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Sample records for drug-naive first-episode schizophrenia

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

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

    2012-11-30

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

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

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

    2017-03-01

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

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

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

    2017-01-01

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

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

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

    2015-11-26

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

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

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

    2011-12-30

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

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

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

    2016-04-30

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

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

    Institute of Scientific and Technical Information of China (English)

    权京菊; 兰菊; 杨晋梅

    2015-01-01

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

  8. Decreased glutathione levels and impaired antioxidant enzyme activities in drug-naive first-episode schizophrenic patients

    Science.gov (United States)

    2011-01-01

    Background The aim of this study was to determine glutathione levels and antioxidant enzyme activities in the drug-naive first-episode patients with schizophrenia in comparison with healthy control subjects. Methods It was a case-controlled study carried on twenty-three patients (20 men and 3 women, mean age = 29.3 ± 7.5 years) recruited in their first-episode of schizophrenia and 40 healthy control subjects (36 men and 9 women, mean age = 29.6 ± 6.2 years). In patients, the blood samples were obtained prior to the initiation of neuroleptic treatments. Glutathione levels: total glutathione (GSHt), reduced glutathione (GSHr) and oxidized glutathione (GSSG) and antioxidant enzyme activities: superoxide dismutase (SOD), glutathione peroxidase (GPx), catalase (CAT) were determined by spectrophotometry. Results GSHt and reduced GSHr were significantly lower in patients than in controls, whereas GSSG was significantly higher in patients. GPx activity was significantly higher in patients compared to control subjects. CAT activity was significantly lower in patients, whereas the SOD activity was comparable to that of controls. Conclusion This is a report of decreased plasma levels of GSHt and GSHr, and impaired antioxidant enzyme activities in drug-naive first-episode patients with schizophrenia. The GSH deficit seems to be implicated in psychosis, and may be an important indirect biomarker of oxidative stress in schizophrenia early in the course of illness. Finally, our results provide support for further studies of the possible role of antioxidants as neuroprotective therapeutic strategies for schizophrenia from early stages. PMID:21810251

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

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    Giacon, Bianca Cristina Ciccone; Galera, Sueli Aparecida Frari

    2006-06-01

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

  10. Lower levels of the glial cell marker TSPO in drug-naive first-episode psychosis patients as measured using PET and [(11)C]PBR28.

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    Collste, K; Plavén-Sigray, P; Fatouros-Bergman, H; Victorsson, P; Schain, M; Forsberg, A; Amini, N; Aeinehband, S; Erhardt, S; Halldin, C; Flyckt, L; Farde, L; Cervenka, S

    2017-02-14

    Several lines of evidence are indicative of a role for immune activation in the pathophysiology of schizophrenia. Nevertheless, studies using positron emission tomography (PET) and radioligands for the translocator protein (TSPO), a marker for glial activation, have yielded inconsistent results. Whereas early studies using a radioligand with low signal-to-noise in small samples showed increases in patients, more recent studies with improved methodology have shown no differences or trend-level decreases. Importantly, all patients investigated thus far have been on antipsychotic medication, and as these compounds may dampen immune cell activity, this factor limits the conclusions that can be drawn. Here, we examined 16 drug-naive, first-episode psychosis patients and 16 healthy controls using PET and the TSPO radioligand [(11)C]PBR28. Gray matter (GM) volume of distribution (VT) derived from a two-tissue compartmental analysis with arterial input function was the main outcome measure. Statistical analyses were performed controlling for both TSPO genotype, which is known to affect [(11)C]PBR28 binding, and gender. There was a significant reduction of [(11)C]PBR28 VT in patients compared with healthy controls in GM as well as in secondary regions of interest. No correlation was observed between GM VT and clinical or cognitive measures after correction for multiple comparisons. The observed decrease in TSPO binding suggests reduced numbers or altered function of immune cells in brain in early-stage schizophrenia.Molecular Psychiatry advance online publication, 14 February 2017; doi:10.1038/mp.2016.247.

  11. Happiness in first-episode schizophrenia.

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    Agid, Ofer; McDonald, Krysta; Siu, Cynthia; Tsoutsoulas, Christopher; Wass, Caroline; Zipursky, Robert B; Foussias, George; Remington, Gary

    2012-10-01

    Happiness is a core dimension of a person's life, related to both functioning and success. As patients with schizophrenia experience marked functional deficits, it would be informative to investigate their level of happiness. There are limited data currently available, perhaps due to the longstanding belief that anhedonia is an inherent feature of this illness. The present study set out to specifically assess happiness in schizophrenia in relation to both clinical and functional measures of outcome. Thirty-one first-episode remitted patients and 29 age- and sex-matched controls participated in the study. Patients' clinical status was assessed and a series of self-report questionnaires were used to measure levels of happiness, life satisfaction, success and functioning in both patients and controls. Patients experienced marked functional impairment versus healthy controls (phappiness (p=0.113) and satisfaction with life (p=0.350). In the patient group, we found that higher happiness ratings were significantly associated with less depression, less negative symptoms, less social withdrawal, greater life satisfaction, and higher social and occupational functioning. Both cognitive functioning and insight had no significant direct effects on ratings of happiness in the patient group. Despite marked functional impairment, individuals with first-episode schizophrenia are as happy as controls. Mechanisms that might allow for this are discussed, as are the implications for rehabilitation efforts that assume an individual holds to the same drives and goals as before the illness onset and/or is unhappy with their present functional status. Copyright © 2012 Elsevier B.V. All rights reserved.

  12. High-field magnetic resonance imaging of structural alterations in first-episode, drug-naive patients with major depressive disorder.

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    Chen, Z; Peng, W; Sun, H; Kuang, W; Li, W; Jia, Z; Gong, Q

    2016-11-08

    Previous structural imaging studies have found evidence of brain morphometric changes in patients with major depressive disorder (MDD), but these studies rarely excluded compounding effects of certain important factors, such as medications and long duration of illnesses. Furthermore, the neurobiological mechanism of the macroscopic findings of structural alterations in MDD patients remains unclear. In this study, we utilized magnetization transfer imaging, a quantitative measure of the macromolecular structural integrity of brain tissue, to identify biophysical alterations, which are represented by a magnetization transfer ratio (MTR), in MDD patients. To ascertain whether MTR changes occur independent of volume loss, we also conduct voxel-based morphometry (VBM) analysis. The participants included 27 first-episode, drug-naive MDD patients and 28 healthy controls matched for age and gender. Whole-brain voxel-based analysis was used to compare MTR and gray matter volume across groups and to analyse correlations between MTR and age, symptom severity, and illness duration. The patients exhibited significantly lower MTR in the left superior parietal lobule and left middle occipital gyrus compared with healthy controls, which may be related to the attentional and cognitive dysfunction in MDD patients. The VBM analysis revealed significantly increased gray matter volume in right postcentral gyrus in MDD patients. These findings in first-episode, drug-naive MDD patients may reflect microstructural gray matter changes in the parietal and occipital cortices close to illness onset that existed before volume loss, and thus potentially provide important new insight into the early neurobiology of depression.

  13. Are Prolactin Levels in Drug-Naive Schizophrenia Patients A Clinical Indicator?

    OpenAIRE

    Demet Yalcin

    2016-01-01

    Aim: The relationship between serum prolactin (PRL) levels in patients with schizophrenia and the psychopathology, risk of relapse, symptom severity, the side effects after antipsychotics and schizophrenia subtypes are known. The aim of this study is to examine the serum PRL level difference between drug naive schizophrenia patients and healthy control group and between schizophrenia subtypes. Material and Method: 45 untreated volunteer participant between the ages of 18-55 who applied to Ank...

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  15. Are Prolactin Levels in Drug-Naive Schizophrenia Patients A Clinical Indicator?

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    Demet Yalcin

    2016-07-01

    Full Text Available Aim: The relationship between serum prolactin (PRL levels in patients with schizophrenia and the psychopathology, risk of relapse, symptom severity, the side effects after antipsychotics and schizophrenia subtypes are known. The aim of this study is to examine the serum PRL level difference between drug naive schizophrenia patients and healthy control group and between schizophrenia subtypes. Material and Method: 45 untreated volunteer participant between the ages of 18-55 who applied to Ankara Numune Training and Research Hospital, in patient and outpatient departments of Psychiatry, diagnosed with schizophrenia with the DSM IV-TR classification were included to study before getting treated. Participants were given sociodemographic information form; Axis-II for definitions Semi-Structured Clinical Interview, the Positive and Negative Syndrome Scale (PANSS and Global Assessment of Functioning Scale (GAF and biochemical measurements were made. Results: The mean serum PRL levels in drug naive patients with schizophrenia were higher compared to the control group (p = 0.004. When patients with schizophrenia divided in to two groups as “paranoid” and “non-paranoid”, the mean serum prolactin levels among these groups were significantly different (p = 0.000. There was no significant relationship between serum PRL levels and GAF scores (P = 0.116 or PANSS total scores (P = 0.676 in patients with drug naive schizophrenia. Discussion: The difference between mean serum PRL levels in drug naive schizophrenia patients and schizophrenia subtypes are consistent with studies in the literature. As to use PRL levels as a marker in the clinic, further studies are needed.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  17. Case study of first episode schizophrenia in pregnancy and postpartum.

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    Kast, Kristopher A; Agarkar, Smita

    2017-08-01

    Patients with first-episode psychosis of peripartum onset commonly prove to have a mood-disorder diathesis; however, a proportion of cases represent first-episode schizophrenia. We present such a case and discuss the clinical relevance of recognizing this small but important population of new mothers. These patients are at considerable risk of misdiagnosis, resulting in ineffective maintenance therapy, poorer recovery of function, and development of treatment resistance. Accurate diagnosis in the peripartum period will impact treatment decisions and long-term therapy. Clinicians need to be vigilant, especially during maintenance therapy, to identify these patients and ensure appropriate antipsychotic therapy is provided.

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

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    Kahn, R S; Sommer, I E

    2015-02-01

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

  19. The neurobiology and treatment of first-episode schizophrenia

    Science.gov (United States)

    Kahn, R S; Sommer, I E

    2015-01-01

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

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

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    Tobias Hornig

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

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

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

    2014-12-15

    Patients with schizophrenia frequently exhibit motor deficits. However, to date, there are no studies comparing motor performance in first episode patients with schizophrenia and schizophrenia spectrum disorders (SSD; e.g. schizoaffective and brief psychosis). Participants comprised 57 first episode patients with schizophrenia, 32 first episode patients with SSD, and 51 healthy controls who underwent neuropsychological testing based on Luria׳s systematic approach, including the following tests on complex motor sequencing: the Fist-Edge-Palm (FEP) test and the bimanual probe (BP). Schizophrenia patients performed worse than SSD patients in FEP and BP, and both patient groups showed decreased scores compared to healthy controls. Furthermore, we found that a higher proportion of schizophrenia cases failed to correct their motor performance and needed external error correction, while SSD cases exhibited a higher proportion of self-correction in FEP and in BP. Lack of insight and poor executive functioning correlated with motor performance in schizophrenia, while impulse control and difficulties in abstract thinking were related to motor performance in schizophrenia spectrum disorder. Thus, psychomotor impairments appear already in first episode patients with schizophrenia and differ from impairments in SSD. Especially the inability to self-correct errors may be characteristic of schizophrenia, suggesting that impairments in error monitoring are related to psychomotor dysfunction in schizophrenia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  2. First-episode schizophrenia: characterization and clinical correlates

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    Robert M. Bilder

    2007-11-01

    Full Text Available Neuropsychological impairments are well documented in schizophrenia and are important targets of treatment. Information about the severity and pattern of deficits after treatment for the first psychotic episode and about relationships between these deficits and syndromal characteristics remains limited. Comprehensive neuropsychological assessments including 41 individual tests were given to 94 patients with first-episode schizophrenia after initial stabilization of psychosis and to a comparison group of 36 healthy volunteers. Profiles of neuropsychological deficits and the relationship of deficits to sex and handedness were examined. Correlations of neuropsychological deficit with a broad range of historical and clinical characteristics, including outcome, were explored. Patients had a large generalized neuropsychological deficit. Patients also had, superimposed on the generalized deficit, subtle relative deficits in memory and executive functions. Learning/memory dysfunction best distinguished patients from healthy individuals; after accounting for this difference, only motor deficits further distinguished the groups. Patients with higher neuropsychological ability had only memory deficits, and patients with lower ability had both memory and executive deficits. Dextral patients had less severe generalized deficit. Severity of residual symptoms was associated with greater generalized deficit. Executive and attentional deficits were most linked to global functional impairment and poor outcome. The results document a large generalized deficit, and more subtle differential deficits, in clinically stabilized first-episode patients. Learning/memory deficits were observed even in patients with less severe generalized deficit, but the pattern was unlike the amnestic syndrome and probably reflects different mechanisms. Executive and attentional deficits marked the more severe ly disabled patients, and may portend relatively poor outcome. Failure to

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

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

    2009-01-01

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

  4. A subtle grey-matter increase in first-episode, drug-naive major depressive disorder with panic disorder after 6 weeks' duloxetine therapy.

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    Lai, Chien-Han; Hsu, Yuan-Yu

    2011-03-01

    We designed this study to investigate the modulating effects of duloxetine on symptoms and grey matter of patients with major depressive disorder combined with panic disorder. We also aimed to discover if there was any persistence of grey-matter deficits after remission and to find 'trait markers' for this comorbidity. High-resolution magnetic resonance imaging and voxel-based morphometric measurements were performed on 15 patients at baseline and remitted status (week 6) compared to 15 healthy control subjects who were scanned twice within 6 wk. The rating scales of depressive and panic symptoms improved with statistical significance (corrected pgrey-matter deficits in infero-frontal, limbic, occipital, temporo-parietal, cerebellar areas (trait marker regions) in drug-naive patients were observed compared to controls at baseline (family-wise error corrected pgrey matter in healthy controls over the 6-wk period. Duloxetine-induced increases of grey matter were very subtle in left infero-frontal cortex, right fusiform gyrus, and right cerebellum VIIIa areas (state marker regions) after 6-wk therapy (uncorrected pgrey matter to the level of control subjects and grey-matter deficits in patients appear largely unaffected by duloxetine. We suggest that short-term duloxetine therapy improved the clinical symptoms of patients with major depressive disorder combined with panic disorder. These improvements might be related to a modest increase of grey matter in state marker regions of the brain. The deficits of trait marker regions were more evident and are likely to be important for pathogenesis.

  5. Executive attention impairment in first-episode schizophrenia

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    Orellana Gricel

    2012-09-01

    Full Text Available Abstract Background We compared the attention abilities of a group of first-episode schizophrenia (FES patients and a group of healthy participants using the Attention Network Test (ANT, a standard procedure that estimates the functional state of three neural networks controlling the efficiency of three different attentional behaviors, i.e., alerting (achieving and maintaining a state of high sensitivity to incoming stimuli, orienting (ability to select information from sensory input, and executive attention (mechanisms for resolving conflict among thoughts, feelings, and actions. Methods We evaluated 22 FES patients from 17 to 29 years of age with a recent history of a single psychotic episode treated only with atypical neuroleptics, and 20 healthy persons matched with FES patients by sex, age, and educational level as the control group. Attention was estimated using the ANT in which participants indicate whether a central horizontal arrow is pointing to the left or the right. The central arrow may be preceded by spatial or temporal cues denoting where and when the arrow will appear, and may be flanked by other arrows (hereafter, flankers pointing in the same or the opposite direction. Results The efficiency of the alerting, orienting, and executive networks was estimated by measuring how reaction time was influenced by congruency between temporal, spatial, and flanker cues. We found that the control group only demonstrated significantly greater attention efficiency than FES patients in the executive attention network. Conclusions FES patients are impaired in executive attention but not in alerting or orienting attention, suggesting that executive attention deficit may be a primary impairment during the progression of the disease.

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

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

    2010-01-01

    to be influenced by a history of substance abuse. Exploratory analyses indicated reduced volume of the nucleus accumbens in patients with first-episode schizophrenia. LIMITATIONS: This study was not a priori designed to test for differences between schizophrenia patients with or without lifetime substance abuse......BACKGROUND: Enlarged ventricles and reduced hippocampal volume are consistently found in patients with first-episode schizophrenia. Studies investigating brain structure in antipsychotic-naive patients have generally focused on the striatum. In this study, we examined whether ventricular...... enlargement and hippocampal and caudate volume reductions are morphological traits of antipsychotic-naive first-episode schizophrenia. METHODS: We obtained high-resolution 3-dimensional T1-weighted magnetic resonance imaging scans for 38 antipsychotic-naive first-episode schizophrenia patients and 43 matched...

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  8. Impaired theory of mind in first-episode schizophrenia: comparison with community, university and depressed controls.

    Science.gov (United States)

    Kettle, Jonathan W L; O'Brien-Simpson, Laurie; Allen, Nicholas B

    2008-02-01

    First order theory of mind, as measured by the 'Reading the Mind in the Eyes Test' Revised, is impaired in schizophrenia. However, no study has investigated whether this occurs in first-episode schizophrenia. Also, it is unclear whether such a deficit is specific to schizophrenia, and whether convenience control samples, particularly undergraduate university students, represent valid comparison groups. This study investigated theory of mind ability, measured by the 'Reading the Mind in the Eyes Test' Revised, in a group of first-episode schizophrenia outpatients (n=13) and three control groups: outpatients with non-psychotic major depression (n=14), individuals from the general community (n=16) and from an undergraduate university course (n=27). The schizophrenia group exhibited significant theory of mind impairments compared to both non-psychiatric control groups but not the depression group. Unexpectedly, the depression group was not significantly impaired compared to the community control group, and the university control group exhibited superior theory of mind ability relative to all three groups. The findings indicate theory of mind deficits in first episode schizophrenia and support the implementation of theory of mind interventions in first-episode schizophrenia treatment programs. Results also indicate that community rather than university control groups represent more valid comparison groups in first-episode schizophrenia research.

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

    Science.gov (United States)

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

    2017-01-01

    Mismatch negativity (MMN) to deviant stimuli is robustly smaller in individuals with chronic schizophrenia compared with healthy controls (Cohen's d > 1.0 or more), leading to the possibility of MMN being used as a biomarker for schizophrenia. However, there is some debate in the literature as to whether MMN is reliably reduced in first-episode schizophrenia patients. For the biomarker to be used as a predictive marker for schizophrenia, it should be reduced in the majority of cases known to have the disease, particularly at disease onset. We conducted a meta-analysis on the fourteen studies that measured MMN to pitch or duration deviants in healthy controls and patients within 12 months of their first episode of schizophrenia. The overall effect size showed no MMN reduction in first-episode patients to pitch-deviants (Cohen's d schizophrenia prediction, while duration-deviant MMN may hold some promise, albeit nearly a third as large an effect as in chronic schizophrenia. Potential causes for discrepancies between studies are discussed. © EEG and Clinical Neuroscience Society (ECNS) 2016.

  10. Effect of blonanserin on cognitive function in antipsychotic-naïve first-episode schizophrenia.

    Science.gov (United States)

    Tenjin, Tomomi; Miyamoto, Seiya; Miyake, Nobumi; Ogino, Shin; Kitajima, Rei; Ojima, Kazuaki; Arai, Jun; Teramoto, Haruki; Tsukahara, Sachiko; Ito, Yukie; Tadokoro, Masanori; Anai, Kiriko; Funamoto, Yasuyuki; Kaneda, Yasuhiro; Sumiyoshi, Tomiki; Yamaguchi, Noboru

    2012-01-01

    The purpose of this study was to evaluate the effects of blonanserin, a novel antipsychotic, on cognitive function in first-episode schizophrenia. Twenty-four antipsychotic-naïve patients with first-episode schizophrenia participated in the study. Blonanserin was given in an open-label design for 8 weeks. The Brief Assessment of Cognition in Schizophrenia-Japanese language version (BACS-J) was administered as the primary outcome measure at baseline and 8 weeks. Clinical evaluation included the Positive and Negative Syndrome Scale (PANSS), the Schizophrenia Quality of Life Scale-Japanese language version (SQLS-J), and the Clinical Global Impression-Severity of Illness Scale (CGI-S). To exclude the possibility of retest effects on the BACS-J, 10 age-matched patients with chronic schizophrenia treated with blonanserin were tested at baseline and after an 8-week interval. Twenty first-episode patients completed the study. Repeated measures analysis of covariance revealed a significant group-by-time interaction effect on the letter fluency task due to better performance in the first-episode group, but not in the control group. Main effect of time or group-by-time interaction effect on the Tower of London task was not significant; however, the first-episode group, but not the control group, showed substantial improvement with a moderate effect size. All items on the PANSS, SQLS-J, and CGI-S significantly improved after 8 weeks of treatment. These results suggest that blonanserin improves some types of cognitive function associated with prefrontal cortical function. Copyright © 2012 John Wiley & Sons, Ltd.

  11. Theory of Mind in first-episode schizophrenia patients: correlations with cognition and personality traits.

    Science.gov (United States)

    Koelkebeck, Katja; Pedersen, Anya; Suslow, Thomas; Kueppers, Kerstin Annika; Arolt, Volker; Ohrmann, Patricia

    2010-06-01

    There is substantial evidence for Theory of Mind (ToM) deficits in patients with schizophrenia. Many psychotic symptoms may best be understood in light of an impaired capacity to infer one's own and other persons' mental states and to relate those to executing behavior. The aim of our study was to investigate ToM abilities in first-episode schizophrenia patients and to analyze them in relation to neuropsychological and psychopathological functioning. A modified Moving Shapes paradigm was used to assess ToM abilities in 23 first-episode patients with schizophrenia and 23 matched healthy controls. Participants had to describe animated triangles which moved (1) randomly, (2) goal-directed, or (3) in complex, socially interactive ways (ToM video sequences). Neuropsychological functioning, psychopathology, autistic and alexithymic features as well as empathetic abilities were correlated with ToM performance. Compared to healthy controls, first-episode schizophrenia patients gave more incorrect descriptions and used less ToM-related vocabulary when responding to socially complex ToM video sequences. No group differences were revealed for videos with random movements. ToM abilities correlated significantly with positive symptoms, reasoning, verbal memory performance and verbal IQ, but not with empathetic abilities or autistic and alexithymic features. When controlling for reasoning, verbal memory performance and verbal IQ, the correctness of video descriptions was still significantly worse in schizophrenia patients. The results of our study in first-episode schizophrenia patients underline recent findings on ToM deficits in the early course of schizophrenia. Only a moderate influence of neurocognitive deficits on ToM performance was observed. Impairment in ToM abilities seems to be predominantly independent of clinical state, alexithymia and empathy. Copyright (c) 2009 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Yu, Yi; Zhao, Yun; Si, Yajing; Ren, Qiongqiong; Ren, Wu; Jing, Changqin; Zhang, Hongxing

    2016-11-25

    In schizophrenia, executive dysfunction is the most critical cognitive impairment, and is associated with abnormal neural activities, especially in the frontal lobes. Complexity estimation using electroencephalogram (EEG) recording based on nonlinear dynamics and task performance tests have been widely used to estimate executive dysfunction in schizophrenia. The present study estimated the cool executive function based on fractal dimension (FD) values of EEG data recorded from first-episode schizophrenia patients and healthy controls during the performance of three cool executive function tasks, namely, the Trail Making Test-A (TMT-A), Trail Making Test-B (TMT-B), and Tower of Hanoi tasks. The results show that the complexity of the frontal EEG signals that were measured using FD was different in first-episode schizophrenia patients during the manipulation of executive function. However, no differences between patients and controls were found in the FD values of the EEG data that was recorded during the performance of the Tower of Hanoi task. These results suggest that cool executive function exhibits little impairment in first-episode schizophrenia patients.

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

    Science.gov (United States)

    Stefanović, Vesna; Mihajlović, Goran; Nenadović, Milutin; Dejanović, Slavica Djukić; Borovcanin, Milica; Trajković, Goran

    2015-12-01

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

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

    DEFF Research Database (Denmark)

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

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

  15. Theory of mind impairments in patients with first-episode schizophrenia and their unaffected siblings.

    Science.gov (United States)

    Ho, Karen K Y; Lui, Simon S Y; Hung, Karen S Y; Wang, Yi; Li, Zhi; Cheung, Eric F C; Chan, Raymond C K

    2015-08-01

    Theory of mind (ToM) impairment has been consistently demonstrated in patients with schizophrenia, but whether ToM impairments exist in unaffected siblings of patients with schizophrenia remains unclear. Few studies have examined the affective and cognitive components of ToM in schizophrenia. This study aimed to examine whether ToM impairments exist in patients with first-episode schizophrenia and their unaffected siblings, and whether there is any dissociation between the affective and cognitive components of ToM. We adopted a family-based case-control design. Participants were 41 patients with first-episode schizophrenia, 43 unaffected siblings, and 42 healthy controls. The Yoni Task which measures the participants' ability to understand first- and second-order affective versus cognitive ToM and the Faux Pas Task which taps into integration of the affective and cognitive components of ToM were administered. Multivariate and univariate ANCOVAs were used to examine the group differences in ToM, while controlling for other neurocognitive functions. Compared with controls, patients with schizophrenia and their unaffected siblings performed poorer on the Faux Pas Task (pschizophrenia performed worse than controls on second-order affective condition of the Yoni Task (p=0.004), but their unaffected siblings did not (p=0.063). We did not find any significant Group-by-Condition interaction in the Yoni Task (p=0.358). Patients with first-episode schizophrenia and their unaffected siblings exhibit ToM impairments, but no dissociation between affective and cognitive component of ToM was found. Our findings support the notion that ToM deficit may be a trait marker of schizophrenia. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Stefanović Vesna

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Natalia eJorquera

    2015-04-01

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

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

    Science.gov (United States)

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

    2000-06-16

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

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

    Directory of Open Access Journals (Sweden)

    Susana Ochoa

    2012-01-01

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

  1. Changes in event-related potentials in patients with first-episode schizophrenia and their siblings.

    Science.gov (United States)

    Yang, Chengqing; Zhang, Tianhong; Li, Zezhi; Heeramun-Aubeeluck, Anisha; Liu, Na; Huang, Nan; Zhang, Jie; He, Leiying; Li, Hui; Tang, Yingying; Chen, Fazhan; Wang, Jijun; Lu, Zheng

    2017-01-17

    This study aimed to explore the characteristics of event-related potentials induced by facial emotion recognition in patients with first-episode schizophrenia and in their siblings. In this case-control study, 30 first-episode schizophrenia patients, 26 siblings, and 30 healthy controls were enrolled. They completed facial emotion recognition tasks from the Ekman Standard Faces Database as an induction for evoked potentials. Evoked potential data were obtained using a 64-channel electroencephalography system. Average evoked potential waveforms were computed from epochs for each stimulus type. The amplitudes and latency of the event-related potentials for P100 (positive potential 100 ms after stimulus onset), N170 (negative potential 170 ms after stimulus onset), and N250 (fronto-central peak) were investigated at O1, O2, P7, and P8 electrode locations. There were significant differences between the groups for P100 amplitude (F = 11.526, P emotion (disgust vs. happiness vs. fear) (F = 1722.467, P emotion intensity (low vs. moderate vs. high) (F = 1737.169, P emotion processing in patients with schizophrenia. P100 may be a characteristic index of schizophrenia.

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  3. Increased Frontal Gyrification Negatively Correlates with Executive Function in Patients with First-Episode Schizophrenia.

