands)

van der Meer, Lisette; van't Wout, Mascha; Aleman, Andre

2009-01-01

Schizophrenia patients might experience difficulties in applying two widely used emotion regulation strategies, reappraisal and suppression. We investigated the relationships among emotion regulation strategies, alexithymia (i.e. inability to identify and verbalize feelings) and the role of

Sensory and cross-network contributions to response inhibition in patients with schizophrenia

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Matthew J. Hoptman

Full Text Available Patients with schizophrenia show response inhibition deficits equal to or greater than those seen in impulse-control disorders, and these deficits contribute to poor outcome. However, little is known about the circuit abnormalities underlying this impairment. To address this, we examined stop signal task performance in 21 patients with schizophrenia and 21 healthy controls using event related potential (ERP and resting state functional connectivity. Patients showed prolonged stop signal reaction time (SSRT and reduced N1, N2, and P3 amplitudes compared to controls. Across groups, P3 amplitudes were maximal after SSRT (i.e., after the time associated with the decision to stop occurred, suggesting that this component indexed response monitoring. Multiple regression analyses showed that longer SSRTs were independently related to 1 patient status, 2 reduced N1 amplitude on successful stop trials and 3 reduced anticorrelated resting state functional connectivity between visual and frontoparietal cortical networks. This study used a combined multimodal imaging approach to better understand the network abnormalities that underlie response inhibition in schizophrenia. It is the first of its kind to specifically assess the brain's resting state functional architecture in combination with behavioral and ERP methods to investigate response inhibition in schizophrenia. Keywords: EEG, Stop signal task, Impulsivity, Schizophrenia, Resting state functional connectivity

Omega-3 fatty acids related to cognitive impairment in patients with schizophrenia

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Kazumi Satogami

2017-09-01

Full Text Available Cognitive impairment is strongly associated with functional outcome in patients with schizophrenia but its pathophysiology remains largely unclear. Involvement of omega-3 fatty acids in the cognitive function of healthy individuals and patients with neuropsychiatric disease has received increasing attention. The aim of this study was to examine the relationship between omega-3 fatty acids with cognitive function, social function, and psychiatric symptoms in patients with schizophrenia. The subjects included 30 patients with schizophrenia or schizoaffective disorder. Psychiatric symptoms, cognitive function, and social function were assessed using the Positive and Negative Syndrome Scale, the Brief Assessment of Cognition in Schizophrenia (BACS, and the Social Functioning Scale (SFS, respectively. Blood serum omega-3 fatty acids were assessed using gas chromatography. The BACS composite score was significantly correlated with blood eicosapentaenoic acid (EPA and docosahexaenoic acid (DHA levels. In addition, a daily dose of antipsychotic medication was negatively and significantly correlated with the blood DHA level and with the BACS composite score. Step-wise multiple regression analyses demonstrated that the SFS score was significantly associated with the BACS composite score. Our results indicate that reduced blood omega-3 fatty acids are associated with cognitive impairment, which then impacts social functioning outcomes in schizophrenia.

[Augmented antipsychotic therapy with pantogam active in patients with schizophrenia].

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Medvedev, V E; Frolova, V I; Gushanskaya, E V; Ter-Israelyan, A U

2015-01-01

to study the efficacy of the GABA-ergic drug pantogam active (D-, L-gopantenic acid) in patients with schizophrenia treated with typical neuroleptics and to assess the rate of treatment response and tolerability of the drug. A sample consisted of 70 patients with schizophrenia stratified into main (n=35) and control (n=35) groups. All patients received one of typical antipsychotics (haloperidol, zuclopenthixol, promazine or perphenazine). Patients of the main group received in addition pantogam active in dose of 1200-1800 mg daily. The maximum allowed dose of 1800 mg daily was used in 62.9% of the patients. The long-term combined therapy with the addition of D-, L-gopantenic acid (pantogam activ) allowed to achieve clinical improvement earlier (on 8th week in the main group versus 16th week in the control group). The frequency and severity of secondary negative symptoms associated with antipsychotic therapy were decreased as well. The high efficacy and tolerability of the combined therapy allow to improve quality of life in patients with schizophrenia and their compliance to treatment as well as to reduce costs of medical care.

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

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Sugawara, Norio; Yasui-Furukori, Norio; Sato, Yasushi; Saito, Manabu; Furukori, Hanako; Nakagami, Taku; Ishioka, Masamichi; Kaneko, Sunao

2014-06-20

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

Semantic Memory Organization in Japanese Patients With Schizophrenia Examined With Category Fluency