    Science.gov (United States)

    Sasabayashi, Daiki; Takayanagi, Yoichiro; Nishiyama, Shimako; Takahashi, Tsutomu; Furuichi, Atsushi; Kido, Mikio; Nishikawa, Yumiko; Nakamura, Mihoko; Noguchi, Kyo; Suzuki, Michio

    2017-04-01

    Previous neuroimaging studies of gyrification, a possible marker of early neurodevelopment, in schizophrenia patients have reported inconsistent results. In addition, it remains unclear whether aberrant gyrification in schizophrenia patients, if present, is associated with cognitive impairment, which is one of the core features of schizophrenia. Magnetic resonance images were obtained from 62 patients with first-episode schizophrenia and 57 healthy control subjects. Using FreeSurfer software, local gyrification index (LGI) of the entire cortex was compared between the groups. The relationship between LGI and performance in the Wisconsin Card Sorting Test (WCST) was also examined in a subgroup of patients (n= 28). Compared with the controls, the patients showed a significantly higher LGI in a wide range of bilateral frontal regions as well as in the right inferior parietal and bilateral occipital regions. The number of WCST categories archived in patients was negatively correlated with the LGI mainly in the rostral middle frontal and anterior cingulate regions in the right hemisphere. Our findings suggested a widespread hypergyrification pattern in schizophrenia patients, which supported early neurodevelopmental abnormalities. Our results also suggested that executive dysfunction in schizophrenia patients may be at least partly related to aberrant neurodevelopment, especially in the right frontal regions. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  4. Detecting incipient schizophrenia: a validation of the Azima battery in first episode psychosis.

    Science.gov (United States)

    Zafran, Hiba; Mazer, Barbara; Tallant, Beverlea; Chilingaryan, Gevorg; Gelinas, Isabelle

    2017-09-01

    Early psychosis intervention aims to accurately detect adolescents and young adults at risk for major mental disorders, particularly schizophrenia, yet early biomedical diagnostic accuracy remains poor. However, phenomenological approaches focusing on eliciting and understanding the subjective experience of help-seeking youth better detect incipient schizophrenia. The Azima Battery is an occupational therapy projective assessment that uses expressive media in a standard setup, in order to phenomenologically elicit and describe the activity performance and narratives of individuals at risk of, or on, the psychotic-spectrum.The purpose of this study was to estimate the predictive validity of the Azima Battery with youth seeking help for a first episode of psychosis, and identify patterns of performance distinctive of a diagnosis of schizophrenia 1-year later. A mixed methods phenomenological approach was used to calculate the predictive validity of the Azima Battery in detecting incipient schizophrenia, and to qualitatively identify patterns of performance. Study results demonstrate that the diagnostic accuracy of the Azima Battery is greater than psychiatric interviewing for a future diagnosis of schizophrenia (N = 62: 88.7 % vs 42 %). Performance elements and patterns statistically distinctive of schizophrenia are described, and relate to the structure of the created objects. Therefore, the Azima Battery is a valid measure for clinical use by occupational therapists working in early intervention for psychosis as a complement to traditional psychiatric interviewing.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Elisabeth Haug

    2016-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Hasan Soltani

    2016-12-01

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

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

    Science.gov (United States)

    Qiao, Ying; Zhang, Lei; He, Shen; Wen, Hui; Yu, Yi-Min; Cao, Chun-Hua; Li, Hua-Fang

    2016-03-23

    Schizophrenia is a persistent chronic mental illness with an unknown pathogenic mechanism; no empirical laboratory-based tests are available to support the diagnosis of schizophrenia or to identify biomarkers correlated with the therapeutic effect of olanzapine. For this study, 15 female first-episode, drug-naïve patients with schizophrenia and 15 healthy female volunteers were recruited. Tests for blood glucose and lipids were conducted at baseline and after 4 weeks of treatment with olanzapine. UPLC-MS based metabonomic analysis was performed on both case and control groups to identify biomarkers of schizophrenia at baseline and to explore which biomarkers correlated with the therapeutic effect of olanzapine after a 4-week treatment. Compared with the control group, the case group showed significant changes in plasma metabolites. Thirteen distinct metabolites were identified. Among all the therapeutically effective cases, levels of these metabolites appeared to shift towards the normal trend; 8 of the identified 13 metabolites changed dramatically. The metabolites that we found are potential biomarkers for the diagnosis and treatment of schizophrenia.

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

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

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

    Science.gov (United States)

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

    2013-07-01

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

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

    Science.gov (United States)

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

    2013-01-10

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Science.gov (United States)

    Grano, Niklas; Lindsberg, Jenni; Karjalainen, Marjaana; Gronroos, Peter; Blomberg, Ari-Pekka

    2010-01-01

    Evidence of association between duration of untreated psychosis (DUP) and negative symptoms of schizophrenia in first-episode psychosis (FEP) patients is inconsistent in the recent literature. In the present study, DUP, schizophrenia symptoms, duration of medication, and diagnosis were obtained from hospital archives in a sample of FEP patients.…

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

    Science.gov (United States)

    Lachman, Anusha

    2014-01-01

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

  16. Out of touch with reality? Social perception in first-episode schizophrenia.

    Science.gov (United States)

    Ebisch, Sjoerd J H; Salone, Anatolia; Ferri, Francesca; De Berardis, Domenico; Romani, Gian Luca; Ferro, Filippo M; Gallese, Vittorio

    2013-04-01

    Social dysfunction has been recognized as an elementary feature of schizophrenia, but it remains a crucial issue whether social deficits in schizophrenia concern the inter-subjective domain or primarily have their roots in disturbances of self-experience. Social perception comprises vicarious processes grounding an experiential inter-relationship with others as well as self-regulation processes allowing to maintain a coherent sense of self. The present study investigated whether the functional neural basis underlying these processes is altered in first-episode schizophrenia (FES). Twenty-four FES patients and 22 healthy control participants underwent functional magnetic resonance imaging during a social perception task requiring them to watch videos depicting other individuals' inanimate and animate/social tactile stimulations, and a tactile localizer condition. Activation in ventral premotor cortex for observed bodily tactile stimulations was reduced in the FES group and negatively correlated with self-experience disturbances. Moreover, FES patients showed aberrant differential activation in posterior insula for first-person tactile experiences and observed affective tactile stimulations. These findings suggest that social perception in FES at a pre-reflective level is characterized by disturbances of self-experience, including impaired multisensory representations and self-other distinction. However, the results also show that social perception in FES involves more complex alterations of neural activation at multiple processing levels.

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

    Science.gov (United States)

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

    2015-11-01

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

  18. Lower LINE-1 methylation in first-episode schizophrenia patients with the history of childhood trauma.

    Science.gov (United States)

    Misiak, Błażej; Szmida, Elżbieta; Karpiński, Paweł; Loska, Olga; Sąsiadek, Maria M; Frydecka, Dorota

    2015-01-01

    We investigated methylation of DNA repetitive sequences (LINE-1 and BAGE) in peripheral blood leukocytes from first-episode schizophrenia (FES) patients and healthy controls (HCs) with respect to childhood adversities. Patients were divided into two subgroups based on the history of childhood trauma - FES(+) and FES(-) subjects. The majority of HCs had a negative history of childhood trauma - HCs(-) subjects. FES(+) patients had significantly lower LINE-1 methylation in comparison with FES(-) patients or HC(-) subjects. Emotional abuse and total trauma score predicted lower LINE-1 methylation in FES patients, while general trauma score was associated with lower BAGE methylation in HCs. Childhood adversities might be associated with global DNA hypomethylation in adult FES patients.

  19. Relationship between negative symptoms and neurocognitive functions in adolescent and adult patients with first-episode schizophrenia

    Directory of Open Access Journals (Sweden)

    Manli Huang

    2016-10-01

    Full Text Available Abstract Background This study aimed to explore differences in links between negative symptoms and neurocognitive deficits in adolescent and adult patients with first-episode schizophrenia. Schizophrenia is a mental disorder often characterized by positive and negative symptoms, reduced emotional expression, excitatory status, and poor cognitive ability. The severity of negative symptoms in patients with schizophrenia was reported to be more related to poor quality of life, weak functional ability, and heavy burden from families than with the severity of positive symptoms. Previous studies suggested correlations between the severity of negative symptoms in patients with schizophrenia and neurocognitive deficits. Methods This study included 92 patients (33 adolescents and 59 adults with first-episode schizophrenia and 57 healthy people matched by age and education level. Neurocognitive functions and clinical symptoms were assessed using a standardized questionnaire. Results Patients with first-episode schizophrenia showed neurocognitive deficits in most neuropsychological assessments compared with healthy people. With the variable of education level controlled, the negative factor score of adolescent patients with first-episode schizophrenia was strongly correlated with more time spent in part 1 (r = .646 and part 2 (r = .663 of the trail making test, and moderately correlated to more perseverative errors (r = .425 of the Wisconsin card sorting test and fewer correct trials 2 (r = −.425 of the continuous performance test. However, no such correlations were found in adult patients. Conclusions This study indicated significant correlations between negative symptoms and most neurocognitive functions in patients with first-episode schizophrenia, with a stronger correlation in adolescent patients. Trial registration The trial registration number is ChiCTR-COC-14005302 , while retrospectively registered on January 5, 2014.

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

    DEFF Research Database (Denmark)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

    LI Shuying; WU Hanrong; GUO Huirong; ZHAO Zheng

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Masopust J

    2015-03-01

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

  4. Comparative study of clozapine versus risperidone in treatment-naive, first-episode schizophrenia: A pilot study

    Directory of Open Access Journals (Sweden)

    Sukhtej Sahni

    2016-01-01

    Interpretation & conclusions: The findings of this preliminary study showed clozapine as a better choice than risperidone in terms of efficacy, tolerability and better quality of life in treatment-naive, first-episode schizophrenia. However, further studies need to be done on a larger group of patients to confirm the findings.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  6. A microstructural study of sleep instability in drug-naive patients with schizophrenia and healthy controls: sleep spindles, rapid eye movements, and muscle atonia.

    Science.gov (United States)

    Guénolé, Fabian; Chevrier, Elyse; Stip, Emmanuel; Godbout, Roger

    2014-05-01

    This study aimed at characterizing the functional stability of sleep in schizophrenia by quantifying dissociated stages of sleep (DSS), and to explore their correlation with psychopathology. The sleep of 10 first-break, drug-naive young adults with schizophrenia and 10 controls was recorded. Four basic DSS patterns were scored: 1) the transitional EEG-mixed intermediate stage (EMIS); 2) Rapid-eye-movement (REM) sleep without rapid eye movement (RSWR); 3) REM sleep without atonia (RSWA); and 4) non-REM sleep with rapid eye movements. An intermediate sleep (IS) score was calculated by summing EMIS and RSWR scores, and the durations of intra-REM sleep periods IS (IRSPIS) and IS scored "at the expense" of REM sleep (ISERS) were determined. Patients were administered the Brief Psychiatric Rating Scale (BPRS) at the time of recording. Proportions of each DSS variables over total sleep time and proportions of IRSPIS and ISERS over REM sleep duration were compared between patients and controls. Correlation coefficients between DSS variables and BPRS total scores were calculated. The proportion of total DSS did not differ between patients and controls. Among DSS subtypes, RSWA was significantly increased in patients while other comparisons showed no significant differences. Significant positive correlations were found between BPRS scores and proportions of DSS, IS, RSWR, IRSPIS and ISERS over total sleep and REM sleep durations. These results demonstrate the functional instability of REM sleep in first-break, drug naive young adults with schizophrenia and unveil a pattern reminiscent of REM sleep behavior disorder. The significant correlation suggests that schizophrenia and REM sleep share common neuronal control mechanisms.

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

    Science.gov (United States)

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

    2010-12-01

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

  8. Impaired cue identification and intention retrieval underlie prospective memory deficits in patients with first-episode schizophrenia.

    Science.gov (United States)

    Liu, Dengtang; Ji, Chengfeng; Zhuo, Kaiming; Song, Zhenhua; Wang, Yingchan; Mei, Li; Zhu, Dianming; Xiang, Qiong; Chen, Tianyi; Yang, Zhilei; Zhu, Guang; Wang, Ya; Cheung, Eric Fc; Xiang, Yu-Tao; Fan, Xiaoduo; Chan, Raymond Ck; Xu, Yifeng; Jiang, Kaida

    2017-03-01

    Schizophrenia is associated with impairment in prospective memory, the ability to remember to carry out an intended action in the future. It has been established that cue identification (detection of the cue event signaling that an intended action should be performed) and intention retrieval (retrieval of an intention from long-term memory following the recognition of a prospective cue) are two important processes underlying prospective memory. The purpose of this study was to examine prospective memory deficit and underlying cognitive processes in patients with first-episode schizophrenia. This study examined cue identification and intention retrieval components of event-based prospective memory using a dual-task paradigm in 30 patients with first-episode schizophrenia and 30 healthy controls. All participants were also administered a set of tests assessing working memory and retrospective memory. Both cue identification and intention retrieval were impaired in patients with first-episode schizophrenia compared with healthy controls ( ps schizophrenia. Cue identification and intention retrieval could be potentially used as biomarkers for early detection and treatment prognosis of schizophrenia. In addition, addressing cue identification deficit through cognitive enhancement training may potentially improve negative symptoms as well.

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    ; however in most first-episode schizophrenia studies the patients are receiving antipsychotic medication, which can affect the results on specific domains such as processing speed. As part of the PECANS project (Pan European Collaboration on Antipsychotic Naïve Schizophrenia) the aim of the present study...... in Schizophrenia) and CANTAB (Cambridge Neuropsychological Test Automated Battery). Premorbid intelligence is estimated using DART (Danish Adult Reading Test) and current intelligence is estimated from 4 subtests from WAIS-III (Wechsler´s Adult Intelligence Scale, 3rd ed.). Psychopathology ratings are obtained...

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  12. Homeostatic imbalance of purine catabolism in first-episode neuroleptic-naive patients with schizophrenia.

    Directory of Open Access Journals (Sweden)

    Jeffrey K Yao

    Full Text Available BACKGROUND: Purine catabolism may be an unappreciated, but important component of the homeostatic response of mitochondria to oxidant stress. Accumulating evidence suggests a pivotal role of oxidative stress in schizophrenia pathology. METHODOLOGY/PRINCIPAL FINDINGS: Using high-pressure liquid chromatography coupled with a coulometric multi-electrode array system, we compared 6 purine metabolites simultaneously in plasma between first-episode neuroleptic-naïve patients with schizophrenia (FENNS, n = 25 and healthy controls (HC, n = 30, as well as between FENNS at baseline (BL and 4 weeks (4w after antipsychotic treatment. Significantly higher levels of xanthosine (Xant and lower levels of guanine (G were seen in both patient groups compared to HC subjects. Moreover, the ratios of G/guanosine (Gr, uric acid (UA/Gr, and UA/Xant were significantly lower, whereas the ratio of Xant/G was significantly higher in FENNS-BL than in HC. Such changes remained in FENNS-4w with exception that the ratio of UA/Gr was normalized. All 3 groups had significant correlations between G and UA, and Xan and hypoxanthine (Hx. By contrast, correlations of UA with each of Xan and Hx, and the correlation of Xan with Gr were all quite significant for the HC but not for the FENNS. Finally, correlations of Gr with each of UA and G were significant for both HC and FENNS-BL but not for the FENNS-4w. CONCLUSIONS/SIGNIFICANCE: During purine catabolism, both conversions of Gr to G and of Xant to Xan are reversible. Decreased ratios of product to precursor suggested a shift favorable to Xant production from Xan, resulting in decreased UA levels in the FENNS. Specifically, the reduced UA/Gr ratio was nearly normalized after 4 weeks of antipsychotic treatment. In addition, there are tightly correlated precursor and product relationships within purine pathways; although some of these correlations persist across disease or medication status, others appear to be lost among FENNS

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    OpenAIRE

    2006-01-01

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

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

    Science.gov (United States)

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

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

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

  17. Basal ganglia volumes in drug-naive first-episode schizophrenia patients before and after short-term treatment with either a typical or an atypical antipsychotic drug

    DEFF Research Database (Denmark)

    Glenthoj, Andreas; Glenthoj, Birte Y; Mackeprang, Torben

    2007-01-01

    of exposure to medication and in controls at baseline. Caudate nucleus, nucleus accumbens, and putamen volumes were measured. Compared with controls, absolute volumes of interest (VOIs) were smaller in patients at baseline and increased after treatment. However, with controls for age, gender and whole brain...... medication groups did not differ significantly with respect to volume changes after 3 months of low dose treatment in any of the VOIs. Nevertheless, when medication groups were examined separately, a significant volume increase in the putamen was evidenced in the risperidone group. The altered asymmetry...

  18. Basal ganglia volumes in drug-naive first-episode schizophrenia patients before and after short-term treatment with either a typical or an atypical antipsychotic drug

    DEFF Research Database (Denmark)

    Glenthoj, Andreas; Glenthøj, Birte Yding; Mackeprang, Torben

    2007-01-01

    and 19 matched controls participated. Patients were randomly assigned to treatment with either low doses of the typical antipsychotic drug, zuclopenthixol, or the atypical compound, risperidone. High-resolution magnetic resonance imaging (MRI) scans were obtained in patients before and after 12 weeks...... medication groups did not differ significantly with respect to volume changes after 3 months of low dose treatment in any of the VOIs. Nevertheless, when medication groups were examined separately, a significant volume increase in the putamen was evidenced in the risperidone group. The altered asymmetry...

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  20. Delusional disorder and schizophrenia: a comparison of the neurocognitive and clinical characteristics in first-episode patients.

    Science.gov (United States)

    Hui, C L M; Lee, E H M; Chang, W C; Chan, S K W; Lin, J; Xu, J Q; Chen, E Y H

    2015-10-01

    Delusional disorder (DD) is thought to be distinct from schizophrenia (SZ). However, few systematic investigations have been conducted on DD because of the difficulty in ascertaining a representative sample size. Existing knowledge has been mostly generated from inpatient cohorts, which may be biased towards a more severe sample. We compared the demographic, clinical and cognitive differences between 71 patients with first-episode DD and 71 age-matched patients with first-episode SZ. Participants were consecutively recruited from a population-based territory-wide study of early psychosis in Hong Kong targeting first-episode psychosis. Basic demographic information, premorbid functioning, duration of untreated psychosis, pathways to care, symptomatology, social, occupational, and cognitive functioning were comprehensively assessed using standardized measurements. Patients with DD had less premorbid schizoid and schizotypal traits compared to patients with SZ. More patients with DD were married compared to patients with SZ. However, at first episode, there were no significant differences between the two groups in regards to the duration of untreated psychosis, pathways to care, symptom severity, neurocognitive performance, treatment, and functioning. Our findings challenge previous thinking that patients with DD had better functioning than patients with SZ. This study not only provides an updated perspective into conceptualizing the clinical differences between DD and SZ, but also expands the descriptive account of the two disorders to include the neurocognitive dimension.

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jinsong Tang

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    Science.gov (United States)

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

    2008-08-01

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

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

    NARCIS (Netherlands)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2012-06-01

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

  7. Longitudinal volume changes of the pituitary gland in patients with schizotypal disorder and first-episode schizophrenia.

    Science.gov (United States)

    Takahashi, Tsutomu; Zhou, Shi-Yu; Nakamura, Kazue; Tanino, Ryoichiro; Furuichi, Atsushi; Kido, Mikio; Kawasaki, Yasuhiro; Noguchi, Kyo; Seto, Hikaru; Kurachi, Masayoshi; Suzuki, Michio

    2011-01-15

    An enlarged volume of the pituitary gland has been reported in the schizophrenia spectrum, possibly reflecting the hypothalamic-pituitary-adrenal (HPA) hyperactivity. However, it remains largely unknown whether the pituitary size longitudinally changes in the course of the spectrum disorders. In the present study, longitudinal magnetic resonance imaging (MRI) data were obtained from 18 patients with first-episode schizophrenia, 13 patients with schizotypal disorder, and 20 healthy controls. The pituitary volume was measured at baseline and follow-up (mean, 2.7 years) scans and was compared across groups. The pituitary volume was larger in the schizophrenia patients than controls at baseline, and both patient groups had significantly larger pituitary volume than controls at follow-up. In a longitudinal comparison, both schizophrenia (3.6%/year) and schizotypal (2.7%/year) patients showed significant pituitary enlargement compared with controls (-1.8%/year). In the schizophrenia patients, greater pituitary enlargement over time was associated with less improvement of delusions and higher scores for thought disorders at the follow-up. These findings suggest that the pituitary gland exhibits ongoing volume changes during the early course of the schizophrenia spectrum as a possible marker of state-related impairments. Copyright © 2010 Elsevier Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Valbak, Kristian; Harder, Susanne

    2006-01-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2011-11-30

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

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

    Science.gov (United States)

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

    2016-01-01

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

  12. The relationship between facial emotion recognition and executive functions in first-episode patients with schizophrenia and their siblings.

    Science.gov (United States)

    Yang, Chengqing; Zhang, Tianhong; Li, Zezhi; Heeramun-Aubeeluck, Anisha; Liu, Na; Huang, Nan; Zhang, Jie; He, Leiying; Li, Hui; Tang, Yingying; Chen, Fazhan; Liu, Fei; Wang, Jijun; Lu, Zheng

    2015-10-08

    Although many studies have examined executive functions and facial emotion recognition in people with schizophrenia, few of them focused on the correlation between them. Furthermore, their relationship in the siblings of patients also remains unclear. The aim of the present study is to examine the correlation between executive functions and facial emotion recognition in patients with first-episode schizophrenia and their siblings. Thirty patients with first-episode schizophrenia, their twenty-six siblings, and thirty healthy controls were enrolled. They completed facial emotion recognition tasks using the Ekman Standard Faces Database, and executive functioning was measured by Wisconsin Card Sorting Test (WCST). Hierarchical regression analysis was applied to assess the correlation between executive functions and facial emotion recognition. Our study found that in siblings, the accuracy in recognizing low degree 'disgust' emotion was negatively correlated with the total correct rate in WCST (r = -0.614, p = 0.023), but was positively correlated with the total error in WCST (r = 0.623, p = 0.020); the accuracy in recognizing 'neutral' emotion was positively correlated with the total error rate in WCST (r = 0.683, p = 0.014) while negatively correlated with the total correct rate in WCST (r = -0.677, p = 0.017). People with schizophrenia showed an impairment in facial emotion recognition when identifying moderate 'happy' facial emotion, the accuracy of which was significantly correlated with the number of completed categories of WCST (R(2) = 0.432, P emotion recognition in the healthy control group. Our study demonstrated that facial emotion recognition impairment correlated with executive function impairment in people with schizophrenia and their unaffected siblings but not in healthy controls.

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

    DEFF Research Database (Denmark)

    Munkner, Runa; Haastrup, Soeren; Joergensen, Torben

    2008-01-01

    Patients with schizophrenia have been shown to have an increased risk of criminality. The aim was to describe possible psychopathological differences between schizophrenia spectrum patients with and without a criminal career before first-episode psychosis. In a multi-centre study, 16 psychiatric...... were linked with data concerning criminal and psychiatric history. No key characteristics were found to assist the early detection of criminal persons before first psychiatric hospital contact for a psychotic incident. However, when adjusted for sex, age, abuse, living conditions, marital status......, employment status and education, a primarily positive symptomatology was associated with a prior criminal career. The premorbid level of functioning and several function parameters were also significantly associated with criminal history. There are significant differences in psychopathology between...

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

    NARCIS (Netherlands)

    Rais, M.

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Dazzan, Paola; Arango, Celso; Fleischacker, Wolfgang

    2015-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

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

    Science.gov (United States)

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

    2015-03-01

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

  19. IgG dynamics of dietary antigens point to cerebrospinal fluid barrier or flow dysfunction in first-episode schizophrenia.

    Science.gov (United States)

    Severance, Emily G; Gressitt, Kristin L; Alaedini, Armin; Rohleder, Cathrin; Enning, Frank; Bumb, J Malte; Müller, Juliane K; Schwarz, Emanuel; Yolken, Robert H; Leweke, F Markus

    2015-02-01

    Schizophrenia is a complex brain disorder that may be accompanied by idiopathic inflammation. Classic central nervous system (CNS) inflammatory disorders such as viral encephalitis or multiple sclerosis can be characterized by incongruent serum and cerebrospinal fluid (CSF) IgG due in part to localized intrathecal synthesis of antibodies. The dietary antigens, wheat gluten and bovine milk casein, can induce a humoral immune response in susceptible individuals with schizophrenia, but the correlation between the food-derived serological and intrathecal IgG response is not known. Here, we measured IgG to wheat gluten and bovine milk casein in matched serum and CSF samples from 105 individuals with first-episode schizophrenia (n=75 antipsychotic-naïve), and 61 controls. We found striking correlations in the levels of IgG response to dietary proteins between serum and CSF of schizophrenia patients, but not controls (schizophrenia, R(2)=0.34-0.55, p⩽0.0001; controls R(2)=0.05-0.06, p>0.33). A gauge of blood-CSF barrier permeability and CSF flow rate, the CSF-to-serum albumin ratio, was significantly elevated in cases compared to controls (p⩽0.001-0.003). Indicators of intrathecal IgG production, the CSF IgG index and the specific Antibody Index, were not significantly altered in schizophrenia compared to controls. Thus, the selective diffusion of bovine milk casein and wheat gluten antibodies between serum and CSF in schizophrenia may be the function of a low-level anatomical barrier dysfunction or altered CSF flow rate, which may be transient in nature. Copyright © 2014 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2005-07-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Wei Lei

    2015-07-01

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

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Science.gov (United States)

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

    2007-05-01

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

  5. Cognitive effects of six months of treatment with quetiapine in antipsychotic-naïve first-episode schizophrenia

    DEFF Research Database (Denmark)

    Andersen, Rune; Fagerlund, Birgitte; Rasmussen, Hans

    2011-01-01

    Effects of quetiapine on cognition were assessed in a group of first-episode antipsychotic-naïve patients with schizophrenia (N=24). A comprehensive battery of neuropsychological tests was administered at baseline and after 6months of treatment with quetiapine. In order to examine retest effects,...... on sustained attention and working memory that were found in healthy controls. The main result of the study is that there was very little evidence of efficacy of quetiapine on cognition. The study also indicated a lack of normal retest effects in patients compared to controls........ Patients also improved on speed of processing; however, this was parallel to the retest effects found in healthy controls. When covaried for differences at baseline, patients showed smaller improvements in speed of processing than the retest effects found in controls, as well as a lack of retest effects...

  6. Retraction: 'Effect of blonanserin on cognitive function in antipsychotic-naïve first-episode schizophrenia'.

    Science.gov (United States)

    Tenjin, Tomomi; Miyamoto, Seiya; Miyake, Nobumi; Ogino, Shin; Kitajima, Rei; Ojima, Kazuaki; Arai, Jun; Teramoto, Haruki; Tsukahara, Sachiko; Ito, Yukie; Tadokoro, Masanori; Anai, Kiriko; Funamoto, Yasuyuki; Kaneda, Yasuhiro; Sumiyoshi, Tomiki; Yamaguchi, Noboru

    2017-05-01

    The above article from Human Psychopharmacology, first published on 25 January 2012 in Wiley OnlineLibrary (onlinelibrary.wiley.com), and in Volume 90, pp. 90-100, has been retracted by agreement between the authors, the journal Editor in Chief, David Baldwin, and John Wiley & Sons Ltd. The retraction has been agreed following an investigation by the St Marianna University Ethics Committee which determined that the paper was not as originally designed and approved. Tenjin, T., Miyamoto, S., Miyake, N., Ogino, S., Kitajima, R., Ojima, K., … Yamaguchi, N. (2012). Effect of blonanserin on cognitive function in antipsychotic-naïve first-episode schizophrenia. Hum. Psychopharmacol Clin Exp, 27, 90-100. https://doi.org/10.1002/hup.1276. Copyright © 2017 John Wiley & Sons, Ltd.

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  8. A History of Childhood Trauma and Response to Treatment With Antipsychotics in First-Episode Schizophrenia Patients: Preliminary Results.