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Chika Sumiyoshi

2018-03-01

Full Text Available BackgroundDisorganization of semantic memory in patients with schizophrenia has been studied by referring to their category fluency performance. Recently, data-mining techniques such as singular value decomposition (SVD analysis have been reported to be effective in elucidating the latent semantic memory structure in patients with schizophrenia. The aim of this study is to investigate semantic memory organization in patients with schizophrenia using a novel method based on data-mining approach.MethodCategory fluency data were collected from 181 patients with schizophrenia and 335 healthy controls at the Department of Psychiatry, Osaka University. The 20 most frequently reported animals were chosen for SVD analysis. In the two-dimensional (2D solution, item vectors (i.e., animal names were plotted in the 2D space of each group. In the six-dimensional (6D solution, inter-item similarities (i.e., cosines were calculated among items. Cosine charts were also created for the six most frequent items to show the similarities to other animal items.ResultsIn the 2D spatial representation, the six most frequent items were grouped in the same clusters (i.e., dog, cat as pet cluster, lion, tiger as wild/carnivorous cluster, and elephant, giraffe as wild/herbivorous cluster for patients and healthy adults. As for 6D spatial cosines, the correlations (Pearson’s r between 17 items commonly generated in the two groups were moderately high. However, cosine charts created for the three pairs from the six most frequent animals (dog–cat, lion–tiger, elephant–giraffe showed that pair-wise similarities between other animals were less salient in patients with schizophrenia.DiscussionSemantic memory organization in patients with schizophrenia, revealed by SVD analysis, did not appear to be seriously impaired in the 2D space representation, maintaining a clustering structure similar to that in healthy controls for common animals. However, the coherence of those

Connectome organization is related to longitudinal changes in general functioning, symptoms and IQ in chronic schizophrenia

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Collin, G.; de Nijs, J.; Hulshoff Pol, H. E.; Cahn, W.; van den Heuvel, M. P.

2016-01-01

Emerging evidence suggests schizophrenia to involve widespread alterations in the macroscale wiring architecture of the human connectome. Recent findings of attenuated connectome alterations in unaffected siblings of schizophrenia patients suggest that altered connectome organization may relate to

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

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

2015-12-30

Neuropsychological deficits are candidate endophenotypes of schizophrenia which can assist to explain the neurocognitive impact of genetic risk variants. The identification of endophenotypes is often based on the familiality of these phenotypes. Several studies demonstrate neuropsychological deficits in unaffected biological relatives of schizophrenia patients without differentiating between genetic and non-genetic factors underlying these deficits. We assessed N=129 unaffected biological parents of schizophrenia patients, N=28 schizophrenia patients (paranoid subtype), and N=143 controls without a family history of schizophrenia with an extensive neuropsychological test battery. Direct comparison of N=22 parents with an ancestral history of schizophrenia (more likely carriers, MLC) and N=17 of their spouses without such a history (less likely carriers, LLC) allowed the separation of genetic and non-genetic aspects in cognition. Overall, parents showed significant deficits in neuropsychological tasks from all cognitive domains with medium effect sizes. Direct comparisons of MLC- and LLC-parents showed that attentional and executive tasks were most strongly affected by genetic loading. To conclude, unaffected parents of schizophrenia patients showed modest yet significant impairments in attention, memory, and executive functioning. In particular, attentional and executive impairments varied most strongly with genetic loading for schizophrenia, prioritising these dysfunctions for genotype-endophenotype analyses. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia.

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Li, Qiongzhen; Du, Xiangdong; Zhang, Yingyang; Yin, Guangzhong; Zhang, Guangya; Walss-Bass, Consuelo; Quevedo, João; Soares, Jair C; Xia, Haishen; Li, Xiaosi; Zheng, Yingjun; Ning, Yuping; Zhang, Xiang Yang

2017-05-01

Obesity is a common comorbidity in schizophrenia. Few studies have addressed obesity in Chinese schizophrenia patients. The aims of this current study were to evaluate the prevalence, risk factors and clinical correlates of obesity in Chinese patients with schizophrenia. A total of 206 patients were recruited from a hospital in Beijing. Their clinical and anthropometric data together with plasma glucose and lipid parameters were collected. Positive and Negative Syndrome Scale (PANSS) was rated for all patients. Overall, 43 (20.9%) patients were obese and 67 (32.5%) were overweight. The obese patients had significantly higher glucose levels, triglyceride levels than non-obese patients. Females and patients with type 2 diabetes mellitus had increased risk for obesity. Correlation analysis showed that BMI was associated with sex, education levels, negative symptoms, total PANSS score, triglyceride levels and type 2 diabetes mellitus. Further stepwise regression analysis showed that sex, type 2 diabetes, education level, triglyceride and amount of smoking/day were significant predictors for obesity. Our study showed that the prevalence of obesity in Chinese patients with schizophrenia is higher than that in the general population. Some demographic and clinical variables are risk factors for obesity in schizophrenia. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Study on Positive and Negative Signs in Chronic Schizophrenic Women

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Sahel Hemmati

2002-10-01

Full Text Available Objective: Schizophrenia has different clinical manifestations, although, it is one disorder patients divided to two groups type 1 and type 2. type 1 who have positive and type 2 who have negative signs. Materials & Methods: They have chronic schizophrenia and treated at least with one antipsychotic drug. With checklist the signs were controlled. Results: In these chronic patients, hallucinations (positive sign are seen with almost all of negative signs. In the other hand, (1 Flat affect (2 A logia & volition (3 Social inattentiveness (4 Inability to feel intimacy are seen more than another signs. Conclusion: For these above  patients new antipsychotic must be examined.