    Science.gov (United States)

    Misiak, Błażej; Frydecka, Dorota

    2016-10-01

    In this study, we aimed to investigate whether a history of childhood trauma (CT) can help predict early response to antipsychotic treatment in patients with first-episode schizophrenia (FES). We recruited 64 FES patients who were followed up after 12 weeks of treatment with second-generation antipsychotics. Symptomatic manifestation was examined using the Positive and Negative Syndrome Scale (PANSS). Childhood adversities were assessed using the Early Trauma Inventory Self-Report-Short Form. Nonresponders had significantly higher general trauma score, emotional abuse score, total trauma score, and baseline PANSS negative factor score. A history of CT was significantly more frequent among nonresponders. Logistic regression analysis revealed that positive history of CT, higher emotional abuse score, and higher baseline PANSS negative factor score are significant predictors of poor response to treatment. Our results indicate that a history of CT, especially emotional abuse, and higher severity of negative symptoms are independent predictors of poor response to treatment with antipsychotics.

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

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia

    2007-01-01

    Gender differences in age at first onset, duration of untreated psychosis, psychopathology, social functioning, and self-esteem were investigated in a group of 578 young adults with a first-episode schizophrenia spectrum disorder. The mean age at first-onset of symptoms, age at first contact......, and duration of untreated psychosis were similar for men and women. Men had more severe negative symptoms, poorer premorbid functioning, and poorer social networks, whereas women had more severe hallucinations. More men than women were substance abusers, were unemployed, and lived alone. Women had poorer self-esteem...... functioning, which cannot be explained by older age of onset for women. Women make more suicide attempts and experience lower self-esteem in spite of better social functioning. Udgivelsesdato: 2007-May...

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

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia

    2007-01-01

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

  11. Suicidal ideation and quality of life in patients with a first episode of schizophrenia

    Directory of Open Access Journals (Sweden)

    Krystyna Górna

    2010-03-01

    Full Text Available Introduction: Risk of suicide in patients with schizophrenia is 20- to 50-fold higher than in the general population. The impact of suicidal behaviour on quality of life rarely was a subject of in-depth analysis. The issue is particularly important in patients after first psychiatric hospitalisation, since the risk of suicide is very high during the first postdischarge months. The aim of this study was to analyse correlations between presence of suicidal ideations prior to first hospitalisation and quality of life of patients with schizophrenia during the first post-hospitalisation year. Material and method: Overall, 86 patients were enrolled in the study. Suicidal ideations and behaviours were assessed based on interviews with patients and their relatives, as well as on medical records. The patients’ quality of life was evaluated one month (1st exam and after one year (2nd exam after discharge. Quality of life was assessed using the WHOQOL questionnaire and the SFS scale. Psychopathological symptoms were evaluated using the PANSS inventory. Results: Prior to first hospitalisation, suicidal ideations were present in 39.5% of our patients. Persons with suicidal thoughts presented more severe psychopathological symptoms (1st exam; p=0.05. Both examinations revealed differences in the patients’ quality of life. Lack of suicidal ideations was associated with a better quality of life as assessed by the WHOQOL questionnaire in the following domains: general well-being (1st and 2nd exam, state of health (1st exam, Mental (1st and 2nd exam, Physical (1st exam, Environmental domains (1st exam and Work/Employment (SFS scale, 1st and 2nd exam. A correlation was noticed between suicidal ideation and change in quality of life (WHOQOL in domains Social relationships and Environmental. An improvement of quality of life in this domain was noticed in persons with suicidal ideations. Conclusions: Suicidal ideations prior to first psychiatric hospitalisation

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Science.gov (United States)

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

    2012-04-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  15. The interrelation of needs and quality of life in first-episode schizophrenia.

    Science.gov (United States)

    Landolt, Karin; Rössler, Wulf; Burns, Tom; Ajdacic-Gross, Vladeta; Galderisi, Silvana; Libiger, Jan; Naber, Dieter; Derks, Eske M; Kahn, René S; Fleischhacker, W Wolfgang

    2012-04-01

    The interrelation between needs for care and quality of life has been described and replicated by several studies. The present work aims to add to the understanding of longitudinal interrelations between needs for care, quality of life, and other outcome measures by analyzing a sample of patients at the onset of schizophrenia. This study relied on data from the EUFEST trial, designed to compare first- and second-generation antipsychotics during 1 year. At baseline, 498 patients have been included. The first (baseline) and the last assessment (12 months after baseline) were used for the analyses. Predictors of quality of life were determined using regression analyses. We tested the complex longitudinal interrelations between baseline and outcome measures with structural equation models. Unmet needs were not definitively confirmed as a predictor of subsequent quality of life, unless unmet needs changing to no needs were separated from unmet needs changing to met needs. Each unmet need that changed to no need enhanced the quality of life (mean score 1-7) by 0.136 scale points. This study suggests that when studying quality of life and needs for treatment, it is crucial to differentiate whether unmet needs disappeared or whether they were met, as the former has a stronger impact on quality of life.

  16. New evidence in theory of mind deficits in subjects with chronic schizophrenia and first episode: correlation with symptoms, neurocognition and social function.

    Science.gov (United States)

    Mazza, Monica; Pollice, Rocco; Pacitti, Francesca; Pino, Maria Chiara; Mariano, Melania; Tripaldi, Simona; Casacchia, Massimo; Roncone, Rita

    2012-01-01

    Currently substantial evidence exists about Theory of Mind (ToM) impairment in subjects affected by chronic and first episode schizophrenia. In particular, in order to enhance the validity of our construct, we used in this study classical false beliefs tasks and advanced theory of mind tasks, together with the application of structural equation model, in order to ex-amine whether we are using ToM tasks with good psychometric properties. The main goal of the present study was to examine ToM deficits in a large sample including subjects suffering from chronic schizophrenia, first episode of schizophrenia and nor-mal controls, by observing in the same task the relationship with symptomatological gravity, neurocognition and social function.Materials and methods. A sample of 178 patients with chronic schizophrenia, a sample of 49 subjects with a first episode of psychosis and 484 healthy controls participated to this study. Measures of social cognition included task of false belief and advanced theory of mind task. No significant differences were found on ToM tasks between subjects affected by chronic and first episode schizophrenia. Social cognition showed in both groups a strong correlation with negative symptoms and social function, but did not evidence any relationship with neurocognition. CONCLUSION; ToM deficits exist in subjects suffering from chronic and first episode schizophrenia. These impairments do not seem to be a consequence of illness condition, they are likely to be state-independent and appear to be the most important cognitive mediator of social functioning in both groups.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  19. Hostility in schizophrenia: An integrated analysis of the combined Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) and the European First Episode Schizophrenia Trial (EUFEST) studies

    Science.gov (United States)

    Volavka, J.; Van Dorn, R.A.; Citrome, L.; Kahn, R.S.; Fleischhacker, W.W.; Czobor, P.

    2016-01-01

    Phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study enrolled a sample of 1493 chronic schizophrenia patients. The European First Episode Schizophrenia Trial (EUFEST) enrolled 498 patients. We have combined these two samples to study the effects of hostility on study discontinuation as well as to examine correlates and predictors of hostility. Individual data from 1154 patients with complete data were used for analyses. Survival analysis demonstrated that higher hostility was associated with earlier all-cause treatment discontinuation. Furthermore, regression analysis indicated that increased hostility was associated with more severe positive symptoms, lower adherence to pharmacological treatment, younger age, impaired insight, and more drug or alcohol consumption. The clinical implications of the results point to the importance of establishing therapeutic alliance while managing patient’s symptoms of hostility with antipsychotics such as olanzapine combined with psychosocial interventions to improve insight and reduce substance use. PMID:26657597

  20. The history of childhood trauma is associated with lipid disturbances and blood pressure in adult first-episode schizophrenia patients.

    Science.gov (United States)

    Misiak, Błażej; Kiejna, Andrzej; Frydecka, Dorota

    2015-01-01

    It has repeatedly been found that early-life traumatic events may contribute to metabolic dysregulation. Therefore, the aim of this study was to investigate the association between the history of childhood trauma and cardiovascular risk factors in first-episode schizophrenia (FES) patients. The history of childhood trauma was assessed using the Early Trauma Inventory Self Report - Short Form (ETISR-SF) in 83 FES patients. Based on the ETISR-SF, patients were divided into those with positive and negative history of childhood trauma: FES(+) and FES(-) patients. Serum levels of fasting glucose lipids, homocysteine, vitamin B12 and folate, as well as anthropometric parameters and resting systolic and diastolic blood pressure (SBP and DBP) were measured. The history of childhood trauma was associated with higher low-density lipoprotein (LDL) levels, SBP and DBP after covarying for age, gender, body mass index, education and chlorpromazine equivalent. There were significant correlations between scores of distinct ETISR-SF subscales and LDL, high-density lipoprotein, SBP, DBP and the number of metabolic syndrome criteria. Results of this study indicate that traumatic events during childhood might be related to higher resting blood pressure and higher LDL levels in adult FES patients. Copyright © 2015. Published by Elsevier Inc.

  1. First episode schizophrenia

    African Journals Online (AJOL)

    chronic state of residual symptoms and functional impairment. As the name indicates, ... response to antipsychotic treatment, and thus the long-term course of the .... Hallucinations. • Disorganised speech ... Stereotypic movements. • Dystonia.

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

    Science.gov (United States)

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

    2016-09-30

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

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

    Directory of Open Access Journals (Sweden)

    Ulysses S. Torres

    2016-01-01

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

  4. A longitudinal study of alterations of hippocampal volumes and serum BDNF levels in association to atypical antipsychotics in a sample of first-episode patients with schizophrenia.

    Directory of Open Access Journals (Sweden)

    Emmanouil Rizos

    Full Text Available BACKGROUND: Schizophrenia is associated with structural and functional abnormalities of the hippocampus, which have been suggested to play an important role in the formation and emergence of schizophrenia syndrome. Patients with schizophrenia exhibit significant bilateral hippocampal volume reduction and progressive hippocampal volume decrease in first-episode patients with schizophrenia has been shown in many neuroimaging studies. Dysfunction of the neurotrophic system has been implicated in the pathophysiology of schizophrenia. The initiation of antipsychotic medication alters the levels of serum Brain Derived Neurotrophic Factor (BDNF levels. However it is unclear whether treatment with antipsychotics is associated with alterations of hippocampal volume and BDNF levels. METHODS: In the present longitudinal study we investigated the association between serum BDNF levels and hippocampal volumes in a sample of fourteen first-episode drug-naïve patients with schizophrenia (FEP. MRI scans, BDNF and clinical measurements were performed twice: at baseline before the initiation of antipsychotic treatment and 8 months later, while the patients were receiving monotherapy with second generation antipsychotics (SGAs. RESULTS: We found that left hippocampal volume was decreased (corrected left HV [t = 2.977, df = 13, p = .011] at follow-up; We also found that the higher the BDNF levels change the higher were the differences of corrected left hippocampus after 8 months of treatment with atypical antipsychotics (Pearson r = 0.597, p = 0.024. CONCLUSIONS: The association of BDNF with hippocampal volume alterations in schizophrenia merits further investigation and replication in larger longitudinal studies.

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

    Science.gov (United States)

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

    2017-01-01

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

  6. Homeostatic imbalance of purine catabolism in first-episode neuroleptic-naïve patients with schizophrenia.

    Science.gov (United States)

    Yao, Jeffrey K; Dougherty, George G; Reddy, Ravinder D; Keshavan, Matcheri S; Montrose, Debra M; Matson, Wayne R; McEvoy, Joseph; Kaddurah-Daouk, Rima

    2010-03-03

    Purine catabolism may be an unappreciated, but important component of the homeostatic response of mitochondria to oxidant stress. Accumulating evidence suggests a pivotal role of oxidative stress in schizophrenia pathology. Using high-pressure liquid chromatography coupled with a coulometric multi-electrode array system, we compared 6 purine metabolites simultaneously in plasma between first-episode neuroleptic-naïve patients with schizophrenia (FENNS, n = 25) and healthy controls (HC, n = 30), as well as between FENNS at baseline (BL) and 4 weeks (4w) after antipsychotic treatment. Significantly higher levels of xanthosine (Xant) and lower levels of guanine (G) were seen in both patient groups compared to HC subjects. Moreover, the ratios of G/guanosine (Gr), uric acid (UA)/Gr, and UA/Xant were significantly lower, whereas the ratio of Xant/G was significantly higher in FENNS-BL than in HC. Such changes remained in FENNS-4w with exception that the ratio of UA/Gr was normalized. All 3 groups had significant correlations between G and UA, and Xan and hypoxanthine (Hx). By contrast, correlations of UA with each of Xan and Hx, and the correlation of Xan with Gr were all quite significant for the HC but not for the FENNS. Finally, correlations of Gr with each of UA and G were significant for both HC and FENNS-BL but not for the FENNS-4w. During purine catabolism, both conversions of Gr to G and of Xant to Xan are reversible. Decreased ratios of product to precursor suggested a shift favorable to Xant production from Xan, resulting in decreased UA levels in the FENNS. Specifically, the reduced UA/Gr ratio was nearly normalized after 4 weeks of antipsychotic treatment. In addition, there are tightly correlated precursor and product relationships within purine pathways; although some of these correlations persist across disease or medication status, others appear to be lost among FENNS. Taken together, these results suggest that the potential for steady formation of

  7. Long-term efficacy and safety of blonanserin in patients with first-episode schizophrenia: a 1-year open-label trial.

    Science.gov (United States)

    Ninomiya, Yuriko; Miyamoto, Seiya; Tenjin, Tomomi; Ogino, Shin; Miyake, Nobumi; Kaneda, Yasuhiro; Sumiyoshi, Tomiki; Yamaguchi, Noboru

    2014-12-01

    The purpose of this study was to evaluate the long-term effectiveness and safety of blonanserin, a second-generation antipsychotic drug developed in Japan, in patients with first-episode schizophrenia. Twenty-three antipsychotic-naïve patients with first-episode schizophrenia were treated within an open-label, 1-year, prospective trial of blonanserin (2-24 mg/day). Clinical evaluations were conducted at baseline and 2, 6, and 12 months after the start of treatment. The main outcome measures were changes in subjective well-being and subjective quality of life, as assessed by the Subjective Well-being under Neuroleptic treatment scale Short form-Japanese version and the Schizophrenia Quality of Life Scale-Japanese version, respectively. Secondary outcome measures included the Positive and Negative Syndrome Scale, the Brief Assessment of Cognition in Schizophrenia-Japanese version, laboratory tests, bodyweight, and extrapyramidal symptoms. Fourteen patients (60.9%) remained on the study at 1 year. In the intention-to-treat analysis, significant improvements were observed in several subscales on the Subjective Well-being under Neuroleptic treatment scale Short form-Japanese version, the Schizophrenia Quality of Life Scale-Japanese version, and the Brief Assessment of Cognition in Schizophrenia-Japanese version, and in all factor scores on the Positive and Negative Syndrome Scale. Improvement in depressive symptoms with blonanserin treatment was positively correlated with improvements in subjective well-being and subjective quality of life, as well as verbal memory. No significant changes were noted for any safety measure during the 1-year study period. Blonanserin was well tolerated and effective for the treatment of first-episode schizophrenia in terms of subjective wellness, cognition, and a wide range of pathological symptoms. Further large-scale studies are warranted to confirm our findings. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    clinically and functionally, it had no effect on either mismatch negativity or P3a amplitude. This suggests that even though there is a dopaminergic involvement in global functioning and symptomatology in schizophrenia, there is no such involvement in these particular measures of early information processing....... in mismatch negativity and P3a amplitude are related to increased dopaminergic activity. This is the first study investigating the effect of amisulpride, a potent D2-antagonist, on mismatch negativity and P3a amplitude in a large group of antipsychotic-naïve, first-episode schizophrenia patients. METHODS......BACKGROUND: Reduced mismatch negativity and P3a amplitude have been suggested to be among the core deficits in schizophrenia since the late 1970s. Blockade of dopamine D2 receptors play an important role in the treatment of schizophrenia. In addition, there is some evidence indicating that deficits...

  11. Elevated homocysteine level in first-episode schizophrenia patients--the relevance of family history of schizophrenia and lifetime diagnosis of cannabis abuse.

    Science.gov (United States)

    Misiak, Blazej; Frydecka, Dorota; Slezak, Ryszard; Piotrowski, Patryk; Kiejna, Andrzej

    2014-09-01

    Accumulating evidence indicates that elevated homocysteine (Hcy) level occurs in first-episode schizophrenia (FES) patients. We included 56 FES patients and 53 healthy controls (HC). Plasma level of Hcy was significantly higher in FES patients than HC (p = 0.044). In addition, plasma levels of high-density lipoproteins (HDL) and folate were significantly lower in FES than in HC (p history of schizophrenia was associated with lower plasma HDL (p = 0.041) and vitamin B12 (p = 0.017), as well as higher level of Hcy (p = 0.017). Patients with FES, who abused cannabis, had higher levels of Hcy (p = 0.017), as well as lower levels of vitamin B12 (p = 0.017) and HDL (p = 0.041). Plasma Hcy negatively correlated with duration of untreated psychosis (r = -0.272, p = 0.042). There was a positive correlation between Hcy level and the severity of negative symptoms (r = 0.363, p = 0.006) and general psychopathology (r = 0.349, p = 0.008) assessed using Positive and Negative Syndrome Scale (PANSS). Vitamin B12 level was negatively associated with the severity of negative symptoms (r = -0.406, p = 0.002), while folate level negatively correlated with general psychopathology score (r = -0.365, p = 0.006) in PANSS. These results indicate that the severity of one-carbon metabolism alterations and HDL deficiency might be associated with family history of schizophrenia and cannabis abuse. Lower vitamin B12 and folate along with elevated Hcy may influence the severity of FES psychopathology.

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

    Science.gov (United States)

    Torres, Ulysses S; Duran, Fabio L S; Schaufelberger, Maristela S; Crippa, José A S; Louzã, Mario R; Sallet, Paulo C; Kanegusuku, Caroline Y O; Elkis, Helio; Gattaz, Wagner F; Bassitt, Débora P; Zuardi, Antonio W; Hallak, Jaime Eduardo C; Leite, Claudia C; Castro, Claudio C; Santos, Antonio Carlos; Murray, Robin M; Busatto, Geraldo F

    2016-01-01

    Structural brain abnormalities in schizophrenia have been repeatedly demonstrated in magnetic resonance imaging (MRI) studies, but it remains unclear whether these are static or progressive in nature. While longitudinal MRI studies have been traditionally used to assess the issue of progression of brain abnormalities in schizophrenia, information from cross-sectional neuroimaging studies directly comparing first-episode and chronic schizophrenia patients to healthy controls may also be useful to further clarify this issue. With the recent interest in multisite mega-analyses combining structural MRI data from multiple centers aiming at increased statistical power, the present multisite voxel-based morphometry (VBM) study was carried out to examine patterns of brain structural changes according to the different stages of illness and to ascertain which (if any) of such structural abnormalities would be specifically correlated to potential clinical moderators, including cumulative exposure to antipsychotics, age of onset, illness duration and overall illness severity. We gathered a large sample of schizophrenia patients (161, being 99 chronic and 62 first-episode) and controls (151) from four previous morphometric MRI studies (1.5 T) carried out in the same geographical region of Brazil. Image processing and analyses were conducted using Statistical Parametric Mapping (SPM8) software with the diffeomorphic anatomical registration through exponentiated Lie algebra (DARTEL) algorithm. Group effects on regional gray matter (GM) volumes were investigated through whole-brain voxel-wise comparisons using General Linear Model Analysis of Co-variance (ANCOVA), always including total GM volume, scan protocol, age and gender as nuisance variables. Finally, correlation analyses were performed between the aforementioned clinical moderators and regional and global brain volumes. First-episode schizophrenia subjects displayed subtle volumetric deficits relative to controls in a

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

    Directory of Open Access Journals (Sweden)

    Radovan Přikryl

    2012-01-01

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

  14. Presence of obsessive compulsive symptoms in first-episode schizophrenia or related disorders is associated with subjective well-being and quality of life.

    Science.gov (United States)

    de Haan, Lieuwe; Sterk, Bouke; van der Valk, Renate

    2013-08-01

    The study aims to evaluate whether the presence of obsessive compulsive symptoms (OCS) in first-episode schizophrenia patients is associated with subjective well-being or quality of life. This study used a cross-sectional study of consecutively diagnosed patients with a first episode of schizophrenia or related disorder. There were 23 out of 198 (12%) consecutively assessed patients that reported co-morbid OCS. Co-morbid OCS were associated with a lower mean total score on a subjective well-being scale (P ≤ 0.001), especially on the social integration subscale (P = 0.002) and emotional regulation subscale (P = 0.008), and lower scores on subjective aspects of quality of life (P = 0.043), especially concerning mental health (P = 0.001) and physical health (P = 0.002). These results support the clinical relevance of OCS co-morbidity in schizophrenia or related disorders and the need for research into specific interventions. © 2012 Wiley Publishing Asia Pty Ltd.

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

    Science.gov (United States)

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

    2015-07-02

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Abstract Objectives. Neuroimaging studies have shown abnormal task-related deactivations during working memory (WM) in schizophrenia patients with recent emphasis on brain regions within the default mode network. Using fMRI, we tested whether antipsychotic-naïve schizophrenia patients were impaired...

  17. Sustained attention and planning deficits but intact attentional set-shifting in neuroleptic-naïve first-episode schizophrenia patients.

    Science.gov (United States)

    Hilti, Caroline C; Delko, Tarik; Orosz, Ariane T; Thomann, Kathrin; Ludewig, Stephan; Geyer, Mark A; Vollenweider, Franz X; Feldon, Joram; Cattapan-Ludewig, Katja

    2010-01-01

    The nature of deficits in tests of sustained attention, planning and attentional set-shifting has not been investigated in neuroleptic-naïve first-episode (FE) schizophrenia patients. Based on previous literature of chronic and medicated FE schizophrenia patients, we predicted that the neuroleptic-naïve patients would show deficits in these cognitive processes. Twenty-nine neuroleptic-naïve FE schizophrenia patients and 33 healthy controls - matched by age, gender, and nicotine consumption - performed 3 tests from the Cambridge Automated Neuropsychological Test Battery (CANTAB) thought to measure these cognitive processes: the Rapid Visual Information Processing task (RVIP, sustained attention), the Stockings of Cambridge task (SOC, planning), and the Intradimensional/Extradimensional set-shifting task (IDED, attention shifting). The patients were significantly impaired in the sensitivity index (A') of the RVIP, and in the number of problems solved with minimum moves on the SOC. Nevertheless, the groups did not differ regarding the number of participants who failed at the crucial extradimensional shift stage of the IDED. Sustained attention and planning abilities are already impaired in neuroleptic-naïve FE schizophrenia patients, whereas set-shifting abilities as measured with the IDED task seem to be intact at illness onset. Since chronic schizophrenia patients have been shown to have impaired IDED performance, we tentatively propose that IDED performance deteriorates over time with illness chronicity and/or medication.

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

    Institute of Scientific and Technical Information of China (English)

    张辉; 王晓英

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-02-01

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

  1. Impaired white matter connectivity between regions containing mirror neurons, and relationship to negative symptoms and social cognition, in patients with first-episode schizophrenia.

    Science.gov (United States)

    Saito, Yukiko; Kubicki, Marek; Koerte, Inga; Otsuka, Tatsui; Rathi, Yogesh; Pasternak, Ofer; Bouix, Sylvain; Eckbo, Ryan; Kikinis, Zora; von Hohenberg, Christian Clemm; Roppongi, Tomohide; Del Re, Elisabetta; Asami, Takeshi; Lee, Sang-Hyuk; Karmacharya, Sarina; Mesholam-Gately, Raquelle I; Seidman, Larry J; Levitt, James; McCarley, Robert W; Shenton, Martha E; Niznikiewicz, Margaret A

    2017-02-28

    In schizophrenia, abnormalities in structural connectivity between brain regions known to contain mirror neurons and their relationship to negative symptoms related to a domain of social cognition are not well understood. Diffusion tensor imaging (DTI) scans were acquired in 16 patients with first episode schizophrenia and 16 matched healthy controls. FA and Trace of the tracts interconnecting regions known to be rich in mirror neurons, i.e., anterior cingulate cortex (ACC), inferior parietal lobe (IPL) and premotor cortex (PMC) were evaluated. A significant group effect for Trace was observed in IPL-PMC white matter fiber tract (F (1, 28) = 7.13, p = .012), as well as in the PMC-ACC white matter fiber tract (F (1, 28) = 4.64, p = .040). There were no group differences in FA. In addition, patients with schizophrenia showed a significant positive correlation between the Trace of the left IPL-PMC white matter fiber tract, and the Ability to Feel Intimacy and Closeness score (rho = .57, p = 0.034), and a negative correlation between the Trace of the left PMC-ACC and the Relationships with Friends and Peers score (rho = remove -.54, p = 0.049). We have demonstrated disrupted white mater microstructure within the white matter tracts subserving brain regions containing mirror neurons. We further showed that such structural disruptions might impact negative symptoms and, more specifically, contribute to the inability to feel intimacy (a measure conceptually related to theory of mind) in first episode schizophrenia. Further studies are needed to understand the potential of our results for diagnosis, prognosis and therapeutic interventions.

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  4. Phonetic measures of reduced tongue movement correlate with negative symptom severity in hospitalized patients with first-episode schizophrenia-spectrum disorders.

    Science.gov (United States)

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

    2012-12-01

    Aprosody, or flattened speech intonation, is a recognized negative symptom of schizophrenia, though it has rarely been studied from a linguistic/phonological perspective. To bring the latest advances in computational linguistics to the phenomenology of schizophrenia and related psychotic disorders, a clinical first-episode psychosis research team joined with a phonetics/computational linguistics team to conduct a preliminary, proof-of-concept study. Video recordings from a semi-structured clinical research interview were available from 47 first-episode psychosis patients. Audio tracks of the video recordings were extracted, and after review of quality, 25 recordings were available for phonetic analysis. These files were de-noised and a trained phonologist extracted a 1-minute sample of each patient's speech. WaveSurfer 1.8.5 was used to create, from each speech sample, a file of formant values (F0, F1, F2, where F0 is the fundamental frequency and F1 and F2 are resonance bands indicating the moment-by-moment shape of the oral cavity). Variability in these phonetic indices was correlated with severity of Positive and Negative Syndrome Scale negative symptom scores using Pearson correlations. A measure of variability of tongue front-to-back position-the standard deviation of F2-was statistically significantly correlated with the severity of negative symptoms (r=-0.446, p=0.03). This study demonstrates a statistically significant and meaningful correlation between negative symptom severity and phonetically measured reductions in tongue movements during speech in a sample of first-episode patients just initiating treatment. Further studies of negative symptoms, applying computational linguistics methods, are warranted. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. A virtual reality task based on animal research - spatial learning and memory in patients after the first episode of schizophrenia.