The mere exposure effect in patients with schizophrenia.

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Marie, A; Gabrieli, J D; Vaidya, C; Brown, B; Pratto, F; Zajonc, R B; Shaw, R J

2001-01-01

The mere exposure effect refers to the development of an emotional preference for previously unfamiliar material because of frequent exposure to that material. This study compared schizophrenia subjects (n = 20) to normal controls (n = 21) to determine whether implicit memory, as demonstrated by the mere exposure effect, was intact. Patients with schizophrenia demonstrated a normal preference for both verbal and visual materials seen earlier relative to novel materials, despite impaired performance on a recognition task for explicit memory using similar materials. Previous studies of schizophrenia subjects have shown a dissociation between implicit and explicit memory on verbal tasks. We found a similar dissociation demonstrated by normal functioning on an implicit memory task and impaired functioning on an explicit memory task. Potential implications of these findings are discussed with regard to treatment and rehabilitation.

Diet, smoking and cardiovascular risk in schizophrenia in high and low care supported housing.

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Gupta, Avirup; Craig, Tom K J

2009-01-01

People suffering from schizophrenia have markedly increased physical morbidity and mortality. A poor diet and sedentary lifestyle make a significant contribution to this ill health. Healthcare professionals need to include assessments of diet and to promote a 'healthy living' lifestyle. To describe the dietary habits and cardiovascular risk factors of people with chronic schizophrenia living in supported accommodation and to audit the provision of cardiovascular health screening in this population. The dietary habits of 69 people with chronic schizophrenia living in community settings were assessed. Tobacco smoking, body mass indices and waist circumference were also measured. The dietary behaviour of patients living in high care settings with care staff present every day was compared with those in low care settings. Residents in both levels of care made poor dietary choices. Patients in high care were consuming more fast food than those in low care. The dietary habits of men and women in both levels of care were worse than reported by surveys of the general population in England. All patients had seen their GP in the previous year though only 3 had received diabetes screening and fewer than half had lipid profiles. People with schizophrenia do not improve their diet just by the provision of healthy food as was the case in high care settings. Secondary care services must address physical health monitoring as well as mental health if the increased mortality of patients with schizophrenia is to be addressed effectively. More effective interventions are necessary to improve and sustain a healthy diet.

Characteristics of motivation and their impacts on the functional outcomes in patients with schizophrenia.

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Tobe, Miki; Nemoto, Takahiro; Tsujino, Naohisa; Yamaguchi, Taiju; Katagiri, Naoyuki; Fujii, Chiyo; Mizuno, Masafumi

2016-02-01

Deficits of motivation have been considered to be a core feature of schizophrenia, and recent studies have begun to reveal the biological and psychological characteristics and mechanisms underlying the deficits in motivation in schizophrenia patients. The aims of the present study were to investigate the characteristics of motivation in schizophrenia patients using the General Causality Orientations Scale (GCOS), and the impacts of motivational orientations on the functional outcomes in schizophrenia patients. A total of 53 outpatients with schizophrenia and 38 healthy controls were recruited for this study. The GCOS was used to assess individual tendencies in respect of three different motivational orientations: the autonomy, controlled, and impersonal orientations, corresponding to intrinsic motivation, extrinsic motivation, and amotivation, respectively. The cognitive functioning, psychiatric symptoms, social functioning, and quality of life of the subjects were also assessed. The score for autonomy orientation was significantly lower in the patient group than that in the control group, while no significant differences were found between the two groups in respect of the scores for the other two orientations. The autonomy orientation was associated with various clinical variables, and regression analysis identified as one of the variables with the highest predictive accuracy for social functioning. Intrinsic motivation measured by the GCOS in schizophrenia patients was significantly lower than that in healthy controls. The deficits of intrinsic motivation were broadly associated with the clinical features and were a determinant of social functioning. Development of treatments for enhancing intrinsic motivation would be essential for functional recovery in schizophrenia patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Extrastriatal dopamine D-2/3 receptors and cortical grey matter volumes in antipsychotic-naive schizophrenia patients before and after initial antipsychotic treatment

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Nørbak-Emig, Henrik; Pinborg, Lars H.; Raghava, Jayachandra M.

2017-01-01

OBJECTIVES: Long-term dopamine D2/3 receptor blockade, common to all antipsychotics, may underlie progressive brain volume changes observed in patients with chronic schizophrenia. In the present study, we examined associations between cortical volume changes and extrastriatal dopamine D2/3 recept...... binding potentials (BPND) in first-episode schizophrenia patents at baseline and after antipsychotic treatment. METHODS: Twenty-two initially antipsychotic-naïve patients underwent magnetic resonance imaging (MRI), [(123)I]epidepride single-photon emission computerised tomography (SPECT......), and psychopathology assessments before and after 3 months of treatment with either risperidone (N = 13) or zuclopenthixol (N = 9). Twenty healthy controls matched on age, gender and parental socioeconomic status underwent baseline MRI and SPECT. RESULTS: Neither extrastriatal D2/3 receptor BPND at baseline, nor...