    Science.gov (United States)

    Fajnerová, Iveta; Rodriguez, Mabel; Levčík, David; Konrádová, Lucie; Mikoláš, Pavol; Brom, Cyril; Stuchlík, Aleš; Vlček, Kamil; Horáček, Jiří

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Iveta eFajnerova

    2014-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张敏桥; 戴天刚; 易鹏程

    2014-01-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

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

    Science.gov (United States)

    Bliksted, Vibeke; Videbech, Poul; Fagerlund, Birgitte; Frith, Chris

    2017-02-01

    There is considerable evidence that patients with schizophrenia have neurocognitive and social-cognitive deficits. It is unclear how such deficits in first-episode schizophrenia relate to current clinical symptoms. Fifty-nine patients with first-episode schizophrenia (FES) were tested using the Danish version of NART (premorbid IQ), subtests from WAIS-III (current IQ), and global cognition using Brief Assessment of Cognition in Schizophrena (BACS), a neurocognitive test battery. Social perception was tested using film clips of everyday interactions (TASIT). Theory of mind (ToM) was tested using silent animations (Animated Triangles Task). The FES subjects had been experiencing psychotic symptoms for several years (mean duration 9.5 years 95% confidence interval (CI [7.6;11.3]). The FES patients were divided into clinical subgroups based on their level of positive and negative symptoms (using SANS and SAPS). Healthy controls were matched to the patients. High levels of negative symptoms were associated with low estimated functional IQ and poor neurocognition and social cognition. All SANS subscales, but Avolition-Apathy, had significant negative impact on social cognition. The effects of positive symptoms were complex. High levels of delusions were associated with higher premorbid IQ. In the presence of high levels of negative symptoms, high levels of positive symptoms were associated with the most comprehensive deficits in social perception, while, in the absence of negative symptoms, high levels of positive symptoms were not associated with such deficits. The results suggest that social-cognitive training will need to take account of the above mentioned effects of symptoms. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

    Science.gov (United States)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Long-Biao eCui

    2015-11-01

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

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

    Science.gov (United States)

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

    2011-08-01

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

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

    Science.gov (United States)

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

    2009-04-30

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2012-05-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  2. The correlation between event-related potential P300 and grey matter volume in female patients with drug-naive first episode major depressive disorder%女性抑郁症首次发病患者认知事件相关电位P300与脑灰质体积的相关分析

    Institute of Scientific and Technical Information of China (English)

    沈宗霖; 莫茵; 李娜; 刘芳; 卢瑾; 陈伟; 许秀峰; 程宇琪

    2014-01-01

    Objective The present study aims to explore the grey matter volume changes in drugnaive first-episode major depressive disorder (MDD) female patients and to find out their correlation with event-related potential P3oo.Methods Twenty-five patients,aging between 18-58 years,diagnosed with first-episode MDD and 28 gender-,age-,education level-matched healthy controls were included in this study.All participants were assigned to receive 3D structural magnetic resonance imaging brain scans,and the patients were assigned to receive P30o tests.Results In contrast with healthy controls,decreased grey matter volume was detected in the right frontal operculum and the right precentral gyrus of patients,both P3 and N2 latencies were positively correlated with bilateral putamen nuclei (all P < 0.01).The P3 latency was also positively associated with the volumes of left middle temporal gyrus,left middle frontal gyrus,and leftfusiform gyrus.The N2 latency was also positively associated with the volumes of left posterior cingulate gyrus,the right fusiform gyrus,the occipital lobe,and the left cerebellum (all P < 0.01).The P3 amplitude was negatively associated with the volumes of left angular gyrus and right superior frontal gyrus (all P <0.01).No statistically significant correlation was found between each component of P300 and Hamilton Depression Scale scores (total and factor).Conclusions The abnormalities of grey matter volume are observed in certain brain regions in unmedicated female patients with first-episode MDD in this study.And the P300 in those patients are in correlation with many grey matter regions of the brain,especially temporal lobes and basal ganglia.%目的 探讨首次发病未服药女性抑郁症患者脑灰质体积变化特点,以及与认知事件相关电位P300的相关分析.方法 对25例18 ~58岁首次发病未服药女性抑郁症患者(患者组)和28名健康对照者(对照组)行头部3D结构MRI扫描,并对患者组进行P300

  3. First Episode Psychosis

    Science.gov (United States)

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

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

    Science.gov (United States)

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

    2015-08-25

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

  5. The history of childhood trauma among individuals with ultra high risk for psychosis is as common as among patients with first-episode schizophrenia.

    Science.gov (United States)

    Sahin, Seda; Yüksel, Çağrı; Güler, Julide; Karadayı, Gülşah; Akturan, Elçin; Göde, Evrim; Özhan, Amber Alix; Üçok, Alp

    2013-11-01

    Childhood trauma (CT) is more common in patients with psychosis than in general population and is found to be related to the severity of symptoms. The objective of this study was to investigate the severity of CT, and its relationship with clinical features in two different groups: first-episode schizophrenia (FES) and ultra high risk for psychosis (UHR) groups. In this cross-sectional study, 83 patients with FES, 41 individuals with UHR and 69 healthy controls were included. Clinical features were evaluated with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Negative Symptoms and the Scale for the Assessment of Positive Symptoms (SAPS). We evaluated CT with the Childhood Trauma Questionnaire (CTQ). UHR group was also assessed with the Calgary Depression Scale for Schizophrenia. The emotional and physical abuse, physical and emotionalneglect subscale scores and CTQ total score of both the UHR group and FES group were higher than the control group. However, the CTQ total score and subscale scores did not differ between FES and UHR groups. UHR group had more Schneiderian symptoms in terms of both number and severity, and severity of sexual abuse was found to be correlated with SAPS scores especially for the 'commenting voices' item. The CTQ emotional abuse and neglect scores were correlated with the severity of depression. FES patients with higher CTQ scores obtained higher total scores on SAPS and higher total scores on Schneiderian items. We found that CT is related to the severity of psychotic symptoms in both FES and UHR groups. Therefore, it is possible that interventions aimed at preventing CT in children would reduce the manifestation of psychosis among young people. © 2013 Wiley Publishing Asia Pty Ltd.

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

    Science.gov (United States)

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

    2005-03-01

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

  7. Nonspecific Effect of Stress on Brain Gray Matter Volume in Drug-naive Female Patients with First Depressive Episode

    Directory of Open Access Journals (Sweden)

    Chuan-Jun Zhuo

    2016-01-01

    Conclusions: Although the results of the present study suggest the absence of significant differences in brain gray matter volume between female drug-naive patients after the first episode of major depression with and without SLEs after FDR correction, the study provides useful information for exploring the definitive role of stress in the onset of depression.

  8. First-episode psychosis

    DEFF Research Database (Denmark)

    Simonsen, Erik

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张延赤; 赵富帅; 赵丽丽; 郑博文

    2015-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘芳; 刘靖; 姚旭东

    2011-01-01

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

  12. Theory of mind impairments in first-episode psychosis, individuals at ultra-high risk for psychosis and in first-degree relatives of schizophrenia: systematic review and meta-analysis.

    Science.gov (United States)

    Bora, Emre; Pantelis, Christos

    2013-03-01

    Theory of mind (ToM) deficit is a well-established feature of schizophrenia and has been suggested as a vulnerability marker of this disorder. However, as most of this evidence is based on studies in chronic patients, it is less clear whether ToM is impaired prior to or following the onset of a first-episode and whether it is evident in unaffected relatives of patients. In this meta-analysis, ToM performance of 3005 individuals with first-episode psychosis (FEP), individuals at ultra-high risk for psychosis (UHR) and unaffected relatives were compared with 1351 healthy controls. ToM was substantially impaired in first-episode psychosis (Cohen d=1.0) and this deficit was comparable to findings in chronic patients. ToM was also impaired in unaffected relatives (d=0.37) and UHR subjects (d=0.45) and performances of these groups were intermediate between FES and healthy controls. Severity of ToM deficits in unaffected relatives and UHR subjects was similar to other cognitive deficits observed in these groups. Longitudinal studies of clinical and genetic high-risk subjects are necessary to investigate the trajectory of development of ToM deficits in schizophrenia. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Reduced γ-Aminobutyric Acid and Glutamate+Glutamine Levels in Drug-Naïve Patients with First-Episode Schizophrenia but Not in Those at Ultrahigh Risk

    Directory of Open Access Journals (Sweden)

    Junjie Wang

    2016-01-01

    Full Text Available Altered γ-aminobutyric acid (GABA, glutamate (Glu levels, and an imbalance between GABAergic and glutamatergic neurotransmissions have been involved in the pathophysiology of schizophrenia. However, it remains unclear how these abnormalities impact the onset and course of psychosis. In the present study, 21 drug-naïve subjects at ultrahigh risk for psychosis (UHR, 16 drug-naïve patients with first-episode schizophrenia (FES, and 23 healthy controls (HC were enrolled. In vivo GABA and glutamate+glutamine (Glx levels in the medial prefrontal cortex were measured using proton magnetic resonance spectroscopy. Medial prefrontal GABA and Glx levels in FES patients were significantly lower than those in HC and UHR, respectively. GABA and Glx levels in UHR were comparable with those in HC. In each group, there was a positive correlation between GABA and Glx levels. Reduced medial prefrontal GABA and Glx levels thus may play an important role in the early stages of schizophrenia.

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

    Institute of Scientific and Technical Information of China (English)

    胡茂荣; 王娟; 李乐华; 陈晋东; 吴仁容; 赵靖平

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李婕

    2014-01-01

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

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

    LENUS (Irish Health Repository)

    Owoeye, Olabisi

    2013-05-28

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

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

    Directory of Open Access Journals (Sweden)

    Bianca Cristina Ciccone Giacon

    2006-06-01

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

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

    Science.gov (United States)

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

    2013-10-30

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

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

    Science.gov (United States)

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

    2008-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张雪英; 王树珍; 余莉; 石璐

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈刚伟

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李波; 黎雪松; 龚道元; 谢国军; 陈家强; 彭艳; 王晓娟

    2013-01-01

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

  4. Nonspecific Effect of Stress on Brain Gray Matter Volume in Drug-naive Female Patients with First Depressive Episode

    Institute of Scientific and Technical Information of China (English)

    Chuan-Jun Zhuo; Hai-Man Bian; Yan-Jie Gao; Xiao-Lei Ma; Sheng-Zhang Ji; Meng-Yuan Yao; Ning Zhai

    2016-01-01

    Background: This study aimed to observe the differences in brain gray matter volume in drug-naive female patients after the first episode of major depression with and without stressful life events (SLEs) before the onset of depression.Methods: Forty-three drug-naive female patients voluntarily participated in the present study after the first major depressive episode.The life event scale was used to evaluate the severity of the impact of SLEs during 6 months before the onset of the major depressive episode.High-field magnetic resonance imaging (MRI) scans were obtained, and the VBM and SPM8 software process were used to process and analyze the MRI.Results: Compared to that in patients without SLEs, the volume of brain gray matter was lower in the bilateral temporal lobe, right occipital lobe, and right limbic lobe in the SLE group.However, the gray matter volume did not differ significantly between the two groups after the application of false discovery rate (FDR) correction.Conclusions: Although the results of the present study suggest the absence of significant differences in brain gray matter volume between female drug-naive patients after the first episode of major depression with and without SLEs after FDR correction, the study provides useful information for exploring the definitive role of stress in the onset of depression.

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

    Institute of Scientific and Technical Information of China (English)

    魏钦令; 李雷俊; 骆众星; 康庄; 韩自力; 张晋碚

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sachsse Jan

    2006-02-01

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

  7. Premorbid Personality and Insight in First-Episode Psychosis

    OpenAIRE

    Campos, Maria S.; Garcia-Jalon, Elena; Gilleen, James K.; David, Anthony S.; Peralta MD, Victor; Cuesta, Manuel J.

    2010-01-01

    Background: Insight in psychosis and schizophrenia is considered a complex biopsychosocial phenomenon. Premorbid personality is regarded by some authors as part of the substrate to many psychiatric phenomena, but it is not clear if this applies to insight. Aim: To examine longitudinal relationships between personality traits and insight dimensions in first-episode psychosis. Methods: One hundred consecutive antipsychotic-naïve first-episode nonaffective psychotic patients admitted to hospital...

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

    Institute of Scientific and Technical Information of China (English)

    刘磊峰; 贺定翠; 邓小鹏; 凃哲明; 刘波

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    庞礼娟; 宋学勤; 李幼辉; 李雪; 高金松

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    吴小立; 文飞; 钟智勇; 韩自力

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    蒲金玉; 蒲冬玉; 张笑梅; 孙梦月; 刘情情

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王颖; 贾艳滨; 凌雪英; 黄力

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    曹九英; 邓文英; 许律琴; 傅深省; 蒋娅玲

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    谭余龙

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孙群星; 刘勇; 李四冬; 尹继续

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    仇红杰

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    黄卓玮; 龚传鹏

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    黄继伟; 李林; 吕维忠; 韩自力

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张文娟; 刘培培; 李健成

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张加明

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    隗春玲

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

  6. 首发男性精神分裂症患者认知功能损害与精神症状的关联%Correlation between cognitive function and psychiatric symptoms in first-episode male schizophrenia patients

    Institute of Scientific and Technical Information of China (English)

    孙金荣; 沙维伟; 张晓斌; 李凌江; 程灶火

    2013-01-01

    目的 探讨首发男性精神分裂症患者认知功能的损害特点,以及认知功能损害与精神症状的关联性.方法 对43例符合精神分裂症诊断标准首次发作男性患者,在其精神症状好转前后,即治疗前与治疗8周后分别用华文认知能力测验(CCAS)和阳性及阴性症状量表(PANSS)评定,同时对患者的临床特征进行研究.结果 首发男性精神分裂症患者治疗前后认知功能与精神症状评分差异有统计学意义(P<0.01).精神症状治疗前患者认知能力总分[(85.7 ±11.5)分]以及各认知功能因子学习能力[(17.9±2.3)分]、推理能力[(16.1±3.4)分]、加工速度[(16.9±2.1)分]、工作记忆[(13.8±2.6)分]、空间/计算[(17.5±2.9)分]、言语智商[(86.8±11.7)分]、操作智商[(83.9±12.4)分];精神症状治疗后患者认知能力总分[(97.6±14.3)分]以及各认知功能因子[学习能力(20.1±2.9)分、推理能力(18.9±3.1)分、加工速度(19.7±1.8)分、工作记忆(15.7±2.5)分、空间/计算(20.8±2.5)分、言语智商(98.3±13.7)分、操作智商(95.8±14.6)分,P<0.01].治疗前后IQ的差值与PANSS总分差值及阳性总分差值具有正相关性(r值分别为0.596及0.783).结论 (1)首发男性精神分裂症患者在发病初期就存在认知功能损害;(2)非典型抗精神病药改善精神分裂症临床症状的同时对改善患者认知功能损害具有一定作用;(3)精神分裂症患者认知功能的改善与患者阳性症状的好转具有一定的正相关,而与阴性症状改善相关无统计学意义.%Objective To study the characteristic of cognitive function impaired and its relationship with the psychiatric symptoms in patients with first-episode schizophrenia.Methods 43 first-episode male schizophrenia patients diagnosed with DSM-Ⅳ were recruited in the study and received the atypical antipsychotics treatment 8weeks.The total score and sub-scores of Chinese Cognitive Ability Scale (CCAS

  7. Early detection of first-episode psychosis

    DEFF Research Database (Denmark)

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

    2006-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    任培丽; 徐莉娟; 王蘅

    2014-01-01

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

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

    Science.gov (United States)

    Vidailhet, P

    2013-09-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孙健; 冯纳婷; 孙群星; 郭华

    2014-01-01

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

  11. Predictive validity of proposed remission criteria in first-episode schizophrenic patients responding to antipsychotics

    NARCIS (Netherlands)

    Wunderink, Lex; Nienhuis, Fokko J.; Sytema, Sjoerd; Wiersma, Durk

    2007-01-01

    The objective of this study was to examine the predictive validity of the remission criteria proposed by Andreasen et all in first-episode patients responding to antipsychotics. Antipsychotic responsive patients with first-episode schizophrenia showing symptom remission (n = 60) were compared with p

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

    Institute of Scientific and Technical Information of China (English)

    杨绪娜; 朱峰; 李乐华

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    国效峰; 郑俊杰; 齐景峰; 胡茂荣; 陈华富; 赵靖平

    2015-01-01

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

  14. Neurocognitive performance in first-episode and chronic schizophrenic patients.

    Science.gov (United States)

    Moritz, Steffen; Andresen, Burghard; Perro, Christian; Schickel, Marc; Krausz, Micheal; Naber, Dieter

    2002-02-01

    Previous research on neuropsychological disturbances in first-episode and chronic schizophrenic patients has provided mixed results which can be partially attributed to methodological inconsistencies. For the present study, 70 schizophrenic patients (40 with chronic and 30 with first-episode schizophrenia) were compared to 30 healthy controls on a large battery of neuropsychological tests. Special attention was paid to potential confounds such as differences in psychopathology, age and educational level between the schizophrenic sub-samples. Healthy controls performed better than both first-episode and chronic patients in almost all cognitive domains (P < 0.01), while the patient samples did not differ in any of the tasks. Results were confirmed in a second series of analyses in which patient subgroups were equated for sociodemographic background variables. The present results confirm recent data collected in longitudinal studies, thus, lending further support for a neurodevelopmental model of schizophrenia. It is suggested that neuropsychological disturbances occur early in schizophrenia and do not worsen in the course beyond age-related decrement. Possible reasons why previous research has produced contradictory findings are discussed.

  15. Caregiver psychoeducation for first-episode psychosis.

    LENUS (Irish Health Repository)

    McWilliams, Stephen

    2010-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    翁睿贞; 程晓雯; 江学锋; 熊祥玉; 张晨

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨冬冰; 马元业; 王军

    2014-01-01

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

  19. Apathy in first episode psychosis patients

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈大春; 陈科; 张荣珍; 冯薇; 高岚; 杨甫德; 张向阳

    2016-01-01

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

  1. Predictors of recovery in first episode psychosis

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    DEFF Research Database (Denmark)

    Hochwälder, Jacek; Mattsson, Maria; Holmqvist, Ragnhild

    2012-01-01

    PURPOSE: To psychometrically evaluate the Satisfaction with Life Scale in two cohorts of first-episode psychosis patients in the Danish National Schizophrenia Project and in the Swedish Parachute Project. METHOD: Four properties of the Satisfaction with Life Scale were examined in the Danish cohort....... The dimensions were confirmed in the Swedish sample. CONCLUSION: The Satisfaction with Life Scale shows satisfactory psychometric properties and seems valid and useful among first-episode psychosis patients....

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

    Institute of Scientific and Technical Information of China (English)

    刘倩倩; 李亚飞; 朱祥路; 蒋天玉

    2014-01-01

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

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

    DEFF Research Database (Denmark)

    Tandberg, Marte; Ueland, Torill; Sundet, Kjetil

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    , delusional disorder or other non-organic psychosis), aged 10-18 to those of 29 matched controls, using optimized voxel-based morphometry. RESULTS: Psychotic patients had frontal white matter abnormalities, but expected (regional) gray matter reductions were not observed. Post hoc analyses revealed...... that schizophrenia patients (n = 15) had significantly larger lateral ventricles as compared to controls. Duration and dose of antipsychotics correlated negatively with global gray matter volume in minimally medicated patients (n = 18). CONCLUSION: Findings of white matter changes and enlarged lateral ventricles...... already at illness onset in young schizophrenia spectrum patients, suggests aberrant neurodevelopmental processes in the pathogenesis of these disorders. Gray matter volume changes, however, appear not to be a key feature in early onset first-episode psychosis....

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

    Institute of Scientific and Technical Information of China (English)

    杨悦; 宋志伟; 韩丽; 马学华; 李秋平; 冯磊光

    2015-01-01

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

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

    Science.gov (United States)

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

    2001-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    马周

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张超; 张彦华

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    毛智群; 李达; 查智群; 顾曙光; 季萍

    2011-01-01

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

  12. How successful are first episode programs?

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  13. Depressive symptoms in first-episode psychosis

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  14. Family Intervention in First-Episode Psychosis

    Directory of Open Access Journals (Sweden)

    Anvar Sadath

    2015-11-01

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

  15. Mental health nursing and first episode psychosis

    NARCIS (Netherlands)

    Dusseldorp, L. van; Goossens, P.J.J.; Achterberg, T. van

    2011-01-01

    The purpose of this literature review is to identify mental health nursing's contribution to the care and treatment of patients with a first episode of psychosis; A systematic literature review was undertaken, with 27 articles selected for study. Five domains were identified: development of

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

    Institute of Scientific and Technical Information of China (English)

    刘娜

    2016-01-01

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

  17. Over-Expression of Dopamine D2 Receptor and Inwardly Rectifying Potassium Channel Genes in Drug-Naive Schizophrenic Peripheral Blood Lymphocytes as Potential Diagnostic Markers

    Directory of Open Access Journals (Sweden)

    Ágnes Zvara

    2005-01-01

    Full Text Available Schizophrenia is one of the most common neuropsychiatric disorders affecting nearly 1% of the human population. Current diagnosis of schizophrenia is based on complex clinical symptoms. The use of easily detectable peripheral molecular markers could substantially help the diagnosis of psychiatric disorders. Recent studies showed that peripheral blood lymphocytes (PBL express subtypes of D1 and D2 subclasses of dopamine receptors. Recently, dopamine receptor D3 (DRD3 was found to be over-expressed in schizophrenic PBL and proposed to be a diagnostic and follow-up marker for schizophrenia. In this study we screened PBL of 13 drug-naive/drug-free schizophrenic patients to identify additional markers of schizophrenia. One of the benefits of our study is the use of blood samples of non-medicated, drug-naive patients. This excludes the possibility that changes detected in gene expression levels might be attributed to the medication rather than to the disorder itself. Among others, genes for dopamine receptor D2 (DRD2 and the inwardly rectifying potassium channel (Kir2.3 were found to be over-expressed in microarray analysis. Increased mRNA levels were confirmed by quantitative real-time PCR (QRT-PCR using the SybrGreen method and dual labeled TaqMan probes. The use of both molecular markers allows a more rapid and precise prediction of schizophrenia and might help find the optimal medication for schizophrenic patients.

  18. Over-expression of dopamine D2 receptor and inwardly rectifying potassium channel genes in drug-naive schizophrenic peripheral blood lymphocytes as potential diagnostic markers.

    Science.gov (United States)

    Zvara, Agnes; Szekeres, György; Janka, Zoltán; Kelemen, János Z; Cimmer, Csongor; Sántha, Miklós; Puskás, László G

    2005-01-01

    Schizophrenia is one of the most common neuropsychiatric disorders affecting nearly 1% of the human population. Current diagnosis of schizophrenia is based on complex clinical symptoms. The use of easily detectable peripheral molecular markers could substantially help the diagnosis of psychiatric disorders. Recent studies showed that peripheral blood lymphocytes (PBL) express subtypes of D1 and D2 subclasses of dopamine receptors. Recently, dopamine receptor D3 (DRD3) was found to be over-expressed in schizophrenic PBL and proposed to be a diagnostic and follow-up marker for schizophrenia. In this study we screened PBL of 13 drug-naive/drug-free schizophrenic patients to identify additional markers of schizophrenia. One of the benefits of our study is the use of blood samples of non-medicated, drug-naive patients. This excludes the possibility that changes detected in gene expression levels might be attributed to the medication rather than to the disorder itself. Among others, genes for dopamine receptor D2 (DRD2) and the inwardly rectifying potassium channel (Kir2.3) were found to be over-expressed in microarray analysis. Increased mRNA levels were confirmed by quantitative real-time PCR (QRT-PCR) using the SybrGreen method and dual labeled TaqMan probes. The use of both molecular markers allows a more rapid and precise prediction of schizophrenia and might help find the optimal medication for schizophrenic patients.

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

    Institute of Scientific and Technical Information of China (English)

    刘军; 周云

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李喆; 邓伟; 李寅飞; 丁蕾; 刘祥; 郑重; 李涛

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Harder, Susanne; Knudsen, Per

    2012-01-01

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

  4. Frontal dopamine D(2/3) receptor binding in drug-naive first-episode schizophrenic patients correlates with positive psychotic symptoms and gender

    DEFF Research Database (Denmark)

    Glenthoj, Birte Y; Mackeprang, Torben; Svarer, Claus

    2006-01-01

    with single-photon emission computerized tomography (SPECT) using the D(2/3)-receptor ligand [123I]epidepride. RESULTS: In the hitherto largest study on extrastriatal D(2/3) receptors we detected a significant correlation between frontal D(2/3) BP values and positive schizophrenic symptoms in the larger group......; the patients, however, had significantly higher BP in the right compared to the left thalamus, whereas no significant hemispheric imbalances were observed in the healthy subjects. CONCLUSIONS: The present data are the first to confirm a significant correlation between frontal D(2/3) receptor BP values...

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

    Institute of Scientific and Technical Information of China (English)

    邓良华; 许世欢; 徐健; 唐立岩

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    徐东; 王秀丽; 杨靖; 万宏颖

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陆强

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨靖; 张勇; 王秀丽; 邵玉单

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    孙玉涛; 刘海军; 张学志

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    邱玲玲; 王继丰; 吴迎春; 刘大威; 朱德超

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    段惠峰; 甘景梨; 连亚军; 史振娟; 高存友; 高延伦; 张毅

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    焦金; 金毅琼; 马素杰; 成艳红

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    郭芳; 郭素芹; 朱俊敬

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    魏钦令; 郑俩荣; 胡冰; 康庄; 国效锋; 胡茂荣; 韩自力

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李娜; 邓伟; 何宗岭; 李名立; 黄明敏; 李涛; 邓红

    2013-01-01

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

  17. Assessing transmissibility of HIV-1 drug resistance mutations from treated and from drug-naive individuals

    Science.gov (United States)

    Winand, Raf; Theys, Kristof; Eusébio, Mónica; Aerts, Jan; Camacho, Ricardo J.; Gomes, Perpetua; Suchard, Marc A.; Vandamme, Anne-Mieke; Abecasis, Ana B.

    2015-01-01

    Objectives: Surveillance drug resistance mutations (SDRMs) in drug-naive patients are typically used to survey HIV-1-transmitted drug resistance (TDR). We test here how SDRMs in patients failing treatment, the original source of TDR, contribute to assessing TDR, transmissibility and transmission source of SDRMs. Design: This is a retrospective observational study analyzing a Portuguese cohort of HIV-1-infected patients. Methods: The prevalence of SDRMs to protease inhibitors, nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) in drug-naive and treatment-failing patients was measured for 3554 HIV-1 subtype B patients. Transmission ratio (prevalence in drug-naive/prevalence in treatment-failing patients), average viral load and robust linear regression with outlier detection (prevalence in drug-naive versus in treatment-failing patients) were analyzed and used to interpret transmissibility. Results: Prevalence of SDRMs in drug-naive and treatment-failing patients were linearly correlated, but some SDRMs were classified as outliers – above (PRO: D30N, N88D/S, L90 M, RT: G190A/S/E) or below (RT: M184I/V) expectations. The normalized regression slope was 0.073 for protease inhibitors, 0.084 for NRTIs and 0.116 for NNRTIs. Differences between SDRMs transmission ratios were not associated with differences in viral loads. Conclusion: The significant linear correlation between prevalence of SDRMs in drug-naive and in treatment-failing patients indicates that the prevalence in treatment-failing patients can be useful to predict levels of TDR. The slope is a cohort-dependent estimate of rate of TDR per drug class and outlier detection reveals comparative persistence of SDRMs. Outlier SDRMs with higher transmissibility are more persistent and more likely to have been acquired from drug-naive patients. Those with lower transmissibility have faster reversion dynamics after transmission and are associated with

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

    Institute of Scientific and Technical Information of China (English)

    杨云斌; 周朝当

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    吴国伟; 张程赪

    2014-01-01

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

  20. Personality disorders in first-episode psychosis

    DEFF Research Database (Denmark)

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

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Agartz Ingrid

    2009-01-01

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

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

    DEFF Research Database (Denmark)

    Bertelsen, Mette; Jeppesen, Pia; Petersen, Lone

    2007-01-01

    : A longitudinal, prospective, 5-year follow-up study of 547 individuals with first-episode schizophrenia spectrum psychosis. Individuals presenting for their first treatment in mental health services in two circumscribed urban areas in Denmark were included in a randomised controlled trial of integrated v......-up. We found a strong association between suicidal thoughts, plans and previous attempts, depressive and psychotic symptoms and young age, and with suicidal plans and attempts at 1- and 2-year follow-up. CONCLUSIONS: In this first-episode cohort depressive and psychotic symptoms, especially...

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

  5. Higher Death Rate Among Youth With First Episode Psychosis

    Science.gov (United States)

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

  6. Gender differences in first episode psychosis

    DEFF Research Database (Denmark)

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

    2008-01-01

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

  7. Premorbid personality and insight in first-episode psychosis.

    Science.gov (United States)

    Campos, Maria S; Garcia-Jalon, Elena; Gilleen, James K; David, Anthony S; Peralta, Victor M D; Cuesta, Manuel J

    2011-01-01

    Insight in psychosis and schizophrenia is considered a complex biopsychosocial phenomenon. Premorbid personality is regarded by some authors as part of the substrate to many psychiatric phenomena, but it is not clear if this applies to insight. To examine longitudinal relationships between personality traits and insight dimensions in first-episode psychosis. One hundred consecutive antipsychotic-naïve first-episode nonaffective psychotic patients admitted to hospital were included in the study. Eighty-one patients completed at 1 month a premorbid personality evaluation, plus baseline, and 6-month insight assessments. We used the Assessment and Documentation of Psychopathology inventory for assessing insight dimensions (not feeling ill, lack of insight, and refusal of treatment) and the Personality Assessment Schedule for ascertaining 5 dimensions of premorbid personality (schizoid, passive-dependent, anancastic, sociopathic, and schizotypy). At baseline, personality dimensions did not show any association with insight dimensions, with the exception of schizotypy traits. At 6 months, schizoid and sociopathic personality showed a significant association with not feeling ill (r = .30, P ≤ .007; r = .27, P = .01) and lack of insight (r = .36, P = .001; r = .41, P schizoid and sociopathic personality had moderate correlation with the lack of insight dimension (r = -.34, P = .002; r = .38, P schizoid personality significantly predicted lack of insight at 6 months and change from baseline to the 6 months assessment. Sociopathic and schizoid personality dimensions were not only significantly associated with lack of insight at 6 months but also predicted change on lack of insight over 6 months. Therefore, exploring premorbid personality traits at the beginning of a psychotic episode may be helpful in identifying patients at high risk for lack of insight during the initial course of the illness.

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

    Institute of Scientific and Technical Information of China (English)

    吴小立; 王继辉; 钟智勇; 韩自力

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘微波; 陈巧珍; 尹厚民; 郑磊磊; 俞少华; 陈一萍; 李惠春

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    吴小立; 魏钦令; 钟智勇; 张晋碚

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2008-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    田博; 陆晓姿

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王厚亮; 赵靖平; 韩洪赢; 温盛霖; 张俊成

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    任丽

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

    Ellersgaard, Ditte; Mors, Ole; Thorup, Anne

    2014-01-01

    AIM: The stability of delusional themes in psychotic disorders is only sparsely lit. The study aims to investigate the stability of delusional themes over a period of time in patients with first-episode non-affective psychosis. METHODS: The data were drawn from a randomized controlled trial of 547...... first-episode patients with schizophrenia spectrum disorders, the OPUS trial. A subsample of 411 patients met our inclusion criteria. They were interviewed at the time of first treatment contact, and at years 1, 2 and 5 after onset. The delusional themes of the 411 patients were classified by applying...... principal component analysis to the patients' scores on 12 items of delusions from the Scale for the Assessment of Positive Symptoms in Schizophrenia, SAPS. The course of the patients' predominant delusional themes was analysed afterwards. RESULTS: The 12 delusional themes from SAPS were converted into five...

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

    Institute of Scientific and Technical Information of China (English)

    陈姬; 韦娟娟; 张毅

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    牛莉莉; 温科奇; 熊鹏; 曾勇; 徐飞; 李明; 黄晓江

    2015-01-01

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

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

    LENUS (Irish Health Repository)

    Aas, Monica

    2011-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨绪娜; 朱峰; 李乐华

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈锦成; 黎彩萍

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    胡光涛; 宋航; 王国威; 陈许波; 贺英

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈方斌; 陈琪; 潘园园; 孙剑; 徐乐平; 王焕林

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王华永; 王刚平

    2014-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    亓高超

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    徐良雄; 高卉; 曾德志; 黄翠萍

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘延辉; 寇海燕; 王福华; 田博; 张心华

    2015-01-01

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

  13. Reducing the duration of untreated first-episode psychosis

    DEFF Research Database (Denmark)

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

    2004-01-01

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

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

    LENUS (Irish Health Repository)

    Renwick, Laoise

    2012-07-01

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

  15. Atypical visual and somatosensory adaptation in schizophrenia-spectrum disorders

    Science.gov (United States)

    Andrade, G N; Butler, J S; Peters, G A; Molholm, S; Foxe, J J

    2016-01-01

    Neurophysiological investigations in patients with schizophrenia consistently show early sensory processing deficits in the visual system. Importantly, comparable sensory deficits have also been established in healthy first-degree biological relatives of patients with schizophrenia and in first-episode drug-naive patients. The clear implication is that these measures are endophenotypic, related to the underlying genetic liability for schizophrenia. However, there is significant overlap between patient response distributions and those of healthy individuals without affected first-degree relatives. Here we sought to develop more sensitive measures of sensory dysfunction in this population, with an eye to establishing endophenotypic markers with better predictive capabilities. We used a sensory adaptation paradigm in which electrophysiological responses to basic visual and somatosensory stimuli presented at different rates (ranging from 250 to 2550 ms interstimulus intervals, in blocked presentations) were compared. Our main hypothesis was that adaptation would be substantially diminished in schizophrenia, and that this would be especially prevalent in the visual system. High-density event-related potential recordings showed amplitude reductions in sensory adaptation in patients with schizophrenia (N=15 Experiment 1, N=12 Experiment 2) compared with age-matched healthy controls (N=15 Experiment 1, N=12 Experiment 2), and this was seen for both sensory modalities. At the individual participant level, reduced adaptation was more robust for visual compared with somatosensory stimulation. These results point to significant impairments in short-term sensory plasticity across sensory modalities in schizophrenia. These simple-to-execute measures may prove valuable as candidate endophenotypes and will bear follow-up in future work. PMID:27163205

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

    Science.gov (United States)

    Orus, Cristián; Aceituno, David

    2016-05-23

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

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

    LENUS (Irish Health Repository)

    Heslin, Margaret

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ricardo Coentre

    2016-05-01

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

  20. Density of striatal D2 receptors in untreated first-episode psychosis: an I123-IBZM SPECT study.

    Science.gov (United States)

    Corripio, Iluminada; Escartí, María J; Portella, Maria J; Pérez, Víctor; Grasa, Eva; Sauras, Rosa B; Alonso, Anna; Safont, Gemma; Camacho, M Valle; Dueñas, Rosa; Arranz, Belén; San, Luis; Catafau, Ana M; Carrió, Ignasi; Alvarez, Enric

    2011-12-01

    There is as yet no definite prognostic marker to determine whether a first-episode psychosis will become schizophrenia or not. The aim of the present study is to address whether the mechanism of sensitization of the subcortical dopaminergic pathway - yielding to an increase of the postsynaptic D2 receptors - may serve as a prognostic marker of clinical outcome in drug naïve patients with a first-episode psychosis, by means of a prospective and multicentric study with untreated first-episode psychosis patients (n=37). 123I-IBZM SPECT was performed at the time of the inclusion in the study, before antipsychotic medication was initiated. One year later, patients were assessed again so as to determine their diagnosis. There was a significant group effect at baseline in D2 Striatal/Frontal (S/F) ratios (F=10.2, p<0.001). Bonferroni posthoc comparisons attested significant differences between diagnosis (p=0.006), and between schizophrenia and control groups (p<0.001) but no differences between non-schizophrenia and control groups (p=0.9). The logistic regression model showed that D2R binding (p=0.02) and PAS (Premorbid Adjustment Scale) adulthood score (p=0.03) were predictive of the final diagnosis (schizophrenia/non-schizophrenia; Nagelkerke R(2)=0.59; X(2)=11.08, p=0.001). These findings replicate previous results on the usefulness of D2R binding as an objective prognostic parameter, together with the evaluation of premorbid adjustment, of the evolution of first-episode psychosis. In this regard, the results may provide a new view in the approach of early and personalized treatment in the debut of a psychosis. Copyright © 2011 Elsevier B.V. and ECNP. All rights reserved.

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

    LENUS (Irish Health Repository)

    Lyne, John

    2012-03-01

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

  2. Patient satisfaction with treatment in first-episode psychosis

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  3. Cognitive dysfunction at baseline predicts symptomatic 1-year outcome in first-episode schizophrenics.

    Science.gov (United States)

    Moritz, S; Krausz, M; Gottwalz, E; Lambert, M; Perro, C; Ganzer, S; Naber, D

    2000-01-01

    The present study addresses the consequences of cognitive disturbances on symptomatic outcome. Fifty-three first-episode schizophrenics were reassessed (n = 32) 1 year after admission. Simple regression analyses revealed that several self-perceived cognitive deficits at baseline as measured with the Frankfurt Complaint Questionnaire significantly predicted increased Brief Psychiatric Rating Scale global scores at follow-up (p = 0.05 to p = 0.005). A stepwise regression analysis proved memory dysfunction to be the strongest predictor of symptomatic worsening (p = 0.005). It is suggested that the exploration and treatment of neuropsychological deficits in schizophrenia is of great clinical importance with regard to its impact on both functional and symptomatic outcome in schizophrenia. Copyright 2000 S. Karger AG, Basel

  4. Five-Year Follow-Up of Supportive Psychodynamic Psychotherapy in First-Episode Psychosis

    DEFF Research Database (Denmark)

    Harder, Susanne; Køster, Anne; Valbak, Kristian

    2014-01-01

    -term outcome of SPP in a prospective, longitudinal, comparative, multicenter investigation of successively referred patients diagnosed with first-episode schizophrenia spectrum disorder. METHOD: Manualized SPP for up to 3 years as a supplement to standard treatment (ST) were compared to ST alone and followed...... up for 5 years (N = 269). The SPP targeted interpersonal relationships, emotion regulation, social cognition, and self-coherence. RESULTS: Significant between-group effects in favor of SPP+ST on social functioning, overall symptoms, and positive psychotic symptoms were found during the period...... of active SPP intervention. These differential effects, however, were not sustained after end of additional SPP at 5-year follow-up. CONCLUSION: The findings are in line with results from other approaches targeting social functioning in schizophrenia and support SPP as a valuable treatment. Further research...

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

    Institute of Scientific and Technical Information of China (English)

    凌仲民

    2015-01-01

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

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

    Science.gov (United States)

    Ellersgaard, Ditte; Mors, Ole; Thorup, Anne; Jørgensen, Per; Jeppesen, Pia; Nordentoft, Merete

    2014-11-01

    The stability of delusional themes in psychotic disorders is only sparsely lit. The study aims to investigate the stability of delusional themes over a period of time in patients with first-episode non-affective psychosis. The data were drawn from a randomized controlled trial of 547 first-episode patients with schizophrenia spectrum disorders, the OPUS trial. A subsample of 411 patients met our inclusion criteria. They were interviewed at the time of first treatment contact, and at years 1, 2 and 5 after onset. The delusional themes of the 411 patients were classified by applying principal component analysis to the patients' scores on 12 items of delusions from the Scale for the Assessment of Positive Symptoms in Schizophrenia, SAPS. The course of the patients' predominant delusional themes was analysed afterwards. The 12 delusional themes from SAPS were converted into five groups using principal component analysis. At all three follow ups there were almost equal proportions of patients with the predominant delusion being from the same group of delusional themes as at baseline and of patients with the predominant delusion being from another group of delusional themes than at baseline. The predominant delusional theme at the time of first treatment contact was seen to be only of some predictive value to the predominant delusional theme at the later follow-up points in patients with first-episode non-affective psychosis. This stresses the importance of a systematic assessment of different delusional themes in the continued monitoring of early signs of psychotic relapse and at each psychotic episode. © 2013 Wiley Publishing Asia Pty Ltd.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  8. Attenuated neural response to gamble outcomes in drug-naive patients with Parkinson’s disease

    DEFF Research Database (Denmark)

    van der Vegt, Joyce P M; Hulme, Oliver J; Zittel, Simone;

    2013-01-01

    Parkinson's disease results from the degeneration of dopaminergic neurons in the substantia nigra, manifesting as a spectrum of motor, cognitive and affective deficits. Parkinson's disease also affects reward processing, but disease-related deficits in reinforcement learning are thought to emerge...... at a slower pace than motor symptoms as the degeneration progresses from dorsal to ventral striatum. Dysfunctions in reward processing are difficult to study in Parkinson's disease as most patients have been treated with dopaminergic drugs, which sensitize reward responses in the ventral striatum, commonly...... resulting in impulse control disorders. To circumvent this treatment confound, we assayed the neural basis of reward processing in a group of newly diagnosed patients with Parkinson's disease that had never been treated with dopaminergic drugs. Thirteen drug-naive patients with Parkinson's disease and 12...

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

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

    Science.gov (United States)

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

    2013-05-01

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

  11. Evaluation of Risk Factors Associated with First Episode Febrile Seizure.

    Science.gov (United States)

    Sharawat, Indar Kumar; Singh, Jitender; Dawman, Lesa; Singh, Amitabh

    2016-05-01

    Febrile seizure (FS) is the single most common type of seizure seen in children between 6 months to 5 years of age. The purpose of our study was to identify the risk factors associated with the first episode of febrile seizures, which would help in the better management and preventive measures in children at risk for FS episodes. To evaluate the risk factors associated with the first episode of febrile seizures in Indian children. This was a hospital based, case control study. The purpose of this study was to identify the risk factors associated with the first FS episode in children. Seventy (70) children between age 6 months to 5 years with their first episode of FS were compared with 70 children with fever but without seizures based on various risk factors. The mean age was 24.90±16.11 months in cases and 26.34±16.93 months in controls. Male: female ratio was 2:1. A positive family history was found in 31.4% of first degree and 11.4% in second degree relatives. Mean maximum temperature was 102.06±1.1°F and URI (upper respiratory infection) was most common cause of fever. Antenatal complication was significantly higher in the case group. RBC (Red Blood Cells) indices like lower mean haemoglobin, MCV (Mean Corpuscular Volume), MCH (Mean Corpuscular Haemoglobin concentration) and higher RDW (Red Cell Distribution Width) values were seen in patients. Serum sodium, Serum calcium and random blood sugar values of the cases were significantly lower than those of controls (pfebrile seizures, peak body temperature, underlying cause of fever, antenatal complications, low serum calcium, sodium, blood sugar and microcytic hypochromic anaemia are the risk factors associated with the occurrence of first episode of febrile seizure and, thus, preventive measures in removing these risk factors could lead to a decrease in incidence of FS.

  12. Theory of mind and social functioning in first episode psychosis.

    Science.gov (United States)

    Sullivan, Sarah; Herzig, Daniela; Mohr, Christine; Lewis, Glyn; Corcoran, Rhiannon; Drake, Richard; Evans, Jonathan

    2013-05-01

    There is evidence of associations between social functioning and theory of mind performance and between social functioning and negative symptoms in chronic psychosis. This study investigates these associations in those with first episode psychosis who are unaffected by factors related to long-term mental illness. Our first hypothesis states that there is an association between theory of mind and social functioning. The second hypothesis states that there is no association between symptoms of psychosis and social functioning. Fifty-two individuals with first episode psychosis were assessed for social functioning, theory of mind ability (using the Hinting test with verbal stimuli and the Visual Cartoon test with pictorial stimuli), and symptoms of psychosis. Multivariable logistic regression was used to examine associations. Social functioning and theory of mind were associated when measured by the Hinting test (OR 1.70, 95% CI 1.08, 2.66), but not with the Visual Cartoon test (ToM jokes OR 0.61, 95% CI 0.15, 2.53). There was no association between social functioning and symptoms (psychotic symptoms; OR 0.95, 95% CI 0.81, 1.12; selected negative symptoms; OR 1.33, 95% CI 0.78, 2.25). Theory of mind assessed by verbal stimuli is associated with social functioning in a population with first episode psychosis. These findings may be related to language disorders in psychosis.

  13. Emotional Intelligence in a group of patients with first-episode psychosis in Iran.

    Science.gov (United States)

    Basseda, Zahra; Amini, Homayoun; Sharifi, Vandad; Kaviani, Hosein; Pooretemad, Hamid Reza; Zadbood, Asieh

    2012-01-01

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

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

    Science.gov (United States)

    Hochwälder, Jacek; Mattsson, Maria; Holmqvist, Ragnhild; Cullberg, Johan; Rosenbaum, Bent

    2013-04-01

    To psychometrically evaluate the Satisfaction with Life Scale in two cohorts of first-episode psychosis patients in the Danish National Schizophrenia Project and in the Swedish Parachute Project. Four properties of the Satisfaction with Life Scale were examined in the Danish cohort (explorative investigation) and then confirmed in the Swedish cohort: (1) the factor structure; (2) correlations between subscales; (3) internal consistencies of subscales; and (4) main tendencies (arithmetic means) and variations (standard deviations) of subscales. The relations between the Satisfaction with Life Scale and various life conditions were investigated in the Swedish cohort. For both samples, the analysis indicated that the obtained four-dimensional 11-item scale had satisfactory properties. Moderately high scores were obtained in the four subscales: "living," "social relationships," "self and present life" and "work." They correlated positively with each other, the internal consistencies of the subscales were acceptable and the means for the subscales indicated no apparent floor or ceiling effects. The four dimensions obtained seem relevant and presented good face validity. The dimensions were confirmed in the Swedish sample. The Satisfaction with Life Scale shows satisfactory psychometric properties and seems valid and useful among first-episode psychosis patients.

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

    Directory of Open Access Journals (Sweden)

    Hamid Reza Pooretemad

    2012-02-01

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

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

    Science.gov (United States)

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

    2014-12-15

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

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

    Directory of Open Access Journals (Sweden)

    Carolyn S. Dewa

    2012-01-01

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

  18. Early Predictors of Ten-Year Course in First-Episode Psychosis.

    Science.gov (United States)

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

    2016-04-01

    Identifying patients at risk of poor outcome at an early stage of illness can aid in treatment planning. This study sought to create a best-fit statistical model of known baseline and early-course risk factors to predict time in psychosis during a ten-year follow-up period after a first psychotic episode. Between 1997 and 2000, 301 patients with DSM-IV nonorganic, nonaffective first-episode psychosis were recruited consecutively from catchment area-based sectors in Norway and Denmark. Specialized mental health personnel evaluated patients at baseline, three months, and one, two, five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores ≥4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years, patients were also evaluated by their clinicians at least biweekly. Baseline and early-course predictors of long-term course were identified with linear mixed-model analyses. Four variables provided significant, additive predictions of longer time in psychosis during the ten-year follow-up: deterioration in premorbid social functioning, duration of untreated psychosis (DUP) of ≥26 weeks, core schizophrenia spectrum disorder, and no remission within three months. First-episode psychosis patients should be followed carefully after the start of treatment. If symptoms do not remit within three months with adequate treatment, there is a considerable risk of a poor long-term outcome, particularly for patients with a deterioration in premorbid social functioning, a DUP of at least half a year, and a diagnosis within the core schizophrenia spectrum.

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

    Science.gov (United States)

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

    2015-12-01

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

  20. Ten year neurocognitive trajectories in first-episode psychosis

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Blackwell Andrew D

    2008-05-01

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

  2. [Imaging strategy for children after a first episode of pyelonephritis].

    Science.gov (United States)

    Bocquet, N; Biebuyck, N; Lortat Jacob, S; Aigrain, Y; Salomon, R; Chéron, G

    2015-05-01

    Pyelonephritis is a common bacterial disease in young children and is a serious infection because of its potential to produce renal scarring. One of the concerns of physicians is therefore the diagnosis of uropathy at risk for recurrence of pyelonephritis, especially high-grade reflux. There are no French recommendations on imaging evaluation after a first episode of pyelonephritis. Voiding cystography was systematically proposed years ago and recommended by the American Academy of Pediatrics until 1999. This systematic strategy exposed all children to a painful, irradiating exam, and exposed them to urinary tract infection. The American recommendations changed in 2011 and cystography is now only proposed to children with recurrence of pyelonephritis or with ultrasound abnormalities. A collaborative review of the literature involving the Pediatric Emergency, Nephrology and Surgery Departments at Necker-Enfants-Malades Hospital led us to propose an algorithm for imaging after the first episode of pyelonephritis in children. This algorithm was based on data from the past medical history (results of prenatal ultrasonography or recurrence of pyelonephritis), the results of the ultrasound exam at the time of diagnosis, and the procalcitonin concentration, to limit the indications for voiding cystography, limiting risk for delaying high-grade reflux diagnosis. Children with low risk for high-grade reflux can be followed up with an ultrasound exam 6 months after acute infection. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Unemployment among patients with newly diagnosed first-episode psychosis: prevalence and clinical correlates in a U.S. sample.

    Science.gov (United States)

    Ramsay, Claire E; Stewart, Tarianna; Compton, Michael T

    2012-05-01

    Although it is well established that people with schizophrenia have markedly high rates of unemployment, less is known about the prevalence and clinical correlates of unemployment in patients newly diagnosed with first-episode psychosis. This analysis documented the prevalence of unemployment and examined previously reported clinical correlates of unemployment in patients with first-episode psychosis hospitalized in an urban, public-sector setting in the southeastern US. Participants (n = 181) were assessed as part of an overarching study of first-episode psychosis using a variety of standardized research instruments. The rate of unemployment was compared to that documented in the general population according to US census data. Bivariate tests of associations between employment status and a number of variables of interest were followed by a multiple logistic regression model based on a previous study from Dublin, Ireland. Some 65.0% of first-episode patients were unemployed in the month prior to hospital admission, which is substantially higher than the rate of unemployment during the same period in the two counties in which recruitment took place. In bivariate tests, unemployment was associated with younger age, fewer years of educational attainment, lower global functioning scores, and more severe negative symptoms. In the logistic regression model, only age and global functioning were independently significant correlates. The remarkably high rate of unemployment in this young, first-episode sample, and the evidence of associations between unemployment, greater symptomatology, and poorer functioning, argue for further research and development on supported employment programs for such patients.

  4. Schizophrenia

    Science.gov (United States)

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    Objectives While caregivers of persons with first-episode psychosis often report a range of negative experiences, little is known about what psychological factors are involved. The aim of this study was to examine how caregivers' general wellbeing, emotional overinvolvement and metacognition...... and overinvolvement were associated with more negative experiences of caregiving while greater metacognitive capacity was associated with more positive experiences of caregiving. Conclusions The experience of positive and negative aspects of caregiving seems to be associated with different variables. Greater...... metacognitive capacity does not necessarily alleviate the suffering and distress, which is a healthy and normal reaction to having a close one suffering from psychosis. But it might help broaden the perspective, allowing for both negative and positive experiences. Clinical implications in terms of expanding...

  6. 10 year course of IQ in first-episode psychosis

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Science.gov (United States)

    Pachoud, B

    2013-09-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2017-03-14

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

  10. Neuropsychological functions predict 1- and 3-year outcome in first-episode psychosis.

    Science.gov (United States)

    Carlsson, R; Nyman, H; Ganse, G; Cullberg, J

    2006-02-01

    To examine neuropsychological performance as a possible predictor of course and outcome in first-episode psychotic (FEP) patients. A group of consecutive FEP patients (n = 120) tested with Wechsler Adult Intelligence Scales-Revised (WAIS-R) at baseline was compared with a healthy group (n = 30) matched for age, education and gender. Relationship between WAIS-R and both Brief Psychiatric Rating Scale and Global Assessment of Function (GAF) ratings were studied at baseline and at 1- and 3-year follow-ups. The performance of FEP patients was significantly lower (P WAIS-R subtests except for Information and Comprehension. The WAIS-R scores of patients with schizophrenia syndromes (DSM-IV) were lower than those of patients with non-schizophrenia syndromes on Block Design. Low WAIS-R Full-Scale IQ scores in FEP patients predicted the presence of negative symptoms at 1-year follow-up and of low GAF ratings at 3-year follow-up. Neurocognitive performance at admission appears to predict various aspects of functional outcome in FEP.

  11. Exploring cognitive heterogeneity in first-episode psychosis: What cluster analysis can reveal.

    Science.gov (United States)

    Reser, Maree P; Allott, Kelly A; Killackey, Eóin; Farhall, John; Cotton, Susan M

    2015-10-30

    Variable outcomes in first-episode psychosis (FEP) are partly attributable to heterogeneity in cognitive functioning. To aid identification of those likely to have poorer or better outcomes, we examined whether purported cognitive profiles identified through use of cluster analysis in chronic schizophrenia were evident in FEP. We also aimed to assess whether there was a relationship between cognitive profile and factors independent of the solution, providing external validation that the cognitive profiles represented distinct subgroups. Ward's method hierarchical cluster analysis, verified by a k-means cluster solution, was performed using data obtained from a cognitive test battery administered to 128 participants aged 15-25 years. Four cognitive profiles were identified. A continuity element was evident; participants in cluster four were more cognitively impaired compared to participants in cluster three, who appeared more cognitively intact. Clusters one and two were distinguishable across measures of attention and working memory and visual recognition memory, most likely reflecting sample specific patterns of deficit. Participants in cluster four had significantly lower premorbid and current IQ and higher negative symptoms compared to participants in cluster three. The distinct levels and patterns of cognition found in chronic schizophrenia cohorts are also evident across diagnostic categories in FEP. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Ten year neurocognitive trajectories in first-episode psychosis

    Directory of Open Access Journals (Sweden)

    Helene Eidsmo Barder

    2013-10-01

    Full Text Available Objective: Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP and the relationship to clinically significant subgroups even more so. We report 10 year longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory.Method: Forty-three FEP subjects (51% male, 28±9 years were followed-up neurocognitively over five assessments spanning 10 years. The test battery was divided into four neurocognitive indices; Executive Function, Verbal Learning, Motor Speed, and Verbal Fluency. The sample was grouped into those relapsing or not within the first, second and fifth year. Results: The four neurocognitive indices showed overall stability over the ten year period. Significant relapse by index interactions were found for all indices except Executive Function. Follow-up analyses identified a larger significant decrease over time for the encoding measure within Verbal Memory for patients with psychotic relapse in the first year (F (4,38=5.8, p=0.001, η2=0.40Conclusions: Main findings are long-term stability in neurocognitive functioning in first episode psychosis patients, with the exception of verbal memory in patients with psychotic relapse or non-remission early in the course of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that most patients should expect no change in cognitive performance during the first 10 years after being diagnosed.