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

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

2011-11-01

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

Prenatal tobacco smoke exposure, risk of schizophrenia, and severity of positive/negative symptoms.

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Stathopoulou, Anastasia; Beratis, Ion N; Beratis, Stavroula

2013-08-01

Prenatal exposure to cigarette smoke causes chronic fetal hypoxia, dysregulation of endocrine equilibrium, and disruption of fetal neurodevelopment associated with brain malfunction, all of which potentially could induce vulnerability to schizophrenia. A total of 212 schizophrenia patients aged 14-30years, and 212 matched controls were studied. Prenatal tobacco smoke exposure of the schizophrenia patients was compared to that of the normal controls by applying logistic regression analysis and controlling for several confounding factors. The outcomes of interest were comparison of the frequency of maternal and paternal smoking between patients and controls, as well as the severity of positive and negative symptoms between the offspring of smoking and nonsmoking parents. Among the mothers of schizophrenia patients and controls, 92 (43.4%) and 46 (21.7%) smoked, respectively. Maternal smoking during pregnancy had a significant unique contribution on increasing the risk for development of schizophrenia (p=0.001), and a greater severity of negative symptoms (p=0.023). Paternal smoking did not have a significant effect on the risk of schizophrenia, or severity of negative symptoms. The findings suggest that maternal smoking during pregnancy puts offspring at an increased risk for later schizophrenia, with increased severity of negative symptoms. Given the wide practice of smoking during pregnancy, fetal exposure to tobacco smoke could be a major preventable neurodevelopmental factor that increases vulnerability to schizophrenia. Copyright © 2013 Elsevier B.V. All rights reserved.

Imaging Frontostriatal Function in Ultra-High-Risk, Early, and Chronic Schizophrenia During Executive Processing

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Morey, Rajendra A.; Inan, Seniha; Mitchell, Teresa V.; Perkins, Diana O.; Lieberman, Jeffrey A.; Belger, Aysenil

2009-01-01

Context Individuals experiencing prodromal symptoms of schizophrenia (ultra-high-risk group) demonstrate impaired performance on tasks of executive function, attention, and working memory. The neurobiological underpinnings of such executive deficits in ultra-high-risk individuals remains unclear. Objective We assessed frontal and striatal functions during a visual oddball continuous performance task, in ultra-high-risk, early, and chronic schizophrenic patients with the use of functional magnetic resonance imaging. Design Cross-sectional case-control design. Setting Community; outpatient clinic. Patients Fifty-two individuals (control, n = 16; ultra-high risk, n = 10; early, n = 15; chronic, n = 11) from a referred clinical sample and age- and sex-matched control volunteers underwent scanning. Main Outcome Measures Percentage of active voxels and percentage signal change calculated for the anterior cingulate gyrus (ACG), middle frontal gyrus (MFG), inferior frontal gyrus (IFG), basal ganglia, and thalamus. Performance on the visual oddball task was measured with percentage of hits and d′ (a measure based on the hit rate and the false-alarm rate). Results The ultra-high-risk group showed significantly smaller differential activation between task-relevant and task-irrelevant stimuli in the frontal regions (ACG, IFG, MFG) than the control group. Frontostriatal activation associated with target stimuli in the early and chronic groups was significantly lower than the control group, while the ultra-high-risk group showed a trend toward the early group. Conclusions Our findings suggest that prefrontal function begins to decline before the onset of syndromally defined illness and hence may represent a vulnerability marker in assessing the risk of developing psychotic disorders among ultra-high-risk individuals. PMID:15753238

Self-ordered pointing and visual conditional associative learning tasks in drug-free schizophrenia spectrum disorder patients

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Galluzzo Alessandro

2008-01-01

Full Text Available Abstract Background There is evidence of a link between schizophrenia and a deficit of working memory, but this has been derived from tasks not specifically developed to probe working memory per se. Our aim was to investigate whether working memory deficits may be detected across different paradigms using the self-ordered pointing task (SOPT and the visual conditional associative learning task (VCALT in patients with schizophrenia spectrum disorders and healthy controls. The current literature suggests deficits in schizophrenia spectrum disorder patients versus healthy controls but these studies frequently involved small samples, broad diagnostic criteria, inclusion of patients on antipsychotic medications, and were not controlled for symptom domains, severity of the disorder, etc. To overcome some of these limitations, we investigated the self-monitoring and conditional associative learning abilities of a numerically representative sample of healthy controls and a group of non-deteriorated, drug-free patients hospitalized for a schizophrenia spectrum disorder with florid, mainly positive psychotic symptoms. Methods Eighty-five patients with a schizophrenia spectrum disorder (DSM-IV-TR diagnosis of schizophrenia (n = 71 or schizophreniform disorder (n = 14 and 80 healthy controls entered the study. The clinical picture was dominated by positive symptoms. The healthy control group had a negative personal and family history of schizophrenia or mood disorder and satisfied all the inclusion and exclusion criteria other than variables related to schizophrenia spectrum disorders. Results Compared to controls, patients had worse performances on SOPT, VCALT and higher SOPT/VCALT ratios, not affected by demographic or clinical variables. ROC curves showed that SOPT, VCALT, and SOPT/VCALT ratio had good accuracy in discriminating patients from controls. The SOPT and VCALT scores were inter-correlated in controls but not in patients. Conclusion The