  13. Neuropsychological Functioning in Obsessive-Compulsive Washers: Drug-Naive Without Depressive Symptoms

    Science.gov (United States)

    Saremi, Ali Akbar; Shariat, Seyed Vahid; Nazari, Mohammad Ali; Dolatshahi, Behrooz

    2017-01-01

    Introduction: Obsessive–Compulsive Disorder (OCD) is a complex and heterogeneous neuropsychiatric syndrome. Contamination obsessions and washing/cleaning compulsions are the most frequent clinical OCD subtypes. The current study aimed at examining the neuropsychological impairments in drug-naive obsessive-compulsive (OC) washers without depressive symptoms and their association with the severity of symptoms. Methods: In the current causal-comparative study, 35 patients with diagnostic and statistical mental disorders class (DSM)-IV diagnosed with washing-subtype OCD and 35 healthy subjects were selected by the convenience sampling method and evaluated by computerized neuropsychology battery and clinical tests as Stroop Color-Word Test (SCWT), Wisconsin Card Sorting Test (WCST), Go/No-Go Test, Digits Forward (DF), Digits Backward (DB), Yale-Brown Obsessive–Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and General Health Questionnaire (GHQ)-28. The patients were matched to the comparison group with regard to age, gender, intelligence quotient (IQ), education, and handedness. All the tests were standardized in Iran. SPSS version 20.00 was used for descriptive and analytical data analysis. Results: There was no statistically significant different between the OCD washing and the control groups regarding socio-demographic variables or IQ. There were significant differences between the OC washer and the healthy control groups on the neuropsychological functioning. The obtained results suggested that OC washers performed significantly worse on neuropsychological measures than the controls. There was no significant association between the severity of OC symptoms and the neuropsychological functions in the OCD washing group. Conclusion: It was concluded that executive function impairment, which is a core feature in OC washers was trait-like in nature. PMID:28781731

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

    Science.gov (United States)

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

    2014-03-01

    While it has been documented that persons with prolonged schizophrenia have deficits in metacognition and social cognition, it is less clear whether these difficulties are already present during a first episode. To explore this issue we assessed and compared metacognition using the Metacognition Assessment Scale-Abbreviated (MAS-A) and social cognition using the Eyes, Hinting and Bell-Lysaker Emotional Recognition Tests (BLERT) in participants with first episode psychosis (FEP; n=26), participants with a prolonged psychosis (n=72), and a psychiatric control group consisting of persons with a substance use disorder and no history of psychosis (n=14). Analyses revealed that both psychosis cohorts scored lower than controls on the MAS-A total and all subscales except metacognitive mastery. Compared to the FEP group, the persons with prolonged psychosis demonstrated greater metacognitive capacities only in those MAS-A domains reflective of the ability to understand the mental state of others and to see that others may have motivations and desires separate from their own. Other domains of metacognition did not differ between psychosis groups. The Eyes, Hinting and BLERT scores of the two psychosis groups did not differ but were poorer than those produced by the control group. Exploratory correlations in the FEP group showed a pattern similar to that previously observed in prolonged psychosis. Taken together, these findings suggest that while certain domains of metacognition could improve with prolonged psychosis, difficulties with global metacognition and social cognition may be stable features of the disorder and perhaps unique to psychosis. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2016-11-01

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

  16. The evaluation of neutrophil-lymphocyte ratio in patients with first episode psychosis

    Directory of Open Access Journals (Sweden)

    Nalan Varsak

    2016-12-01

    Full Text Available Introduction: There is a growing consensus in the literature that inflammation may play a role in the pathophysiology of schizophrenia. The blood neutrophil-lymphocyte ratio is a simple, inexpensive and reliable marker of inflammation. The aim of this study is to assess the relationship between first episode psychosis (FEP and neutrophil–lymphocyte ratio (NLR and to investigate if there is a relation between NLR and severity of disease.Methods: In this retrospective study we analyzed 58 FEP patients’ medical records from January 2011 to June 2014 who had been treated at our hospital. Hematologic parameters, Brief Psychiatric Rating Scale (BPRS scores and demographic data of the patients were obtained from the medical records of 58 FEP patients. Hematologic parameters and NLR values of 58 patients with FEP compared to values of 37 healthy control group. Correlation between NLR and BPRS scores were calculated.Results: Mean NLR was significantly higher in patients compared to control group (2.22 ± 1.25 vs. 1.63 ± 0.38, p = 0.041. Neutrophil count was not different between patients and healthy control (4.03 ± 0.70 vs. 4.20 ± 1.48, p = 0.525, but lymphocyte count was significantly lower in patients (2.56 ± 0.55 vs. 2.19 ± 0.77, p = 0.013.  In the FEP patients, NLR was not significantly correlate with severity of disease (BPRS score (n = 58; r = 0.060, p = 0.655.Conclusion: Our findings suggest that NLR levels are increased in physically healthy antipsychotic- naive first episode psychosis patients compared to physically and mentally healthy individuals.

  17. A study of theory of mind deficit in first-episode schizophrenic patients%首发精神分裂症患者心灵理论损伤的研究

    Institute of Scientific and Technical Information of China (English)

    汪永光; 汪凯; 朱春燕; 汪辉

    2006-01-01

    成绩呈显著正相关.结论 首发、未服药的精神分裂症患者存在心灵理论能力的损害,并且这种损害可能与其额叶功能的障碍有关.两种不同亚型的精神分裂症患者可能存在着不同形式的心灵理论的损害.%Background The disability of theory of mind (ToM) has been confirmed in chronic or acute medicated schizophrenic patients.The role of ToM ability in first-episode, drug-naive schizophrenic patients was investigated in this study.Methods ToM was assessed with the Eyes task and Faux pas task in first-episode, drug-naive schizophrenic patients( n =52)compared with healthy controls ( n =64). Verbal Fluency Test (VFT) and Digit Span Test (DST) were also examined in two groups. Psychiatric symptoms were evaluated by the Positive and Negative Syndrome Scale (PANSS).Results The tests that involved the ToM ability (I. E. Mind reading and Faux pas questions) were impaired in the schizophrenic group. The schizophrenia performed worse than the normal controls on the VFT. The schizophrenic negative subgroup performed worse than the positive subgroup in Mind reading and VFT. There was a significantly positive correlation between the performances of the tests that involved the ToM ability and the scores of VFT in schizophrenic patients. There was a significantly negative correlation between the performances of the tests that involved the ToM ability and negative symptom scores in the patients.Conclusions The patients with schizophrenia exhibit ToM deficit that is probably associated with the frontal lobe dysfunction.The performance of ToM dysfunction might be different between negative subjects and positive ones.

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

    Directory of Open Access Journals (Sweden)

    Jone Bjornestad

    2016-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Monica eAas

    2014-01-01

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

  20. Predictors of engagement in first-episode psychosis.

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    亓高超

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    徐彩; 李美银; 邓文

    2012-01-01

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

  4. Schizophrenia

    Science.gov (United States)

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

  5. Ten year neurocognitive trajectories in first-episode psychosis.

    Science.gov (United States)

    Barder, Helene E; Sundet, Kjetil; Rund, Bjørn R; Evensen, Julie; Haahr, Ulrik; Ten Velden Hegelstad, Wenche; Joa, Inge; Johannessen, Jan O; Langeveld, Johannes; Larsen, Tor K; Melle, Ingrid; Opjordsmoen, Stein; Røssberg, Jan I; Simonsen, Erik; Vaglum, Per; McGlashan, Thomas; Friis, Svein

    2013-01-01

    Neurocognitive impairment is commonly reported at onset of psychotic disorders. However, the long-term neurocognitive course remains largely uninvestigated in first episode psychosis (FEP) and the relationship to clinically significant subgroups even more so. We report 10 year longitudinal neurocognitive development in a sample of FEP patients, and explore whether the trajectories of cognitive course are related to presence of relapse to psychosis, especially within the first year, with a focus on the course of verbal memory. Forty-three FEP subjects (51% male, 28 ± 9 years) were followed-up neurocognitively over five assessments spanning 10 years. The test battery was divided into four neurocognitive indices; Executive Function, Verbal Learning, Motor Speed, and Verbal Fluency. The sample was grouped into those relapsing or not within the first, second and fifth year. The four neurocognitive indices showed overall stability over the 10 year period. Significant relapse by index interactions were found for all indices except Executive Function. Follow-up analyses identified a larger significant decrease over time for the encoding measure within Verbal Memory for patients with psychotic relapse in the first year [F (4, 38) = 5.8, p = 0.001, η(2) = 0.40]. Main findings are long-term stability in neurocognitive functioning in FEP patients, with the exception of verbal memory in patients with psychotic relapse or non-remission early in the course of illness. We conclude that worsening of specific parts of cognitive function may be expected for patients with on-going psychosis, but that the majority of patients do not show significant change in cognitive performance during the first 10 years after being diagnosed.

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

    Institute of Scientific and Technical Information of China (English)

    葛茂宏; 孙红立; 王程辉

    2016-01-01

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

  7. Development of Metabolic Syndrome in Drug-Naive Adolescents After 12 Months of Second-Generation Antipsychotic Treatment

    DEFF Research Database (Denmark)

    Sjo, Christina Power; Stenstrøm, Anne Dorte; Bojesen, Anders Bo

    2017-01-01

    OBJECTIVES: Mental illness is often accompanied by poor physical health and shorter life expectancy. Second-generation antipsychotics (SGAs) are suspected of increasing cardiovascular risk, possibly through development of metabolic syndrome (MetS), and the risk of adverse outcome is even higher...... if obesity or metabolic aberration starts in childhood or adolescence. METHODS: Drug-naive adolescents were recruited after contact with an outpatient Psychosis Team. Changes relative to baseline in body mass index (BMI), waist circumference (WC), blood pressure (BP), fasting blood glucose (FBG...

  8. Suicidal behavior and mortality in first-episode psychosis

    DEFF Research Database (Denmark)

    Nordentoft, Merete; Madsen, Trine; Fedyszyn, Izabela

    2015-01-01

    Suicide is a serious public health problem, with more than 800,000 deaths taking place worldwide each year. Mental disorders are associated with increased risk of suicide. In schizophrenia and other psychotic disorders, the lifetime risk of suicide death is estimated to be 5.6%. The risk is parti......Suicide is a serious public health problem, with more than 800,000 deaths taking place worldwide each year. Mental disorders are associated with increased risk of suicide. In schizophrenia and other psychotic disorders, the lifetime risk of suicide death is estimated to be 5.6%. The risk...... is particularly high during the first year of the initial contact with mental health services, being almost twice as high as in the later course of the illness. The most consistently reported risk factor for suicide among people with psychotic disorders is a history of attempted suicide and depression. Suicide...... different studies indicate that the risk of suicide attempt during the first year of treatment is as high as 10%. The most important risk factors for attempted suicide after the first contact are young age, female sex, suicidal plans, and a history of suicide attempt. Early intervention services are helpful...

  9. Depressive symptoms in first-episode psychosis: a 10-year follow-up study.

    Science.gov (United States)

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

    2016-06-01

    The present study examined if any patient characteristics at baseline predicted depressive symptoms at 10 years and whether patients prone to depressive symptoms in the first year of treatment had a different prognosis in the following years. A total of 299 first-episode psychosis (FEP) patients with schizophrenia spectrum disorders were assessed for depressive symptoms with PANSS depression item (g6) at baseline, and 1, 2, 5 and 10 years of follow up. At 10 years, depressive symptoms were also assessed with Calgary Depression Scale for Schizophrenia (CDSS). A PANSS g6 ≥ 4 and CDSS score ≥ 6 were used as a cut-off score for depression. A total of 122 (41%) patients were scored as depressed at baseline, 75 (28%) at 1 year, 50 (20%) at 2 years, 33 (16%) at 5 years, and 35 (19%) at 10 years of follow up. Poor childhood social functioning and alcohol use at baseline predicted depression at 10 years of follow up. Thirty-eight patients were depressed at both baseline and 1 year follow up. This group had poorer symptomatic and functional outcome in the follow-up period compared to a group of patients with no depression in the first year of treatment. Depressive symptoms are frequent among FEP patients at baseline but decrease after treatment because their general symptoms have been initiated. Patients with poor social functioning in childhood and alcohol use at baseline are more prone to have depressive symptoms at 10 years of follow up. Patients struggling with depressive symptoms in the first year of treatment should be identified as having poorer long-term prognosis. © 2014 Wiley Publishing Asia Pty Ltd.

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

    Directory of Open Access Journals (Sweden)

    Dietrich eLehmann‡

    2014-08-01

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

  11. Social class mobility in first episode psychosis and the association with depression, hopelessness and suicidality.

    Science.gov (United States)

    O'Donoghue, Brian; Lyne, John P; Fanning, Felicity; Kinsella, Anthony; Lane, Abbie; Turner, Niall; O'Callaghan, Eadbhard; Clarke, Mary

    2014-08-01

    Psychotic disorders are associated with a significant impairment in occupational functioning that can begin in the prodromal phase of the disorder. As a result, individuals with a psychotic disorder may not maintain their social class at birth. The aim of this study was to examine the distribution of the social classes of individuals presenting with a first episode of psychosis (FEP) compared to the general population and to their family of origin. We evaluated whether social drift was associated with depression, hopelessness and suicidality at first presentation. All individuals with a FEP presenting to a community mental health service between 1995 and 1999 and to an early intervention service between 2005 and 2011were included. Diagnosis was established using the Structured Clinical Interview for DSM IV diagnoses and clinical evaluations included the Calgary Depression Scale for Schizophrenia, Beck Hopelessness Scale and the Suicidal Intent Scale. 330 individuals were included in the study and by the time of presentation, individuals with a FEP were more likely to be represented in the lower social classes compared to the general population. 43% experienced a social drift and this was associated with a diagnosis of a non-affective disorder, co-morbid cannabis abuse and a longer DUP. Individuals who did not experience a social drift had a higher risk of hopelessness. Social drift is common in psychotic disorders; however, individuals who either maintain their social class or experience upward social class mobility are more susceptible to hopelessness. Copyright © 2014 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Subandi, M A

    2015-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Susana Vaz Carreiro

    2014-06-01

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

  14. Deficits in social cognition in first episode psychosis: A review of the literature.

    Science.gov (United States)

    Healey, Kristin M; Bartholomeusz, Cali F; Penn, David L

    2016-12-01

    Individuals with chronic schizophrenia (SCZ) consistently show impairments in social cognition (SC) that are associated with functional decline, and work suggests that similar associations exist in first-episode psychosis (FEP). The goal of the current article is to review and synthesize the current body of work examining SC in FEP. Secondary aims are to examine the relationship between SC and symptoms, and change in SC over time in FEP. Literature is reviewed from four key SC domains: emotion processing (EP), theory of mind (ToM), social perception (SP), and attributional style (AS). Targeted searches of PsycINFO and Google Scholar were conducted to identify relevant manuscripts. Data from 48 relevant studies (6 longitudinal) were reviewed and integrated. (1) FEP individuals show consistent deficits in SC compared to healthy controls, most consistently in EP (particularly, fear and sadness recognition) and ToM compared to SP and AS, (2) individuals with FEP and SCZ show comparable SC deficits, (3) some evidence indicates SC deficits in FEP are associated with negative and positive symptoms, and (4) SC appears to be stable over time in FEP. Published by Elsevier Ltd.

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

    Science.gov (United States)

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

    2014-07-01

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

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

    LENUS (Irish Health Repository)

    Ihara, Kazushige

    2009-01-01

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

  17. Schizophrenia and Metacognition

    DEFF Research Database (Denmark)

    Austin, Stephen F.; Mors, Ole; Nordentoft, Merete

    2014-01-01

    tested for relationships between course of illness and levels of specific metacognitions in schizophrenia spectrum disorders. A large cohort of people with first episode psychosis (n = 578) recruited as part the OPUS trial (1998–2000) were tested. Information about course of illness (remitted, episodic...... beliefs may also impact on positive symptoms and course of illness within schizophrenia....

  18. Diagnostic Specificity and Neuroanatomical Validity of Neurological Abnormalities in First-Episode Psychoses

    National Research Council Canada - National Science Library

    Keshavan, Matcheri S; Sanders, Richard D; Sweeney, John A; Diwadkar, Vaibhav A; Goldstein, Gerald; Pettegrew, Jay W; Schooler, Nina R

    2003-01-01

    OBJECTIVE: Neurological abnormalities are frequently seen in patients with first-episode psychotic disorders but are generally considered to be diagnostically nonspecific, neurologically nonlocalizing, and, hence, "soft...

  19. Facial emotion identification in early-onset and first-episode psychosis: a systematic review with meta-analysis.

    Science.gov (United States)

    Barkl, Sophie J; Lah, Suncica; Harris, Anthony W F; Williams, Leanne M

    2014-10-01

    Patients with chronic schizophrenia are characterized by deficits in identifying facial expressions of emotion, and these deficits relate to impaired social and occupational function. It is not yet known if these deficits are trait-like and present at the onset of psychosis, preceding a subsequent diagnosis of schizophrenia. Our objective was to systematically review and analyze the extant literature to assess if there is a consistent profile of emotion identification problems in early-onset and first-episode psychosis. We conducted a systematic review and meta-analysis of 12 peer-reviewed studies of facial emotion identification in early-onset and first-episode psychosis, published between 1980 and March 2013. We examined the average mean difference between patients and controls on measures of facial emotion identification. Findings suggest that patients with early-onset and first-episode psychosis have impairment in identifying facial expressions of biologically salient emotion. Across the 12 studies, the onset of psychosis was distinguished by a generalized effect of significantly poorer accuracy for identifying facial expressions of emotion than healthy controls, and this difference had a substantial effect size (d=-0.88, N=378, 95% CI=-1.42 to -0.32). Within this general effect some emotions were also harder for patients to identify than others, with the magnitude of impairment found to be (i) large for disgust, fear and surprise, and (ii) medium for sadness, and happiness. No between groups mean differences were found for anger or neutral facial expressions. Deficits in facial emotion identification are evident at first onset of a psychotic episode. The findings suggest that, over and above a generalized deficit in identifying facial emotion, patients may find some emotions harder to identifying than others. This reflects findings with chronic schizophrenia populations and suggests that emotion identification impairment represents a trait susceptibility

  20. Schizophrenia

    Science.gov (United States)

    ... what causes it. Genes may play a role. Schizophrenia occurs in just as many men as women. It usually begins in the teen or young ... but it may begin later in life. In women, it tends to begin later ... Schizophrenia in children usually begins after age 5. Childhood ...

  1. Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

    Ali, U.A.; Issa, Y.; Hagenaars, J.C.; Bakker, O.J.; Goor, H. van; Nieuwenhuijs, V.B.; Bollen, T.L.; Ramshorst, B. van; Witteman, B.J.; Brink, M.A.; Schaapherder, A.F.; Dejong, C.H.; Spanier, B.W.; Heisterkamp, J.; Harst, E. van der; Eijck, C.H. van; Besselink, M.G.; Gooszen, H.G.; Santvoort, H.C. van; Boermeester, M.A.

    2016-01-01

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

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

    NARCIS (Netherlands)

    Ahmed Ali, Usama; Issa, Yama; Hagenaars, Julia C.|info:eu-repo/dai/nl/380766086; Bakker, Olaf J.|info:eu-repo/dai/nl/314099050; van Goor, Harry; Nieuwenhuijs, Vincent B.; Bollen, Thomas L.; van Ramshorst, Bert; Witteman, Ben J.; Brink, Menno A.; Schaapherder, Alexander F.; Dejong, Cornelis H.; Spanier, B. W Marcel; Heisterkamp, Joos; van der Harst, Erwin; van Eijck, Casper H.; Besselink, Marc G.; Gooszen, Hein G.; van Santvoort, Hjalmar C.|info:eu-repo/dai/nl/304821721; Boermeester, Marja A.

    2016-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  10. Metacognition as a Mediating Variable Between Neurocognition and Functional Outcome in First Episode Psychosis.

    Science.gov (United States)

    Davies, Geoff; Fowler, David; Greenwood, Kathryn

    2016-09-02

    Neurocognitive and functional outcome deficits have long been acknowledged in schizophrenia and neurocognition has been found to account for functional disability to a greater extent than psychopathology. Much of the variance in functional outcome however still remains unexplained and metacognition may mediate the relationship between neurocognition, functional capacity, and self-reported social and occupational function. Eighty first episode psychosis participants were recruited and completed measures of neurocognition (memory, executive function, and intelligence quotient), metacognition (Beck Cognitive Insight Scale, Metacognitive Awareness Interview), psychopathology (PANSS), and both functional capacity (UPSA) and real-life social and occupational function (The Time Use Survey). Path analyses investigated the relationships between variables through structural equation modeling. A series of path models demonstrated that metacognition partially mediates the relationship between neurocognition and functional capacity, and fully mediates the relationship between functional capacity and social and occupational function. The present study findings identify that metacognition may be critical to translating cognitive and functional skills into real-world contexts, and this relationship is found at early stages of illness. Understanding how individuals translate cognitive and functional skills into the real-world (the competence-performance gap) may offer valuable guidance to intervention programs. This finding is important to models of recovery as it suggests that intervention programs that focus on enhancing metacognition abilities may have a greater impact than traditional rehabilitation programs focusing on cognitive abilities, on social and occupational outcomes. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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

    Science.gov (United States)

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

    2016-01-01

    A substantial proportion of schizophrenia-spectrum patients exhibit a cognitive impairment at illness onset. However, the long-term course of neurocognition and a possible neurotoxic effect of time spent in active psychosis, is a topic of controversy. Furthermore, it is of importance to find out what predicts the long-term course of neurocognition. Duration of untreated psychosis (DUP), accumulated time in psychosis the first year after start of treatment, relapse rates and symptoms are potential predictors of the long-term course. In this study, 261 first-episode psychosis patients were assessed neuropsychologically on one or more occasions. Patients were tested after remission of psychotic symptoms and reassessed 1, 2, 5, and 10 years after inclusion. The neurocognitive battery consisted of California Verbal Learning Test, Wisconsin Card Sorting Test, Controlled Oral Word Association Task, Trail Making A and B, and Finger Tapping. We calculated a composite score by adding the z-scores of 4 tests that were only moderately inter-correlated, not including Finger Tapping. Data were analyzed by a linear mixed model. The composite score was stable over 10 years. No significant relationship between psychosis before (DUP) or after start of treatment and the composite score was found, providing no support for the neurotoxicity hypothesis, and indicating that psychosis before start of treatment has no significant impact on the course and outcome in psychosis. We found no association between symptoms and the neurocognitive trajectory. Stable remission during the first year predicted neurocognitive functioning, suggesting that the early clinical course is a good predictor for the long-term course. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  12. Apathy in first episode psychosis patients: a ten year longitudinal follow-up study.

    Science.gov (United States)

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

    2012-04-01

    Apathy is a common symptom in first episode psychosis (FEP), and is associated with poor functioning. Prevalence and correlates of apathy 10 years after the first psychotic episode remain unexplored. The aims of the study were twofold: 1) to examine prevalence and predictors of apathy at 10 years, and 2) to examine the relationship between apathy at 10 years and concurrent symptoms, functioning and outcome, including subjective quality of life. Three-hundred-and-one patients with FEP were included at baseline, 186 participated in the 10 year follow-up. Of these, 178 patients completed the Apathy Evaluation Scale (AES-S-Apathy). Patients were classified as having apathy (AES-S-Apathy≥27) or not. The relationship between apathy and baseline variables (Demographics, Diagnosis, Duration of Untreated Psychosis), measures of symptomatology (Positive and Negative Syndrome Scale, Calgary Depression Scale for Schizophrenia), functioning (Global Assessment of Functioning Scale, Strauss Carpenter Level of Functioning Scale) and subjective quality of life (Lehman's Quality of Life Interview) were estimated through correlation analyses and blockwise multiple hierarchical regression analysis. Nearly 30% of patients met the threshold for being apathetic at follow-up. No baseline variables predicted apathy significantly at 10 years. Apathy was found to contribute independently to functioning and subjective quality of life, even when controlling for other significant correlates. Apathy is a common symptom in a FEP cohort 10 years after illness debut, and its presence relates to impaired functioning and poorer subjective quality of life. Copyright © 2011 Elsevier B.V. All rights reserved.

  13. Incomes and Outcomes: Social Security Disability Benefits in First-Episode Psychosis.

    Science.gov (United States)

    Rosenheck, Robert A; Estroff, Sue E; Sint, Kyaw; Lin, Haiqun; Mueser, Kim T; Robinson, Delbert G; Schooler, Nina R; Marcy, Patricia; Kane, John M

    2017-09-01

    Social Security Administration (SSA) disability benefits are an important source of income for people with psychoses and confer eligibility for health insurance. The authors examined the impact of coordinated specialty care on receipt of such benefits in first-episode psychosis, along with the correlates and consequences of receiving them. The Recovery After an Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) study, a 34-site cluster-randomized trial, compared NAVIGATE, a coordinated specialty care program, to usual community care over 2 years. Receipt of SSA benefits and clinical outcomes were assessed at program entry and every 6 months for 2 years. Piecewise regression analysis was used to identify relative change in outcome trajectories after receipt of disability benefits. Among 399 RAISE-ETP participants, 36 (9%) were receiving SSA disability benefits at baseline; of the remainder, 124 (34.1%) obtained benefits during the 2-year study period. The NAVIGATE intervention improved quality of life, symptoms, and employment but did not significantly reduce the likelihood of receiving SSA disability benefits. Obtaining benefits was predicted by more severe psychotic symptoms and greater dysfunction and was followed by increased total income but fewer days of employment, reduced motivation (e.g., sense of purpose, greater anhedonia), and fewer days of intoxication. A 2-year coordinated specialty care intervention did not reduce receipt of SSA disability benefits. There were some advantages for those who obtained SSA disability benefits over the 2-year treatment period, but there were also some unintended adverse consequences. Providing income supports without impeding recovery remains an important policy challenge.

  14. Associations between Purine Metabolites and Monoamine Neurotransmitters in First-Episode Psychosis

    Directory of Open Access Journals (Sweden)

    Jeffrey K Yao

    2013-06-01

    Full Text Available Schizophrenia (SZ is a biochemically complex disorder characterized by widespread defects in multiple metabolic pathways whose dynamic interactions, until recently, have been difficult to examine. Rather, evidence for these alterations has been collected piecemeal, limiting the potential to inform our understanding of the interactions amongst relevant biochemical pathways. We herein review perturbations in purine and neurotransmitter metabolism observed in early SZ using a metabolomic approach. Purine catabolism is an underappreciated, but important component of the homeostatic response of mitochondria to oxidant stress. We have observed a homeostatic imbalance of purine catabolism in first-episode neuroleptic-naive patients with SZ (FENNS. Precursor and product relationships within purine pathways are tightly correlated. Although some of these correlations persist across disease or medication status, others appear to be lost among FENNS suggesting that steady formation of the antioxidant uric acid via purine catabolism is altered early in the course of illness. As is the case for within-pathway correlations, there are also significant cross-pathway correlations between respective purine and tryptophan pathway metabolites. By contrast, purine metabolites show significant cross-pathway correlation only with tyrosine, and not with its metabolites. Furthermore, several purine metabolites (uric acid, guanosine, or xanthine are each significantly correlated with 5-hydroxyindoleacetic acid (5-HIAA in healthy controls, but not in FENNS at baseline or 4-week after antipsychotic treatment. Taken together, the above findings suggest that purine catabolism strongly associates with the tryptophan pathways leading to serotonin (5-HT and kynurenine metabolites. The Lack of a significant correlation between purine metabolites and 5-HIAA, suggests alterations in key 5-HT pathways that may both be modified by and contribute to oxidative stress via purine

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

    DEFF Research Database (Denmark)

    Petersen, Lone; Jeppesen, Pia; Thorup, Anne

    2007-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  18. Reduced Implicit and Explicit Sequence Learning in First-Episode Schizophrenia

    Science.gov (United States)

    Pedersen, Anya; Siegmund, Ansgar; Ohrmann, Patricia; Rist, Fred; Rothermundt, Matthias; Suslow, Thomas; Arolt, Volker

    2008-01-01

    A high prevalence of deficits in explicit learning has been reported for schizophrenic patients, but it is less clear whether these patients are impaired in implicit learning. Deficits in implicit learning indicative of a fronto-striatal dysfunction have been reported using a serial reaction-time task (SRT), but the impact of typical neuroleptic…

  19. Working Memory Modulation of Frontoparietal Network Connectivity in First-Episode Schizophrenia

    DEFF Research Database (Denmark)

    Nielsen, Jesper Duemose; Madsen, Kristoffer Hougaard; Wang, Zheng

    2017-01-01

    between regions (left inferior frontal gyrus (IFG), left inferior parietal lobe (IPL), and primary visual area) identified in a psychophysiological interaction (PPI) analysis was performed to characterize effective connectivity during the n-back task. The PPI analysis revealed that the connectivity...

  20. Adjunctive Taurine in First-Episode Psychosis: A Phase 2, Double-Blind, Randomized, Placebo-Controlled Study.

    Science.gov (United States)

    O'Donnell, Colin P; Allott, Kelly A; Murphy, Brendan P; Yuen, Hok Pan; Proffitt, Tina-Marie; Papas, Alicia; Moral, Jennifer; Pham, Tee; O'Regan, Michaela K; Phassouliotis, Christina; Simpson, Raelene; McGorry, Patrick D

    2016-12-01

    Taurine is an inhibitory neuromodulatory amino acid in the central nervous system that activates the GABA- and glycine-insensitive chloride channel and inhibits the N-methyl-D-aspartate receptor. It also functions as a neuroprotective agent and has a role in neural development and neurogenesis. The aim of this study was to determine the efficacy of adjunctive taurine in improving symptomatology and cognition among patients with a DSM-IV first-episode psychotic disorder. 121 patients with first-episode psychosis, aged 18-25 years, attending early intervention services consented to participate in this randomized, double-blind, placebo-controlled trial conducted from January 2007 to May 2009. Patients taking low-dose antipsychotic medication were randomly assigned to receive once-daily taurine 4 g or placebo for 12 weeks. The coprimary outcomes were change in symptomatology (measured by the Brief Psychiatric Rating Scale [BPRS] total score) and change in cognition (measured by the Measurement and Treatment Research to Improve Cognition in Schizophrenia [MATRICS] Consensus Cognitive Battery composite score) at 12 weeks. Secondary outcomes included tolerability and safety and additional clinical and functioning measures. 86 participants (n = 47 taurine; n = 39 placebo) were included in the final analysis. Taurine significantly improved symptomatology measured by the BPRS total score (95% CI, 1.8-8.5; P = .004) and psychotic subscale (95% CI, 0.1-1.5; P = .026) compared to placebo. Additionally, improvements were observed in the Calgary Depression Scale for Schizophrenia (95% CI, 0.1-3.0; P = .047) and Global Assessment of Functioning (95% CI, 0.3-8.8; P = .04) scores. There was no group difference in composite cognitive score (95% CI, -1.7 to 1.0; P = .582). A significant group difference was found on one safety and tolerability item (psychic item 2, asthenia/lassitude/increased fatigability) of the Udvalg for Kliniske Undersogelser, with the taurine group showing a

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

    Directory of Open Access Journals (Sweden)

    Sun Pamela

    2011-05-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  3. A narrative analysis investigating the impact of first episode psychosis on siblings' identity

    OpenAIRE

    S. Newman; Simonds, LM; Billings, J

    2011-01-01

    Research investigating the impact and experience of first episode psychosis amongst siblings is limited. This study reports the findings of a narrative analysis of the accounts of four siblings, two male and two female, aged between 17 and 24 years, of young people with a first episode of psychosis. The aim of the analysis was to explore the impact of this experience on siblings’ sense of self and their identity development and the roles they adopt within their families. The analysis focused ...

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Adam UU

    2014-10-01

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

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

    Directory of Open Access Journals (Sweden)

    Xiaoguang Fan

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

  7. Increased interictal cerebral glucose metabolism in a cortical-subcortical network in drug naive patients with cryptogenic temporal lobe epilepsy.

    Science.gov (United States)

    Franceschi, M; Lucignani, G; Del Sole, A; Grana, C; Bressi, S; Minicucci, F; Messa, C; Canevini, M P; Fazio, F

    1995-01-01

    Positron emission tomography with [18F]-2-fluoro-2-deoxy-D-glucose ([18F]FDG) has been used to assess the pattern of cerebral metabolism in different types of epilepsies. However, PET with [18F]FDG has never been used to evaluate drug naive patients with cryptogenic temporal lobe epilepsy, in whom the mechanism of origin and diffusion of the epileptic discharge may differ from that underlying other epilepsies. In a group of patients with cryptogenic temporal lobe epilepsy, never treated with antiepileptic drugs, evidence has been found of significant interictal glucose hypermetabolism in a bilateral neural network including the temporal lobes, thalami, basal ganglia, and cingular cortices. The metabolism in these areas and frontal lateral cortex enables the correct classification of all patients with temporal lobe epilepsy and controls by discriminant function analysis. Other cortical areas--namely, frontal basal and lateral, temporal mesial, and cerebellar cortices--had bilateral increases of glucose metabolism ranging from 10 to 15% of normal controls, although lacking stringent statistical significance. This metabolic pattern could represent a pathophysiological state of hyperactivity predisposing to epileptic discharge generation or diffusion, or else a network of inhibitory circuits activated to prevent the diffusion of the epileptic discharge. PMID:7561924

  8. Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

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

  9. Schizophrenia

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

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

  10. Relationship between menarche and psychosis onset in women with first episode of psychosis.

    Science.gov (United States)

    Rubio-Abadal, Elena; Usall, Judith; Barajas, Anna; Carlson, Janina; Iniesta, Raquel; Huerta-Ramos, Elena; Baños, Iris; Dolz, Montserrat; Sánchez, Bernardo; Ochoa, Susana

    2016-10-01

    The aim of this study was to explore the relationship between age at menarche and age at first episode of psychosis, as well as clinical severity and outcome, in a population of women with first-episode psychosis. Clinical and socio-demographical data, age at menarche and at first-episode psychosis, parental history of psychosis and cannabis-use habits were obtained from 42 subjects with a first episode of psychosis. Positive and Negative Syndrome Scale, Clinical Global Impression, Global Assessment Function, Disability Assessment Schedule, Wechsler Adult Intelligence Scale and Wechsler Intelligence Scale for Children, European Quality of Life, and Lewis and Murray Obstetric Complication Scales were administered. Statistical analysis was performed by means of zero-order correlations and Mann-Whitney U and Kruskal-Wallis tests using SPSS version 17.0. We found no significant correlation between age at menarche and age at first-episode psychosis, or with the clinical scores performed. We observed that subjects with earlier age at menarche had more parental history of psychosis. Our negative results do not support the theory of a possible protective role of oestrogen, which seems to be more complex than previously thought. We would suggest that further research is needed to investigate developmental influences of sex steroids on the onset of psychosis and potentially therapeutic benefits based upon oestrogen. © 2014 Wiley Publishing Asia Pty Ltd.

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

    Directory of Open Access Journals (Sweden)

    Martine Solesvik

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

  12. Female sexual dysfunction: A comparative study in drug naive 1st episode of depression in a general hospital of South Asia

    OpenAIRE

    Roy, Payel; Manohar, Shivananda; Raman, Rajesh; Sathyanarayana Rao, T. S.; Darshan, M. S.

    2015-01-01

    Background: Women's sexual dysfunction is found to be highly prevalent in western and Indian literature. Limited studies are available on drug naive depression in western literature and in Indian population. Aim: To determine the prevalence rate and symptom profile of female sexual dysfunctions in patients with untreated depression. Design: A cross-sectional study in the psychiatry out-patient department of general hospital in South India. Materials and Methods: Following written informed con...

  13. No change of dopamine transporter density in basal ganglia after risperidone treatment in drug-naive children with Tourette's disorder

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, W. K.; Ryu, Y. H.; Yoon, M. J.; Chun, K. A.; Lee, J. D. [College of Medicine, Univ. of Yonsei, Seoul (Korea, Republic of); Zee, D. Y. [Univ. of Inhwa, Incheon (Korea, Republic of); Choi, T. H. [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

    2003-07-01

    Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the DAT densities between drug-naive children with TD and normal children investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using lodine-123 labelled N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta-(4-chlorophenyl) tropane(I-123 IPT) single photon emission computed tomography (SPECT). I-123 IPT SPECT imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in eight drug-naive children with TD. Eight normal children also underwent SPECT imaging 2 hours after an intravenous administration of I-123 IPT and carried out both quantitative and qualitative analyses using the obtained SPECT data, which were reconstructed for the assessment of the specific/non-specific DAT binding ratio in the basal ganglia. The drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with riperidone in children with TD was not found, although tic symptoms were significantly improved with risperidone. These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system.

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

    Science.gov (United States)

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

    2007-01-15

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

  15. Risk Factors for the First Episode of Peritonitis in Southern Chinese Continuous Ambulatory Peritoneal Dialysis Patients

    Science.gov (United States)

    Fan, Xiaoguang; Huang, Rong; Wang, Juan; Ye, Hongjian; Guo, Qunying; Yi, Chunyan; Lin, Jianxiong; Zhou, Qian; Shao, Fengmin; Yu, Xueqing; Yang, Xiao

    2014-01-01

    Background The first episode of peritonitis affects survival of the peritoneal membrane as a medium for dialysis as well as survival of patients. The aim of this study is to investigate risk factors associated with the first episode of peritonitis in Southern Chinese continuous ambulatory peritoneal dialysis (CAPD) patients. Methods This is a single-center, retrospective, cohort study. All incident CAPD patients from 1 January 2006 to 31 December 2010 were recruited, and followed up until their first episode of peritonitis or 31 December, 2012. Baseline demographic, socioeconomic, clinical and laboratory data were collected. Cox proportional model was used to determine the factors associated with the first episode of peritonitis. Results In a cumulative 30756.5 patient-months follow-up (the median vintage 26.1 months) of 1117 CAPD patients, 309(27.7%) patients presented the first episodes of peritonitis. The cumulative peritonitis-free survival was 86.2%, 78.1%, 71.4% and 57.8% at 1, 2, 3 and 5 year, respectively. The multivariate analysis showed that factors associated with risk for the first episode of peritonitis were elderly patients (>65 years) [hazard ratio (HR) = 1.427, 95% confidence interval (CI) = 1.051 to 1.938, P = 0.023], male(HR = 1.315, 95% CI = 1.028 to 1.684, P = 0.030), lower education level (HR = 1.446, 95% CI: 1.127 to 1.855, P = 0.004) and albumin peritonitis in Southern Chinese CAPD patients. PMID:25222609

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

    Møller, Paul; Haug, Elisabeth; Raballo, Andrea

    2011-01-01

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

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

    DEFF Research Database (Denmark)

    Møller, Paul; Haug, Elisabeth; Raballo, Andrea

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

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

    LENUS (Irish Health Repository)

    Hodgins, Sheilagh

    2011-02-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    Science.gov (United States)

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

    2003-07-15

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

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

    NARCIS (Netherlands)

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

    2003-01-01

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

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

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-07-30

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

  11. Incidence of stressful life events and influence of sociodemographic and clinical variables on the onset of first-episode psychosis.

    Science.gov (United States)

    Butjosa, Anna; Gómez-Benito, Juana; Huerta-Ramos, Elena; Del Cacho, Núria; Barajas, Ana; Baños, Iris; Usall, Judith; Dolz, Montserrat; Sánchez, Bernardo; Carlson, Janina; Maria Haro, Josep; Ochoa, Susana

    2016-11-30

    This study presents a quantitative analysis of the incidence of stressful life events (SLEs) and the variables gender, age at onset, family history and psychotic symptoms in patients with first-episode psychosis (FEP). A descriptive, cross-sectional methodology was used to interview 68 patients with FEP between 13 and 47 years of age. The Psychiatric Epidemiology Research Interview Life Events Scale collected one-year period prior to onset of FEP - used to analyse the subcategories academic, work, love and marriage, children, residence, legal affairs, finances and social activities-, Positive and Negative Syndrome Scale, and Clinical Global Impression-Schizophrenia scale were used to assess the relevance of certain SLEs during adolescence. Age at onset showed a significant negative correlation with the categories academic and social activities. By contrast, it showed a positive correlation with work and children. A significant relationship was found between paternal family history and social activities and between maternal family history and academic and love and marriage. Finally, an inverse relationship was observed between negative symptoms and the categories children and finance. Depressive symptoms were significantly correlated with the category academic. Our results show the importance of SLEs during adolescence and suggest that there is a clear need to develop preventive actions that promote effective strategies for dealing with the accumulation of psychosocial stress. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. The relationship of verbal learning and verbal fluency with written story production: implications for social functioning in first episode psychosis.

    Science.gov (United States)

    Stain, Helen J; Hodne, Sigrun; Joa, Inge; Hegelstad, Wenche Ten Velden; Douglas, Katie M; Langveld, Johannes; Gisselgard, Jens P; Johannesen, Jan Olav; Larsen, Tor K

    2012-07-01

    Impairments in speech, communication and Theory of Mind are common in schizophrenia, and compromise social functioning. Some of these impairments may already be present pre-morbidly. This study aimed to investigate verbal functions in relation to written story production and social functioning in people experiencing a first episode of psychosis (FEP). Two groups of participants: FEP (N=31) and healthy controls (HC, N=31), completed measures of clinical status, social functioning, a series of neuropsychological tests targeting verbal functioning, and the "Frog Where Are You?" story production task. Story results showed reduced efficiency (words per minute) and self-monitoring (corrections per minute) for FEP compared with HC groups (plearning and verbal fluency. Story production was positively associated with verbal learning and verbal fluency for the FEP group only (plearning and memory for the FEP group. Individuals with FEP show a childhood history of reduced social and academic performance that is associated with skills essential for daily social interactions, as evidenced by the findings for story production, verbal learning and verbal fluency. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

  13. Exciting career opportunity beckons! Early intervention and vocational rehabilitation in first-episode psychosis: employing cautious optimism.

    Science.gov (United States)

    Killackey, Eoin J; Jackson, Henry J; Gleeson, John; Hickie, Ian B; McGorry, Patrick D

    2006-01-01

    While there are now effective interventions for the symptoms of psychosis and schizophrenia, treatment for the functional domains of these illnesses has received less attention. A key area affected by psychotic illness is vocational functioning. This area is currently of interest to clinicians, policy-makers, politicians and patients. This paper reviews several forms of vocational intervention practised over the years and highlights the issues around adopting an early intervention approach towards vocational rehabilitation. The paper has four aims: first, to consider some of the consequences of unemployment for those with psychotic illnesses; second, to review methods that have been used to address unemployment among the mentally ill; third, to highlight the importance of vocational development at a developmentally appropriate life stage; and finally, to consider the application of evidence-based vocational rehabilitation to those with first-episode psychosis. An initial broad literature search was conducted using PsychInfo and Medline databases. Further narrower searches were conducted electronically where indicated. Finally, some articles were sourced through manual searches of relevant journals. People with psychotic illness have a high rate of unemployment at the outset of their illness which tends to worsen over time. This is complicated by systemic factors such as the structure of the welfare system. Approaches for assisting people with mental illness return to work have evolved over the history of psychiatry. There now exists an evidence-based method of intervention. To date this has not been trialled in a systematic way with people in the early stages of psychotic illness. There is cause for cautious optimism in the vocational recovery of people with psychotic illnesses. Limited evidence exists that the individual placement and support approach developed with chronic populations is very effective in early episode patients. There are a number of challenges

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

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

    LENUS (Irish Health Repository)

    Hill, M

    2012-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Anuj Khandelwal

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  19. First episode psychosis and outcome : Findings from a swedish multi-centre study

    OpenAIRE

    Mattsson, Maria

    2007-01-01

    The Parachute Project was a Swedish multi-centre project that included 175 First Episode Psychosis patients who were followed over five years. The aim was to provide need adapted care with low medication and based on out-patient support in order to positively affect long-term outcome. One historical and one prospective treatment-as-usual group provided comparison follow-up data. The aim of this thesis is to describe outcome from various perspectives in FEP patients. Stud...

  20. Self-Determination Theory and First-Episode Psychosis: A Replication

    Directory of Open Access Journals (Sweden)

    Nicholas J. K. Breitborde

    2014-01-01

    Full Text Available Self-determination theory (SDT posits that human well-being depends on the satisfaction of three basic psychological needs: autonomy, competence, and relatedness. Although many scholars have suggested that SDT may be relevant to psychotic disorders, only one empirical study of SDT in individuals with psychosis has been completed to date by Breitborde and colleagues (2012. This study revealed that individuals with first-episode psychosis reported lower satisfaction of the three basic psychological needs as compared to individuals without psychosis. Moreover, greater satisfaction of basic psychological needs was modestly associated with lower general symptoms (e.g., anxiety and depression, greater social functioning, and better quality of life. Thus, the goal of this project was to replicate Breitborde et al.’s (2012 investigation of basic psychological need satisfaction among individuals with first-episode psychosis. Our results supported the conclusion that individuals with first-episode psychosis report lower autonomy, competence, and relatedness than individuals without psychosis. Moreover, our results comport with the finding that greater need satisfaction was associated with less severe symptomatology and better social functioning and quality of life. In total, the findings lend further credence to the hypothesis that SDT may help to inform the development of improved clinical services for individuals with psychotic disorders.

  1. Explanatory models in patients with first episode depression: a study from north India.

    Science.gov (United States)

    Grover, Sandeep; Kumar, Vineet; Chakrabarti, Subho; Hollikatti, Prabhakar; Singh, Pritpal; Tyagi, Shikha; Kulhara, Parmanand; Avasthi, Ajit

    2012-09-01

    The purpose of this work was to study the explanatory models of patients with first episode depression presenting to a tertiary care hospital located in North-western India. One hundred sixty four consecutive patients with diagnosis of first episode depression (except severe depression with psychotic symptoms) according to the International Classification of Diseases-10th Revision (ICD-10) and ≥18 years of age were evaluated for their explanatory models using the causal models section of Explanatory Model Interview Catalogue (EMIC). The most common explanations given were categorized into Karma-deed-heredity category (77.4%), followed by psychological explanations (62.2%), weakness (50%) and social causes (40.2%). Among the various specific causes the commonly reported explanations by at least one-fourth of the sample in decreasing order were: will of god (51.2%), fate/chance (40.9%), weakness of nerves (37.8%), general weakness (34.7%), bad deeds (26.2%), evil eye (24.4%) and family problems (21.9%). There was some influence of sociodemographic features on the explanations given by the patients. From the study, it can be concluded that patients with first episode depression have multiple explanatory models for their symptoms of depression which are slightly different than those reported in previous studies done from other parts of India. Understanding the multiple explanatory models for their symptoms of depression can have important treatment implications. Copyright © 2012 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Vandad Sharifi

    2010-05-01

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

  3. Treatment and violent behavior in persons with first episode psychosis during a 10-year prospective follow-up study

    DEFF Research Database (Denmark)

    Langeveld, Johannes; Bjørkly, Stål; Auestad, Bjørn

    2014-01-01

    BACKGROUND: First episode psychosis (FEP) patients have an increased risk for violence and criminal activity prior to initial treatment. However, little is known about the prevalence of criminality and acts of violence many years after implementation of treatment for a first episode psychosis. AI...

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

    Directory of Open Access Journals (Sweden)

    Huiran Zhang

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

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

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

    Science.gov (United States)

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

    2013-07-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  8. Evolution of metabolic risk factors over a two-year period in a cohort of first episodes of psychosis.

    Science.gov (United States)

    Bioque, Miquel; García-Portilla, M A Paz; García-Rizo, Clemente; Cabrera, Bibiana; Lobo, Antonio; González-Pinto, Ana; Díaz-Caneja, Covadonga M; Corripio, Iluminada; Vieta, Eduard; Castro-Fornieles, Josefina; Bobes, Julio; Gutiérrez-Fraile, Miguel; Rodriguez-Jimenez, Roberto; Mezquida, Gisela; Llerena, Adrián; Saiz-Ruiz, Jeronimo; Bernardo, Miguel

    2017-06-26

    Patients with a first episode of psychosis (FEP) display a broad range of metabolic risk factors related to the development of diverse medical comorbidities. Initial stages of these disorders are essential in understanding the increased vulnerability of developing cardiometabolic disturbances, associated with a reduced life expectancy. This study aimed to evaluate the metabolic profile of a cohort of patients with a FEP and its evolution during a two year follow-up, as well as the factors that influence the changes in their metabolic status. 16 participating centers from the PEPs Project recruited 335 subjects with a FEP and 253 matched healthy controls, aged 9-35years. We investigated a set of anthropometric measures, vital signs and laboratory data obtained from each participant over two years in a prospective, naturalistic study. From the beginning of the study the FEP group showed differences in the metabolic profile compared to the control group, together with a progressive worsening in the major part of the analyzed variables during the follow-up period, with higher rates of obesity and metabolic syndrome. Certain risk factors were related to determinate clinical variables such as male gender, the presence of affective symptoms or an early onset or to treatment variables such as the use of antipsychotic polypharmacy, antidepressants or mood stabilizers. Our results highlight the extremely high risk of patients at early phases of schizophrenia and other psychotic disorders of developing cardiovascular comorbidity and the fast worsening of the metabolic profile during the first two years. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Quetiapine extended release versus aripiprazole in children and adolescents with first-episode psychosis: the multicentre, double-blind, randomised tolerability and efficacy of antipsychotics (TEA) trial

    DEFF Research Database (Denmark)

    Pagsberg, Anne Katrine; Jeppesen, Pia; Klauber, Dea Gowers

    2017-01-01

    of quetiapine-extended release (quetiapine-ER) versus aripiprazole in children and adolescents with first-episode psychosis, to determine whether differences between the two treatments were sufficient to guide clinicians in their choice of one drug over the other. Methods In this multicentre, double......-blind, randomised trial in seven Danish university clinics, we recruited children and adolescents aged 12–17 years with a diagnosis of ICD-10 schizophrenia-spectrum disorder, delusional disorder, or affective-spectrum psychotic disorder, and psychotic symptoms scoring at least 4 on at least one of the following......-generated concealed sequence with a block size of 8, and stratified by baseline PANSS positive score (≤20 points or >20 points) and age (12–14 years or 15–17 years). Study drugs were administered in identical capsules, and interventions, assessments, and data analysis were done masked. The primary outcome was PANSS...

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

    Directory of Open Access Journals (Sweden)

    Martino Belvederi Murri

    2016-01-01

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

  11. Substance Use in Patients With First-Episode Psychosis: Is Gender Relevant?

    Science.gov (United States)

    Arranz, Belen; Safont, Gemma; Corripio, Iluminada; Ramirez, Nicolas; Dueñas, Rosa Maria; Perez, Victor; Alvarez, Enric; San, Luis

    2015-01-01

    Only a few studies in patients with first-episode psychosis have included gender in the study hypothesis or considered this a primary study variable. The aim of this study was to explore the influence of gender in the pattern of substance use in patients with first-episode psychosis. This is a sub-analysis of a randomized open clinical trial that compared 1-year treatment retention rates of patients with first-episode psychosis randomized to haloperidol, olanzapine, quetiapine, risperidone, or ziprasidone. Our sub-analysis included 85 men and 29 women. Substance use was relatively high among these patients and differed significantly by gender. Men were more likely to use substances overall than women (89.4% for men vs. 55.2% for women), χ(2) = 16.2, df = 1, p <.001, and were also more likely to use alcohol (χ(2) = 13, df = 1, p <.001), cannabis (χ(2) = 9.9; df = 1, p <.002), and cocaine (χ(2) = 10.3; df = 1, p <.001), compared to women. While there were no gender differences in age at first consumption of alcohol or cocaine, men were significantly younger at first consumption of cannabis (M = 16.08 years, SD = 2.1) than women (M = 18.0 years, SD = 3.8), F(1, 59) = 5, p <.02. When analyzed separately by gender, women showed no significant differences in the influence of number of substances used on age at onset of psychosis, F(3, 29) = 1.2, p =.30. However, there was a significant difference among men, with earlier onset of psychosis noted in men consuming multiple substances; F(4, 85) = 5.8, p <.0001. Regarding prediction of age at onset of psychosis, both male gender and the use of a higher number of substances significantly predicted an earlier age at onset of psychosis. Our study provides some evidence of gender differences in the pattern of substance use in patients with first-episode psychosis, suggesting the possible need for gender-specific approaches in the interventions performed in these patients. This study is registered as #12610000954022 with the

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

    Science.gov (United States)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

    Thorup, Anne; Petersen, Lone; Jeppesen, Pia

    2010-01-01

    BACKGROUND: From an 'objective' perspective, treatment of first-episode psychosis has improved in many ways with the development of specialised early and intensive team-based treatment like e.g. the 'OPUS' treatment. However, the patients' perspective is also important and was investigated in the...... extent and more strongly with the affective balance and level of self-esteem....... by Lancashire QoLP in a significantly different way from the standard treatment (ST). There were no significant differences in quality of life between the ST group and the OPUS group concerning the 9 life domains. Quality of life correlated with psychopathology (both psychotic and negative symptoms) to a minor...

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

    Science.gov (United States)

    Voges, Marcia; Addington, Jean

    2005-07-15

    The purpose of the study was to examine the relationship between social anxiety and social functioning in first episode psychosis, and to determine whether those with psychosis have any maladaptive or irrational beliefs regarding social situations. A sample of 60 first episode patients (41 males, 19 females) participated in the study. The presence of social phobia was determined using the Structured Clinical Interview for DSM-IV (SCID-I). Measures included The Social Phobia and Anxiety Inventory (SPAI), the Social Functioning Scale (SFS), the Quality of Life Scale (QLS) and the Social Interaction Self-Statement Test. Thirty-two percent of the sample met SCID-I criteria for social phobia and approximately 60% of participants were experiencing elevated levels of social anxiety according to the SPAI (M=69.57, S.D.=27.42). Results were that negative symptoms and negative self-statements, but not social anxiety, were significant predictors of social functioning. This has implications for addressing these negative cognitions in early psychosis.

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

    Directory of Open Access Journals (Sweden)

    Kermott Cindy A

    2012-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Itxaso González-Ortega

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

  17. Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes.

    Science.gov (United States)

    Czerwonko, Matías E; Huespe, Pablo; Bertone, Santiago; Pellegrini, Pablo; Mazza, Oscar; Pekolj, Juan; de Santibañes, Eduardo; Hyon, Sung Ho; de Santibañes, Martín

    2016-12-01

    In times of modern surgery, transplantation and percutaneous techniques, pyogenic liver abscess (PLA) has essentially become a problem of biliary or iatrogenic origin. In the current scenario, diagnostic approach, clinical behavior and therapeutic outcomes have not been profoundly studied. This study analyzes the clinical and microbiological features, diagnostic methods, therapeutic management and predictive factors for recurrence and mortality of first episodes of PLA. A retrospective single-center study was conducted including 142 patients admitted to the Hospital Italiano de Buenos Aires, between 2005 and 2015 with first episodes of PLA. Prevailing identifiable causes were biliary diseases (47.9%) followed by non-biliary percutaneous procedures (NBIPLA, 15.5%). Seventeen patients (12%) were liver recipients. Eleven patients (7.8%) died and 18 patients (13.7%) had recurrence in the first year of follow up. The isolation of multiresistant organisms (p = 0.041) and a history of cholangitis (p 5 mg/dL (p = 0.022) and bilateral involvement (p = 0.014) in the multivariate analysis. NBPLA and PLA after transplantation may be increasing among the population of PLA in referral centers. History of cholangitis is a strong predictor for recurrence. Mortality is associated to hiperbilirrubinemia and anatomical distribution of the lesions. Copyright © 2016 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

  18. The longitudinal association between social functioning and theory of mind in first-episode psychosis.

    Science.gov (United States)

    Sullivan, Sarah; Lewis, Glyn; Mohr, Christine; Herzig, Daniela; Corcoran, Rhiannon; Drake, Richard; Evans, Jonathan

    2014-01-01

    There is some cross-sectional evidence that theory of mind ability is associated with social functioning in those with psychosis but the direction of this relationship is unknown. This study investigates the longitudinal association between both theory of mind and psychotic symptoms and social functioning outcome in first-episode psychosis. Fifty-four people with first-episode psychosis were followed up at 6 and 12 months. Random effects regression models were used to estimate the stability of theory of mind over time and the association between baseline theory of mind and psychotic symptoms and social functioning outcome. Neither baseline theory of mind ability (regression coefficients: Hinting test 1.07 95% CI -0.74, 2.88; Visual Cartoon test -2.91 95% CI -7.32, 1.51) nor baseline symptoms (regression coefficients: positive symptoms -0.04 95% CI -1.24, 1.16; selected negative symptoms -0.15 95% CI -2.63, 2.32) were associated with social functioning outcome. There was evidence that theory of mind ability was stable over time, (regression coefficients: Hinting test 5.92 95% CI -6.66, 8.92; Visual Cartoon test score 0.13 95% CI -0.17, 0.44). Neither baseline theory of mind ability nor psychotic symptoms are associated with social functioning outcome. Further longitudinal work is needed to understand the origin of social functioning deficits in psychosis.

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

    Science.gov (United States)

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

    2010-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Emilie Leclerc

    2015-06-01

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

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

    Science.gov (United States)

    González-Ortega, Itxaso; Alberich, Susana; Echeburúa, Enrique; Aizpuru, Felipe; Millán, Eduardo; Vieta, Eduard; Matute, Carlos; González-Pinto, Ana

    2015-01-01

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

  2. Psychotic symptoms, cognition and affect as predictors of psychosocial problems and functional change in first-episode psychosis

    NARCIS (Netherlands)

    Stouten, Luyken H.; Veling, Wim; Laan, Winfried; van der Helm, Mischa; van der Gaag, Mark

    2014-01-01

    Objective: To enable further understanding of how cognitive deficits and psychopathology impact psychosocial functioning in first-episode psychosis patients, we investigated how psychopathology and cognitive deficits are associated with psychosocial problems at baseline, and how these predict psycho

  3. The effect of repeated nicotine administration on the performance of drug-naive rats in a five-choice serial reaction time task.