Theory of mind deficits for processing counterfactual information in persons with chronic schizophrenia.

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Kern, R S; Green, M F; Fiske, A P; Kee, K S; Lee, J; Sergi, M J; Horan, W P; Subotnik, K L; Sugar, C A; Nuechterlein, K H

2009-04-01

Interpersonal communication problems are common among persons with schizophrenia and may be linked, in part, to deficits in theory of mind (ToM), the ability to accurately perceive the attitudes, beliefs and intentions of others. Particular difficulties might be expected in the processing of counterfactual information such as sarcasm or lies. The present study included 50 schizophrenia or schizo-affective out-patients and 44 demographically comparable healthy adults who were administered Part III of The Awareness of Social Inference Test (TASIT; a measure assessing comprehension of sarcasm versus lies) as well as measures of positive and negative symptoms and community functioning. TASIT data were analyzed using a 2 (group: patients versus healthy adults) x 2 (condition: sarcasm versus lie) repeated-measures ANOVA. The results show significant effects for group, condition, and the group x condition interaction. Compared to controls, patients performed significantly worse on sarcasm but not lie scenes. Within-group contrasts showed that patients performed significantly worse on sarcasm versus lie scenes; controls performed comparably on both. In patients, performance on TASIT showed a significant correlation with positive, but not negative, symptoms. The group and interaction effects remained significant when rerun with a subset of patients with low-level positive symptoms. The findings for a relationship between TASIT performance and community functioning were essentially negative. The findings replicate a prior demonstration of difficulty in the comprehension of sarcasm using a different test, but are not consistent with previous studies showing global ToM deficits in schizophrenia.

Risk for cancer in a cohort of patients hospitalized for schizophrenia in Denmark, 1969-1993

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Dalton, Susanne Oksbjerg; Mellemkjær, Lene; Thomassen, L.

2005-01-01

with national incidence rates, adjusted for sex, age and calendar time. The risk for cancer was increased for both men and women during the first year of follow-up. When the first year of follow-up was excluded, the risk for all tobacco-associated cancers and for prostate and rectal cancers was reduced for male...... patients with schizophrenia. The standardized incidence ratio (SIR) of lung cancer was marginally reduced (SIR, 0.86; 95% CI: 0.65, 1.02) for male patients with schizophrenia; this was due, however, to a reduction in risk for older patients. An increased risk for breast cancer found for female patients...... with schizophrenia (SIR, 1.20; 95% CI: 1.05, 1.38) should be interpreted with caution, given the high proportion of nulliparous women with schizophrenia in Denmark. The data might support reduced risks for prostate and rectal cancer among male patients with schizophrenia, whereas a changing smoking pattern might...

[Metabolic Control, Evaluation and Follow-up Interventions in Patients With Schizophrenia].

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Oviedo, Gabriel Fernando; Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana; García Valencia, Jenny; Jaramillo, Luis Eduardo; Tamayo, Nathalie; Arenas, María Luisa; Vélez Fernández, Carolina

2015-01-01

To determine the laboratory tests, related to metabolic risk that should be practiced to adult patients diagnosed with schizophrenia. To assist the clinician decision-making process about complementary diagnostic evaluation strategies in adult diagnosed with schizophrenia. A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. The evidence of NICE guide 82 was adopted and updated. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The risk of overall mortality in schizophrenia is higher than in the general population excluding suicide. Results related with mortality associated to antipsychotics showed contradictory results. Metabolic outcomes showed a higher incidence and association with schizophrenia and treatment with antipsychotics (AP). The diagnosis of dyslipidemia in men with schizophrenia appears to be lower in comparison with the general population. However, changes in weight, blood sugar levels, HDL cholesterol and triglycerides are influenced by the use of antipsychotics in general there is a higher risk of developing diabetes mellitus in adults with schizophrenia. Based on the evidence found a plan was formulated for the evaluation of physiological and paraclinical variables during and before the management with AP in adult diagnosed with schizophrenia. The overall quality of evidence is low considering that most of the reports come from observational studies that have risk of bias and some designs have methodological limitations. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Subjective quality of life and suicidal behavior among Taiwanese schizophrenia patients.