    Science.gov (United States)

    Blondel, A; Simon, H; Sanger, D J; Moser, P

    1999-11-01

    Nicotine improves cognitive performance both in animals and in humans, particularly in tests involving attentional processes. The five-choice serial reaction time task (5-CSRTT) is widely used as a model of attentional performance in rats, and previous studies have demonstrated effects of nicotine in this task on measures such as improved reaction time. Using a modified version of this task (in which rats were required to respond to the disappearance of one of five stimulus lights), we evaluated the effects of repeated nicotine administration (0.3 mg/kg, intraperitoneally, on three occasions over 7 days) in drug-naive rats. After the first administration, nicotine increased accuracy and reduced inappropriate responding (anticipatory responses and responses during time-out) compared to performance following vehicle administration on the preceding day. However, with repeated administration the improvement in accuracy disappeared, and other effects became apparent. Thus, after the third administration the main effects of nicotine were to increase inappropriate responding and to reduce reaction times. A fourth administration 1-2 weeks later produced similar results to the third administration, suggesting that the effects of nicotine were now constant. Despite the general increase in inappropriate responding, there was no impairment in accuracy. In contrast to the response to repeated nicotine, the performance of the rats on the 3 vehicle days remained constant. These data demonstrate that the administration of nicotine to drug-naive subjects improves performance in the 5-CSRTT but that with repeated administration this effect disappears and is replaced by a profile in which inappropriate and impulsive responding predominate.

  4. Clinical significance of increased cerebellar default-mode network connectivity in resting-state patients with drug-naive somatization disorder

    Science.gov (United States)

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

    2016-01-01

    Abstract The cerebellum has been proven to be connected to the brain network, as in the default-mode network (DMN), among healthy subjects and patients with psychiatric disorders. However, whether or not abnormal cerebellar DMN connectivity exists and what its clinical significance is among drug-naive patients with somatization disorder (SD) at rest remain unclear. A total of 25 drug-naive patients with SD and 28 healthy controls were enrolled for a resting-state scan. The imaging data were analyzed using the seed-based functional connectivity (FC) method. Compared with the controls, patients with SD showed increased left/right Crus I-left/right angular gyrus (AG) connectivity and Lobule IX-left superior medial prefrontal cortex (MPFC) connectivity. The FC values of the left/right Crus I-right AG connectivity of the patients were positively correlated with their scores in the somatization subscale of the symptom checklist-90 (Scl-90). A trend level of correlations was observed between the FC values of the left Crus I-left AG connectivity of the patients and their scores for the somatization subscale of Scl-90, as well as between the FC values of their Lobule IX-left superior MPFC connectivity and their scores for the Eysenck personality questionnaire (EPQ) extraversion. Our findings show the increased cerebellar DMN connectivity in patients with SD and therefore highlight the importance of the DMN in the neurobiology of SD. Increased cerebellar DMN connectivities are also correlated with their somatization severity and personality, both of which bear clinical significance. PMID:27428190

  5. Integrated Treatment to Achieve Functional Recovery for First-Episode Psychosis

    Directory of Open Access Journals (Sweden)

    Marcelo Valencia

    2012-01-01

    Full Text Available This study describes an integrated treatment approach that was implemented to enhance functional recovery in first-episode psychotic patients. Patients were randomized to two treatment conditions: either to an integrated treatment approach: pharmacotherapy, psychosocial treatment, and psychoeducation (experimental group: N=39 or to medication alone (control group: N=34. Patients were evaluated at baseline and after one year of treatment. Functional recovery was assessed according to symptomatic and functional remission. At the end of treatment, experimental patients showed a 94.9% of symptomatic remission compared to 58.8% of the control group. Functional remission was 56.4% for the experimental group and 3.6% for the control group, while 56.4% of the experimental group met both symptomatic and functional remission criteria and were considered recovered compared to 2.9% of the control group.

  6. Assessment of posttraumatic symptoms in patients with first-episode psychosis.

    LENUS (Irish Health Repository)

    2011-11-01

    Posttraumatic stress disorder is common among patients with psychotic disorders. The present study examined the internal reliability and comparability of the Impact of Event Scale (IES) in a sample of 38 patients with first-episode psychosis and 47 controls exposed to severe physical and\\/or sexual abuse. The IES total score and both subscales showed high internal consistency in both groups (Cronbach\\'s alpha coefficients of approximately 0.9 or higher). Given their equivalent trauma reporting, the lack of differences in IES scores between patients and controls seems to indicate that patients are likely to report accurately and neither exaggerate nor minimize their posttraumatic symptoms. Overall, the findings suggest that the IES can be used to assess symptoms of posttraumatic stress in patients with psychotic disorders as in other populations.

  7. Change in cannabis use, clinical symptoms and social functioning among patients with first-episode psychosis

    DEFF Research Database (Denmark)

    Clausen, L; Hjorthøj, C R; Thorup, Anne A.E.

    2014-01-01

    BACKGROUND: Several studies indicate that cannabis use among patients with psychotic disorders is associated with worse outcome, but only a few studies have controlled for baseline condition and medication. METHOD: At 5-year follow-up, interviews were carried out with 314 first-episode psychosis.......26, 95% CI 2.13-14.39, p = 0.01). Those who stopped using cannabis between entry and 5-year follow-up had a significantly lower level of psychotic symptoms at 5-year follow-up even after controlling for baseline level of psychotic symptoms and for insufficient antipsychotic medication (adjusted...... difference in psychotic dimension -1.04, 95% CI -1.77 to -0.31, p = 0.006). CONCLUSIONS: Continuous cannabis use was associated with higher levels of psychotic symptoms after 5 years, and this association was only partly explained by insufficient antipsychotic medication....

  8. Metacognition in first-episode psychosis and its association with positive and negative symptom profiles

    DEFF Research Database (Denmark)

    Trauelsen, Anne Marie; Gumley, Andrew; Jansen, Jens Einar

    2016-01-01

    There is growing evidence that metacognitive abilities which include the ability to synthesize knowledge regarding mental states in self and others and use this ability to solve problems are impaired in non-affective psychosis and associated with positive and negative symptom severity. We sought...... to (a) investigate the severity of metacognitive impairments in first-episode psychosis (FEP) compared to non-clinical controls and (b) explore associations with positive and negative symptom profiles. Ninety-seven people with FEP were compared to 101 control persons. Metacognition was assessed...... with interviews and the Metacognitive assessment scale-abbreviated. Four groups based on positive and negative symptoms were identified by cluster analysis and compared on metacognition, childhood adversities, duration of untreated psychosis and premorbid social and academic adjustment. Those with high levels...

  9. Do stressful life events predict medical treatment outcome in first episode of depression?

    DEFF Research Database (Denmark)

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

    2009-01-01

    BACKGROUND: It is unclear whether medical treatment outcome in first episode depression differ for patients with and without stressful life events prior to onset of depression. METHODS: Patients discharged with a diagnosis of a single depressive episode from a psychiatric in- or outpatient hospital......-II) and the interview of recent life events (IRLE). Medical treatment history was assessed in detail using standardised procedures (TRAQ). Remission was defined as a score Depression Rating Scale, 17 items and a score >or= 4 on TRAQ following (1) first trial of antidepressant treatment (2) two...... adequate trials of antidepressant treatment. RESULTS: A total of 399 patients participated in the interview and among these 301 patients obtained a SCAN diagnosis of a single depressive episode. A total of 62.8% of the 301 patients experienced at least one moderate to severe stressful life event in a 6...

  10. Urovirulence determinants in Escherichia coli isolates causing first-episode and recurrent cystitis in women.

    Science.gov (United States)

    Stapleton, A; Moseley, S; Stamm, W E

    1991-04-01

    To assess the prevalence of urovirulence determinants among Escherichia coli isolates from women with acute uncomplicated cystitis, 121 isolates from 87 women with first-episode or recurrent cystitis and 156 fecal isolates from 52 women without recent urinary tract infection were tested using DNA probes for P fimbriae, hemolysin, aerobactin, and diffuse adhesin and for expression of hemolysin and P and F adhesins. P fimbrial genotype (P = .002), hemolysin phenotype (P = .007), and the diffuse adhesin determinant (P = .03), but not aerobactin, were found more frequently in E. coli from women with acute cystitis, and expression of the F adhesin (41%) was more common than the P adhesin (24%; P = .001). E. coli isolates that caused cystitis in women using diaphragms had fewer virulence determinants than those from nonusers (P = .04), suggesting that diaphragm use may allow infection with less virulent E. coli.

  11. Early Predictors of Ten-Year Course in First-Episode Psychosis

    DEFF Research Database (Denmark)

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

    2016-01-01

    OBJECTIVE: Identifying patients at risk of poor outcome at an early stage of illness can aid in treatment planning. This study sought to create a best-fit statistical model of known baseline and early-course risk factors to predict time in psychosis during a ten-year follow-up period after a first...... psychotic episode. METHODS: Between 1997 and 2000, 301 patients with DSM-IV nonorganic, nonaffective first-episode psychosis were recruited consecutively from catchment area-based sectors in Norway and Denmark. Specialized mental health personnel evaluated patients at baseline, three months, and one, two......, five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores ≥4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years...

  12. Pathways to Care for Patients With First-Episode Psychosis in Singapore.

    Science.gov (United States)

    Chesney, Edward; Abdin, Edimansyah; Poon, Lye Yin; Subramaniam, Mythily; Verma, Swapna

    2016-04-01

    In this study, we aim to describe the pathways to care for patients with first-episode psychosis in Singapore. We analyzed data from 900 individuals accepted by the Singapore Early Psychosis Intervention Programme between 2007 and 2012. The most common first contacts were specialist care (59%), primary care (27%), and the police (12%). Multivariate regression models showed that first contact with services varied according to demographic variables and diagnosis. The duration of untreated psychosis, total number of contacts before referral, and rate of referral to the Early Psychosis Intervention Programme varied according to demographic and clinical variables and first contact. We hope that this information will enable clinicians, managers, and other service providers to target interventions to streamline referrals, reduce distress, and improve the treatment of young people with psychotic illnesses.

  13. Metacognition, symptoms and premorbid functioning in a first episode psychosis sample.

    Science.gov (United States)

    Macbeth, Angus; Gumley, Andrew; Schwannauer, Matthias; Carcione, Antonino; Fisher, Rebecca; McLeod, Hamish J; Dimaggio, Giancarlo

    2014-02-01

    Significant metacognitive impairments are observed in chronic psychosis samples but metacognition is less understood in first episode psychosis (FEP). The current study explored correlations between metacognition, symptoms and premorbid functioning in an FEP sample. In a cross-sectional cohort study, individuals in the first 12 months of treatment metacognition were assessed with the Metacognition Assessment Scale-Revised version (MAS-R). Psychotic symptomatology, premorbid adjustment, and clinician rated service engagement were also measured. Lower scores for metacognitive understanding of other's minds were significantly correlated with greater negative symptoms, poorer early adolescent social adjustment and poorer clinician rated help-seeking. Our findings suggest that FEP individuals with difficulties in understanding other's minds have more social deficits and may be less able to make effective use of treatment.

  14. An examination of associations between the inability to taste phenylthiocarbamide (PTC) and clinical characteristics and trait markers in first-episode, nonaffective psychotic disorders.

    Science.gov (United States)

    Compton, Michael T; Ionescu, Dawn F; Broussard, Beth; Cristofaro, Sarah L; Johnson, Stephanie; Haggard, Patrick J; Potts, Amy A; Wan, Claire Ramsay; Walker, Elaine F

    2013-08-30

    Research findings are mixed as to whether or not the inability to taste phenylthiocarbamide (PTC) might represent an endophenotypic trait marker for schizophrenia. We hypothesized associations between PTC-tasting status and select clinical characteristics and trait markers in patients with psychotic disorders that, if present, would provide support for the inability to taste PTC as a trait marker. In a first-episode psychosis sample (n=93), we measured PTC tasting, family history of psychosis, age at onset of prodrome and psychosis, severity of positive and negative symptoms, global impairment in functioning, neurological soft signs, and four neurocognitive domains (verbal learning/memory, visual learning/memory, verbal working memory, and spatial working memory). Associations between PTC-non-tasting and clinical/neurocognitive variables were examined with χ(2) tests and independent samples t tests. Among participants, 67.7% tasted PTC in comparison to a strip of control paper, and 25.8% were non-tasters. Tasters and non-tasters did not show statistically significant differences with respect to family history, age at onset, severity of symptoms, neurological soft signs, or the four neurocognitive domains. In conjunction with other findings, it is unlikely that PTC-non-tasting is a trait marker of schizophrenia, though a conclusive study is warranted. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Social functioning in Chinese college students with and without schizotypal personality traits: an exploratory study of the Chinese version of the First Episode Social Functioning Scale.

    Directory of Open Access Journals (Sweden)

    Yi Wang

    Full Text Available OBJECTIVES: The First Episode Social Functioning Scale (FESFS was designed to measure social functioning of young individuals with schizophrenia. The aim of this study was to validate a Chinese version of the FESFS in a sample of young Chinese adults. METHOD: The FESFS was translated to Chinese prior to being administered to 1576 college students. The factor structure, reliability, and validity of the scale were examined. RESULTS: Two items were deleted after item analysis and the internal consistency of the whole scale was .89. A six-factor structure was derived by exploratory factor analysis. The factors were interpersonal, family and friends, school, living skills, intimacy, and balance. Estimates of the structural equation model supported this structure, with Goodness of Fit Chi-Square χ(2 = 1097.53 (p<0.0001, the root mean square error of approximation (RMSEA = 0.058, and the comparative fit index (CFI = 0.93. Scale validity was supported by significant correlations between social functioning factors scores and schizophrenia personality questionnaire (SPQ scores. Individuals with schizotypal personality features presented poorer social functioning than those without schizotypal personality features. CONCLUSIONS: The Chinese revised version of the FESFS was found to have good psychometric properties and could be used in the future to examine social functioning in Chinese college students.

  16. Metacognition in First Episode Psychosis: Item Level Analysis of Associations with Symptoms and Engagement.

    Science.gov (United States)

    MacBeth, Angus; Gumley, Andrew; Schwannauer, Matthias; Carcione, Antonino; McLeod, Hamish J; Dimaggio, Giancarlo

    2016-07-01

    Significant metacognitive impairments are observed in first episode psychosis (FEP) and chronic psychosis samples. There is evidence of associations between metacognition and presentation in FEP, but the relative contribution of metacognitive understanding of the self and the other is as yet unclear. The current study is a secondary analysis of date on metacognition, symptoms and engagement with treatment (help-seeking) in an FEP sample. In a cross-sectional cohort study, individuals in the first 12 months of treatment metacognition were assessed with the Metacognition Assessment Scale-Revised version (MAS-R). Psychotic symptomatology and help-seeking within treatment (clinician-rated service engagement) were also measured. An item level analysis of the MAS-R was conducted exploring associations between symptoms and cognitive, emotional, differentiation, integration and decentration aspects of metacognition. We report that associations between negative symptoms and deficits in the understanding of other's mental states extend across cognitive, emotional, integrative and decentration aspects of metacognition. We also report associations between negative symptoms and understanding one's own mind. We also note that cognitive and decentration aspects of metacognition were significantly associated with help-seeking once in treatment. Our findings suggest that an appreciation of metacognitive processes may inform treatment frameworks for FEP. Copyright © 2015 John Wiley & Sons, Ltd. Individual components of metacognition including the capacity to relate cognitive and emotional variables are important in first episode phychosis. Impaired metacognitive understanding of both one's own and others' mental states is associated with increased negative symptoms. Metacognitive variables may be important in understanding how different individuals seek help or engage with services after the initiation of treatment. Copyright © 2015 John Wiley & Sons, Ltd.

  17. Contribution of ultrasound scans in the first episode of urinary tract infection in children.

    Science.gov (United States)

    Jellouli, Manel; Ben Mansour, Asma; Abidi, Kamel; Ferjani, Meriem; Naija, Ouns; Hammi, Yousra; Zarrouk, Chokri; Gargah, Tahar

    2016-06-01

    Background - Vesicoureteral reflux (VUR) is a common pediatric urologic disorder. After the first urinary tract infection (UTI), imaging studies are recommended, starting with a renal ultrasound (US) and voiding cystourethrography (VCUG). We propose to determine whether abnormalities found on US can help indicate the necessity of VCUG in children after the first urinary tract infection. Methods - A retrospective study included all children admitted with their first episode of urinary tract infection from January 2007 to December 2012. Results - A total of 311 children were included. The median age was 2.5 years, 72.3% were female. VUR Prevalence was 14%.  Forty-four patients were found to have VUR on VCUG, giving a prevalence of 14%. Of these 44 patients, 11 had grade I reflux, 6 had grade II reflux, 3 had grade III reflux, 15had grade IV reflux, and 9 had grade V reflux. Ultrasound findings were positive for VUR in 43 patients, 19 of them had RVU. Twenty five patients had a normal ultrasound but showed VUR on VCUG (11 had grade I reflux, six grade II reflux, three grade III reflux and five grade IV reflux).  The sensitivity and specificity of ultrasound in suggesting VUR were 43% and 91%, respectively. The positive predictive value of ultrasound in suggesting VUR was 44%; the negative predictive value was 91%. Conclusion - Renal ultrasound findings are specific for VUR in children with a first UTI, but no sensitive. Clinicians should consider renal ultrasound results to take decision on whether or not to proceed with a VCUG in the investigation of a first episode UTI in young children.

  18. Fusion analysis of first episode depression: Where brain shape deformations meet local composition of tissue

    Directory of Open Access Journals (Sweden)

    Mahdi Ramezani

    2015-01-01

    Full Text Available Computational neuroanatomical techniques that are used to evaluate the structural correlates of disorders in the brain typically measure regional differences in gray matter or white matter, or measure regional differences in the deformation fields required to warp individual datasets to a standard space. Our aim in this study was to combine measurements of regional tissue composition and of deformations in order to characterize a particular brain disorder (here, major depressive disorder. We use structural Magnetic Resonance Imaging (MRI data from young adults in a first episode of depression, and from an age- and sex-matched group of non-depressed individuals, and create population gray matter (GM and white matter (WM tissue average templates using DARTEL groupwise registration. We obtained GM and WM tissue maps in the template space, along with the deformation fields required to co-register the DARTEL template and the GM and WM maps in the population. These three features, reflecting tissue composition and shape of the brain, were used within a joint independent-components analysis (jICA to extract spatially independent joint sources and their corresponding modulation profiles. Coefficients of the modulation profiles were used to capture differences between depressed and non-depressed groups. The combination of hippocampal shape deformations and local composition of tissue (but neither shape nor local composition of tissue alone was shown to discriminate reliably between individuals in a first episode of depression and healthy controls, suggesting that brain structural differences between depressed and non-depressed individuals do not simply reflect chronicity of the disorder but are there from the very outset.

  19. Fusion analysis of first episode depression: where brain shape deformations meet local composition of tissue.

    Science.gov (United States)

    Ramezani, Mahdi; Abolmaesumi, Purang; Tahmasebi, Amir; Bosma, Rachael; Tong, Ryan; Hollenstein, Tom; Harkness, Kate; Johnsrude, Ingrid

    2015-01-01

    Computational neuroanatomical techniques that are used to evaluate the structural correlates of disorders in the brain typically measure regional differences in gray matter or white matter, or measure regional differences in the deformation fields required to warp individual datasets to a standard space. Our aim in this study was to combine measurements of regional tissue composition and of deformations in order to characterize a particular brain disorder (here, major depressive disorder). We use structural Magnetic Resonance Imaging (MRI) data from young adults in a first episode of depression, and from an age- and sex-matched group of non-depressed individuals, and create population gray matter (GM) and white matter (WM) tissue average templates using DARTEL groupwise registration. We obtained GM and WM tissue maps in the template space, along with the deformation fields required to co-register the DARTEL template and the GM and WM maps in the population. These three features, reflecting tissue composition and shape of the brain, were used within a joint independent-components analysis (jICA) to extract spatially independent joint sources and their corresponding modulation profiles. Coefficients of the modulation profiles were used to capture differences between depressed and non-depressed groups. The combination of hippocampal shape deformations and local composition of tissue (but neither shape nor local composition of tissue alone) was shown to discriminate reliably between individuals in a first episode of depression and healthy controls, suggesting that brain structural differences between depressed and non-depressed individuals do not simply reflect chronicity of the disorder but are there from the very outset.

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

    Science.gov (United States)

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

    2016-04-01

    Subjective quality of life (S-QoL) is an important outcome measure in first episode psychosis (FEP). The aims of this study were to describe S-QoL-development the first 10-years in FEP patients and to identify predictors of this development. A representative sample of 272 patients with a first episode psychotic disorder was included from 1997 through 2000. At 10 year follow-up 186 patients participated. QoL was measured by the Lehman's Quality of Life Interview. Linear mixed model analyses were performed to investigate longitudinal effects of baseline psychiatric symptoms and socio-economic variables and the effects of changes in the same variables on S-QoL-development. S-QoL improved significantly over the follow-up period. More contact with family and a better financial situation at baseline had a positive and longstanding effect on S-QoL-development, but changes in these variables were not associated with S-QoL-development. Higher depressive symptoms and less daily activities at baseline both had a negative independent effect, but a positive interaction effect with time on S-QoL-development indicating that the independent negative effect diminished over time. In the change analysis, increased daily activities and a decrease in depressive symptoms were associated with a positive S-QoL-development. Treatment of depressive symptoms and measures aimed at increasing daily activities seem important to improve S-QoL in patients with psychosis. More contact with family and a better financial situation at baseline have a long-standing effect on S-QoL-development in FEP patients. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Abnormal resting-state brain activities in patients with first-episode obsessive-compulsive disorder

    Science.gov (United States)

    Niu, Qihui; Yang, Lei; Song, Xueqin; Chu, Congying; Liu, Hao; Zhang, Lifang; Li, Yan; Zhang, Xiang; Cheng, Jingliang; Li, Youhui

    2017-01-01

    Objective This paper attempts to explore the brain activity of patients with obsessive-compulsive disorder (OCD) and its correlation with the disease at resting duration in patients with first-episode OCD, providing a forceful imaging basis for clinic diagnosis and pathogenesis of OCD. Methods Twenty-six patients with first-episode OCD and 25 healthy controls (HC group; matched for age, sex, and education level) underwent functional magnetic resonance imaging (fMRI) scanning at resting state. Statistical parametric mapping 8, data processing assistant for resting-state fMRI analysis toolkit, and resting state fMRI data analysis toolkit packages were used to process the fMRI data on Matlab 2012a platform, and the difference of regional homogeneity (ReHo) values between the OCD group and HC group was detected with independent two-sample t-test. With age as a concomitant variable, the Pearson correlation analysis was adopted to study the correlation between the disease duration and ReHo value of whole brain. Results Compared with HC group, the ReHo values in OCD group were decreased in brain regions, including left thalamus, right thalamus, right paracentral lobule, right postcentral gyrus, and the ReHo value was increased in the left angular gyrus region. There was a negative correlation between disease duration and ReHo value in the bilateral orbitofrontal cortex (OFC). Conclusion OCD is a multifactorial disease generally caused by abnormal activities of many brain regions at resting state. Worse brain activity of the OFC is related to the OCD duration, which provides a new insight to the pathogenesis of OCD. PMID:28243104

  2. Deficits in Neurite Density Underlie White Matter Structure Abnormalities in First-Episode Psychosis.

    Science.gov (United States)

    Rae, Charlotte L; Davies, Geoff; Garfinkel, Sarah N; Gabel, Matt C; Dowell, Nicholas G; Cercignani, Mara; Seth, Anil K; Greenwood, Kathryn E; Medford, Nick; Critchley, Hugo D

    2017-02-17

    Structural abnormalities across multiple white matter tracts are recognized in people with early psychosis, consistent with dysconnectivity as a neuropathological account of symptom expression. We applied advanced neuroimaging techniques to characterize microstructural white matter abnormalities for a deeper understanding of the developmental etiology of psychosis. Thirty-five first-episode psychosis patients, and 19 healthy controls, participated in a quantitative neuroimaging study using neurite orientation dispersion and density imaging, a multishell diffusion-weighted magnetic resonance imaging technique that distinguishes white matter fiber arrangement and geometry from changes in neurite density. Fractional anisotropy (FA) and mean diffusivity images were also derived. Tract-based spatial statistics compared white matter structure between patients and control subjects and tested associations with age, symptom severity, and medication. Patients with first-episode psychosis had lower regional FA in multiple commissural, corticospinal, and association tracts. These abnormalities predominantly colocalized with regions of reduced neurite density, rather than aberrant fiber bundle arrangement (orientation dispersion index). There was no direct relationship with active symptoms. FA decreased and orientation dispersion index increased with age in patients, but not control subjects, suggesting accelerated effects of white matter geometry change. Deficits in neurite density appear fundamental to abnormalities in white matter integrity in early psychosis. In the first application of neurite orientation dispersion and density imaging in psychosis, we found that processes compromising axonal fiber number, density, and myelination, rather than processes leading to spatial disruption of fiber organization, are implicated in the etiology of psychosis. This accords with a neurodevelopmental origin of aberrant brain-wide structural connectivity predisposing individuals to

  3. Subclinical Depressive Symptoms and Continued Cannabis Use: Predictors of Negative Outcomes in First Episode Psychosis

    Science.gov (United States)

    González-Ortega, Itxaso; Alberich, Susana; Echeburúa, Enrique; Aizpuru, Felipe; Millán, Eduardo; Vieta, Eduard; Matute, Carlos; González-Pinto, Ana

    2015-01-01

    Background Although depressive symptoms in first episode psychosis have been associated with cannabis abuse, their influence on the long-term functional course of FEP patients who abuse cannabis is unknown. The aims of the study were to examine the influence of subclinical depressive symptoms on the long-term outcome in first episode-psychosis patients who were cannabis users and to assess the influence of these subclinical depressive symptoms on the ability to quit cannabis use. Methods 64 FEP patients who were cannabis users at baseline were followed-up for 5 years. Two groups were defined: (a) patients with subclinical depressive symptoms at least once during follow-up (DPG), and (b) patients without subclinical depressive symptoms during follow-up (NDPG). Psychotic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), depressive symptoms using the Hamilton Depression Rating Scale (HDRS)-17, and psychosocial functioning was assessed using the Global Assessment of Functioning (GAF). A linear mixed-effects model was used to analyze the combined influence of cannabis use and subclinical depressive symptomatology on the clinical outcome. Results Subclinical depressive symptoms were associated with continued abuse of cannabis during follow-up (β= 4.45; 95% confidence interval [CI]: 1.78 to 11.17; P = .001) and with worse functioning (β = -5.50; 95% CI: -9.02 to -0.33; P = .009). Conclusions Subclinical depressive symptoms and continued cannabis abuse during follow-up could be predictors of negative outcomes in FEP patients. PMID:25875862

  4. Posttraumatic growth following a first episode of psychosis: a mixed methods research protocol using a convergent design.

    Science.gov (United States)

    Jordan, Gerald; Malla, Ashok; Iyer, Srividya N

    2016-07-25

    The suffering people experience following a first episode of psychosis is great, and has been well-investigated. Conversely, potential positive outcomes following a first episode of psychosis have been under-investigated. One such outcome that may result from a first episode of psychosis is posttraumatic growth, or a positive aftermath following the trauma of a first psychotic episode. While posttraumatic growth has been described following other physical and mental illnesses, posttraumatic growth has received very little attention following a first episode of psychosis. To address this research gap, we will conduct a mixed methods study aimed at answering two research questions: 1) How do people experience posttraumatic growth following a first episode of psychosis? 2) What predicts, or facilitates, posttraumatic growth following a first episode of psychosis? The research questions will be investigated using a mixed methods convergent design. All participants will be service-users being offered treatm