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Kao, Yu-Chen; Liu, Yia-Ping; Cheng, Tsung-Hsing; Chou, Ming-Kuen

2012-04-01

Research of suicidal behavior in individuals with schizophrenia has often suggested that clinical characteristics and symptoms likely influence a patient's suicidal risk. However, there is a lack of research describing the link between patients' subjective quality of life (SQOL) and suicidal behavior in non-Western countries. Therefore, the current study attempts to explore how schizophrenia patients' SQOL and their suicidal behavior are related in a Taiwanese sample. In this study, 102 schizophrenia outpatients were investigated using the Taiwanese World Health Organization Quality of Life Schedule-Brief Version (WHO-QOL-BREF-TW), several Beck-Related symptom rating scales, and the Positive and Negative Syndrome Scale (PANSS) for psychopathology. These patients were also evaluated for suicidal risk using the critical items of the Scale for Suicide Ideation (SSI) and lifetime suicide attempts. Statistical analyses, including independent sample t tests, analysis of covariance (ANCOVA) and logistic stepwise regression models were completed. Compared with the non-suicidal group, suicidal patients had significantly lower scores in SQOL domains. The differences in social domain remained significant after adjusting for depressive symptoms. In multiple logistic regression analyses, level of depressive and psychotic symptoms increased and poor social and psychological SQOL were significant contributors to suicidal behavior. Having removed depressive symptoms from the model, only dissatisfaction with social SQOL was associated with heightened suicidal risk. Schizophrenia is associated with a high suicidal risk, of which depressive and psychotic symptoms are the major correlates. Again, the present study confirms and extends previous research showing that dissatisfied SQOL, particularly dissatisfaction with social relationships, should be considered in the assessment of suicidal risk in outpatients with schizophrenia, even when accounting other possible confounding factor

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

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

2014-11-01

Self-concept is deeply affected in schizophrenia. Positive symptoms in particular are related to disturbed self/other distinctions. The neural networks underlying self-evaluation in schizophrenia have barely been investigated. The study reported here involved 13 patients with schizophrenia and 13 matched controls. During functional MRI, participants decided in three conditions whether the presented positive and negative personality traits characterized themselves, an intimate person, or included a certain letter. Based on the responses, each experimental condition was designed using a flexible factorial model. Controls and patients showed a similar behavioral pattern during self-evaluation, with group comparison revealing decreased activation in patients in the left inferior temporal gyrus and both temporal poles during self-ascription of traits, and in the anterior medial prefrontal cortex during evaluation of an intimate person. In patients, positive symptoms correlated positively with brain activation in the left parahippocampus during trait self-ascription. Hence, while evaluating themselves, schizophrenia patients revealed decreased activation in areas related to self-awareness overlapping with networks involved in theory of mind, empathy and social knowledge. Moreover, patients' brain activation during self-reflection was affected by the current positive symptomatology. The close interaction between self and other highlights the clinical and social relevance of self-processing deficits in schizophrenia. © The Author (2013). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Performance on the Wechsler Adult Intelligence Scale-III in Japanese patients with schizophrenia.

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Fujino, Haruo; Sumiyoshi, Chika; Sumiyoshi, Tomiki; Yasuda, Yuka; Yamamori, Hidenaga; Ohi, Kazutaka; Fujimoto, Michiko; Umeda-Yano, Satomi; Higuchi, Arisa; Hibi, Yumiko; Matsuura, Yukako; Hashimoto, Ryota; Takeda, Masatoshi; Imura, Osamu

2014-07-01

Patients with schizophrenia have been reported to perform worse than non-schizophrenic populations on neuropsychological tests, which may be affected by cultural factors. The aim of this study was to examine the performance of a sizable number of patients with schizophrenia on the Japanese version of the Wechsler Adult Intelligence Scale-III (WAIS-III) compared with healthy controls. Performance on the WAIS-III was evaluated in 157 Japanese patients with schizophrenia and in 264 healthy control subjects. All IQ scores and four indices from the WAIS-III were impaired for patients with schizophrenia compared with healthy controls. Processing Speed was markedly disturbed, approximately 2 SD below that of the healthy control group. Among the 13 subtests, Comprehension (z = -1.70, d = 1.55), Digit Symbol Coding (z = -1.84, d = 1.88), and Symbol Search (z = -1.85, d = 1.77) were profoundly impaired relative to the healthy controls. These results indicate that the pattern and degree of impairment, as evaluated by the WAIS-III, in Japanese patients are similar to those previously reported in English-speaking patients and that the deficits of some neuropsychological domains relevant to functional outcomes are universally characteristic of schizophrenia. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Detection of subclinical atherosclerosis and diastolic dysfunction in patients with schizophrenia

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Ünsal C

2013-10-01

Full Text Available Cüneyt Ünsal,1 Mustafa Oran,2 Hande Oktay Tureli,3 Seref Alpsoy,4 Sema Yesilyurt,5 Mehtap Arslan,6 Birol Topcu,7 Osman Karakaya,8 Erhan Kurt6 1Department of Psychiatry, Namik Kemal University, School of Medicine, Tekirdag, Turkey; 2Department of Internal Medicine, Namik Kemal University, School of Medicine, Tekirdag, Turkey; 3Department of Cardiology, Bakirkoy Dr Sadi Konuk Education and Research Hospital, Istanbul, Turkey; 4Department of Cardiology, Namik Kemal University, School of Medicine, Tekirdag, Turkey; 5Department of Psychiatry, Bağcilar Training and Research Hospital, Istanbul, Turkey; 6Department of Psychiatry, Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey; 7Department of Biostatistics, Namik Kemal University, School of Medicine, Tekirdag, Turkey; 8Department of Social Service, Yalova University, Faculty of Economics and Administrative Sciences, Yalova, Turkey Background: Patients with schizophrenia have a higher risk for cardiovascular diseases, which is associated with early mortality compared with the nonschizophrenic population. Early diagnosis of cardiovascular diseases in asymptomatic periods in patients with schizophrenia would enhance their quality of life and reduce mortality. Echocardiography, carotid ultrasonography, and ankle brachial index (ABI measurement are known to be beneficial methods of detecting subclinical cardiovascular diseases and of risk stratification. The present study investigated carotid intima media thickness (CIMT and ABI and echocardiographic parameters measured via conventional and tissue Doppler echocardiography in patients with schizophrenia in comparison with a control group. Methods: The present case-control study included 116 patients with schizophrenia and 88 healthy patients. Participants with any current comorbid psychiatric disorder, current or lifetime neurological and medical problems, current coronary artery disease, diabetes

Oxytocin administration selectively improves olfactory detection thresholds for lyral in patients with schizophrenia.

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Woolley, J D; Lam, O; Chuang, B; Ford, J M; Mathalon, D H; Vinogradov, S

2015-03-01

Olfaction plays an important role in mammalian social behavior. Olfactory deficits are common in schizophrenia and correlate with negative symptoms and low social drive. Despite their prominence and possible clinical relevance, little is understood about the pathological mechanisms underlying olfactory deficits in schizophrenia and there are currently no effective treatments for these deficits. The prosocial neuropeptide oxytocin may affect the olfactory system when administered intranasally to humans and there is growing interest in its therapeutic potential in schizophrenia. To examine this model, we administered 40IU of oxytocin and placebo intranasally to 31 patients with a schizophrenia spectrum illness and 34 age-matched healthy control participants in a randomized, double-blind, placebo-controlled, cross-over study. On each test day, participants completed an olfactory detection threshold test for two different odors: (1) lyral, a synthetic fragrance compound for which patients with schizophrenia have specific olfactory detection threshold deficits, possibly related to decreased cyclic adenosine 3',5'-monophosphate (cAMP) signaling; and (2) anise, a compound for which olfactory detection thresholds change with menstrual cycle phase in women. On the placebo test day, patients with schizophrenia did not significantly differ from healthy controls in detection of either odor. We found that oxytocin administration significantly and selectively improved olfactory detection thresholds for lyral but not for anise in patients with schizophrenia. In contrast, oxytocin had no effect on detection of either odor in healthy controls. Our data indicate that oxytocin administration may ameliorate olfactory deficits in schizophrenia and suggest the effects of intranasal oxytocin may extend to influencing the olfactory system. Given that oxytocin has been found to increase cAMP signaling in vitro a possible mechanism for these effects is discussed. Published by Elsevier Ltd.

Are patients with schizophrenia rational maximizers? Evidence from an ultimatum game study.

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Csukly, Gábor; Polgár, Patrícia; Tombor, László; Réthelyi, János; Kéri, Szabolcs

2011-05-15

Schizophrenia is associated with impaired social cognition and community functioning. Social decision-making strategies of healthy controls and patients with schizophrenia were compared by using the ultimatum game (UG). In this game two players have to split a sum of money. The proposer offers a portion to the responder, who decides to either accept or reject the offer. Rejection results in no income to either of the parties. Unfair proposals are frequently rejected by nonclinical individuals, a phenomenon described as altruistic punishment. Patients and controls participated in a series of UG interactions as responders in a computerized test setting. We also tested the effect of the proposer's facial expression on decision-making. Our results indicate that patients with schizophrenia accepted unfair offers at a significantly higher rate than did healthy controls. In contrast, at fair proposals, the acceptance rate was lower in patients compared with controls. At higher offers, the proposer's facial expression (positive/negative) significantly influenced the acceptance rate (positive facial expression increased the likelihood of acceptance) in the control group. This effect was not observed in the patient group. These results suggest that schizophrenia patients are impaired in socioeconomic interactions requiring emotion recognition and decision-making, which may result in unstable behavioral strategies. Copyright © 2010 Elsevier Ltd. All rights reserved.

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

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Thuaire, Flavien; Izaute, Marie; Bacon, Elisabeth

2012-01-30

The aim of this study was to gain a better understanding of schizophrenia patients' strategic use of learning time allocation during encoding, and determine whether they are able to use their monitoring and previous performances to adapt their learning behavior efficiently. Schizophrenia is considered to be a pathology of consciousness as well as being associated with impaired awareness of cognitive processes. In this study, after a learning session, individuals may express a Judgment of Learning (JOL), which reflects their sense of being able to retrieve the information later and which forms the basis for their decision whether or not to carry on learning. The introspective abilities of schizophrenia patients and subsequent strategic control of study time during the encoding of easy or difficult word pairs were investigated in 23 patients and 23 healthy comparison subjects. In spite of their memory impairment, patients were able to judge the difficulty of the word pairs with accuracy and adapt their learning time accordingly. Schizophrenia patients are sensitive to difficulty when rating JOLs and afterwards controlling study time. Monitoring their knowledge at the start helped patients to adapt their learning efficiently. These findings may be of value for cognitive remediation. © 2011 Elsevier Ltd. All rights reserved.

Asymmetric dimethylarginine in somatically healthy schizophrenia patients treated with atypical antipsychotics

DEFF Research Database (Denmark)

Jørgensen, Anders; Knorr, Ulla Benedichte Søsted; Soendergaard, Mia Greisen

2015-01-01

ratio are positively correlated to measures of oxidative stress. METHODS: We included 40 schizophrenia patients treated with AAP, but without somatic disease or drug abuse, and 40 healthy controls. Plasma concentrations of ADMA and L-arginine were determined by high-performance liquid chromatography...... in a range of cardiovascular disorders. Increased ADMA levels may also lead to increased oxidative stress. We hypothesized that ADMA and the L-arginine:ADMA ratio are increased in somatically healthy schizophrenia patients treated with atypical antipsychotics (AAP), and that the ADMA and the L-arginine: ADMA....... Data were related to markers of systemic oxidative stress on DNA, RNA and lipids, as well as measures of medication load, duration of disease and current symptomatology. RESULTS: Plasma ADMA and the L-arginine:ADMA ratio did not differ between schizophrenia patients and controls. Furthermore, ADMA...

Enhanced facilitation of spatial attention in schizophrenia.

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Spencer, Kevin M; Nestor, Paul G; Valdman, Olga; Niznikiewicz, Margaret A; Shenton, Martha E; McCarley, Robert W

2011-01-01

While attentional functions are usually found to be impaired in schizophrenia, a review of the literature on the orienting of spatial attention in schizophrenia suggested that voluntary attentional orienting in response to a valid cue might be paradoxically enhanced. We tested this hypothesis with orienting tasks involving the cued detection of a laterally presented target stimulus. Subjects were chronic schizophrenia patients (SZ) and matched healthy control subjects (HC). In Experiment 1 (15 SZ, 16 HC), cues were endogenous (arrows) and could be valid (100% predictive) or neutral with respect to the subsequent target position. In Experiment 2 (16 SZ, 16 HC), subjects performed a standard orienting task with unpredictive exogenous cues (brightening of the target boxes). In Experiment 1, SZ showed a larger attentional facilitation effect on reaction time than HC. In Experiment 2, no clear sign of enhanced attentional facilitation was found in SZ. The voluntary, facilitatory shifting of spatial attention may be relatively enhanced in individuals with schizophrenia in comparison to healthy individuals. This effect bears resemblance to other relative enhancements of information processing in schizophrenia such as saccade speed and semantic priming. (c) 2010 APA, all rights reserved.

Validation of the Persian version of the brief assessment of cognition in schizophrenia in patients with schizophrenia and healthy controls.

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Mazhari, Shahrzad; Parvaresh, Nooshin; Eslami Shahrbabaki, Mahin; Sadeghi, Mohammad M; Nakhaee, Nouzar; Keefe, Richard S E

2014-02-01

The Brief Assessment of Cognition in Schizophrenia (BACS) is designed for assessment of cognitive function in patients with schizophrenia. Versions of the BACS in English and other languages have been shown to be as sensitive to cognitive dysfunction as a standard test battery, with the advantage of brief administration and scoring time. The present study aimed to test the concurrent validity of the Persian version of the BACS (Persian-BACS). A group of 50 patients with schizophrenia-spectrum disorders and a group of 50 healthy controls received the Persian-BACS in a first session, and in a second session a standard neurocognitive battery. Cronbach's alpha for the Persian-BACS was 0.74. All the Persian-BACS subscales were significantly correlated with the corresponding standard neurocognitive subscales and the Pearson correlation of the composite scores from the two instruments was 0.71. Moreover, a one-factor solution was found that accounted for 67.9% of the variance. Finally, the Persian-BACS demonstrated high ability to discriminate patients with schizophrenia from healthy controls. Good psychometric properties of the Persian-BACS suggest that it is a useful tool for assessing cognition in schizophrenic patients with Persian as their primary language. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

Serum cytokine contents in schizophrenia patient with metabolic syndrome and their correlation with nerve electrophysiology