Shame and guilt/self-blame as predictors of expressed emotion in family members of patients with schizophrenia

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Wasserman, Stephanie; Weisman de Mamani, Amy; Suro, Giulia

2012-01-01

Expressed emotion (EE) is a measure of the family environment reflecting the amount of criticism and emotional over-involvement expressed by a key relative towards a family member with a disorder or impairment. Patients from high EE homes have a poorer illness prognosis than do patients from low EE homes. Despite EE's well-established predictive validity, questions remain regarding why some family members express high levels of EE attitudes while others do not. Based on indirect evidence from previous research, the current study tested whether shame and guilt/self-blame about having a relative with schizophrenia serve as predictors of EE. A sample of 72 family members of patients with schizophrenia completed the Five Minute Speech Sample to measure EE, along with questionnaires assessing self-directed emotions. In line with the hypotheses, higher levels of both shame and guilt/self-blame about having a relative with schizophrenia predicted high EE. Results of the current study elucidate the EE construct and have implications for working with families of patients with schizophrenia. PMID:22357355

Sex differences in familiality effects on neurocognitive performance in schizophrenia.

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Calkins, Monica E; Ray, Amrita; Gur, Ruben C; Freedman, Robert; Green, Michael F; Greenwood, Tiffany A; Light, Gregory A; Nuechterlein, Keith H; Olincy, Ann; Radant, Allen D; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Stone, William S; Sugar, Catherine; Swerdlow, Neal R; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Braff, David L; Lazzeroni, Laura C; Gur, Raquel E

2013-05-15

Numerous studies have documented that patients with schizophrenia show neurocognitive impairments, which are also heritable in schizophrenia families. In view of these findings, the current investigation tested the hypothesis that neurocognitive performance of schizophrenia probands can predict the neurocognitive performance of their unaffected family members. Participants (n=1967; schizophrenia=369; first-degree relatives=1072; community comparison subjects=526) in the Consortium on the Genetics of Schizophrenia were administered the Penn Computerized Neurocognitive Battery. Consistent with prior work, probands showed significant neurocognitive impairment, and neurocognitive ability was significantly heritable across domains. On average, unaffected relatives did not differ from community comparison subjects in their neurocognitive performance. However, in six of seven domains, proband scores predicted the performance of their unaffected siblings. Male, but not female, proband performance was predictive of their unaffected relatives' (siblings and mothers) performance, most consistently in face memory and spatial processing. Using a novel approach in which individual probands are paired with their respective unaffected relatives within each family, we found that male proband performance predicted both sister and brother performance, an effect that was most powerfully observed for face memory and spatial processing. Results suggest that the familial transmission of sexually dimorphic neurocognitive domains, in which a particular sex tends to show a performance advantage over the other, may not itself be sex specific in schizophrenia families. Copyright © 2013 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Familial Aggregation and Heritability of Schizophrenia and Co-aggregation of Psychiatric Illnesses in Affected Families.

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Chou, I-Jun; Kuo, Chang-Fu; Huang, Yu-Shu; Grainge, Matthew J; Valdes, Ana M; See, Lai-Chu; Yu, Kuang-Hui; Luo, Shue-Fen; Huang, Lu-Shuang; Tseng, Wen-Yi; Zhang, Weiya; Doherty, Michael

2017-09-01

Strong familial aggregation of schizophrenia has been reported but there is uncertainty concerning the degree of genetic contribution to the phenotypic variance of the disease. This study aimed to examine the familial aggregation and heritability of schizophrenia, and the relative risks (RRs) of other psychiatric diseases, in relatives of people with schizophrenia using the Taiwan National Health Insurance Database. The study population included individuals with affected first-degree or second-degree relatives identified from all beneficiaries (n = 23 422 955) registered in 2013. Diagnoses of schizophrenia made by psychiatrists were ascertained between January 1, 1996 and December 31, 2013. Having an affected co-twin, first-degree relative, second-degree relative, or spouse was associated with an adjusted RR (95% CI) of 37.86 (30.55-46.92), 6.30 (6.09-6.53), 2.44 (1.91-3.12), and 1.88 (1.64-2.15), respectively. Compared with the general population, individuals with one affected first-degree relative had a RR (95% CI) of 6.00 (5.79-6.22) and those with 2 or more had a RR (95% CI) of 14.66 (13.00-16.53) for schizophrenia. The accountability for the phenotypic variance of schizophrenia was 47.3% for genetic factors, 15.5% for shared environmental factors, and 37.2% for non-shared environmental factors. The RR (95% CI) in individuals with a first-degree relative with schizophrenia was 3.49 (3.34-3.64) for mood disorders and 3.91 (3.35-4.57) for delusional disorders. A family history of schizophrenia is therefore associated with a higher risk of developing schizophrenia, mood disorders, and delusional disorders. Heritability and environmental factors each account for half of the phenotypic variance of schizophrenia. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

Schizophrenia: management and family burden.

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Sebit, M B

2007-01-01

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

Resilience in families in which a member has been diagnosed with schizophrenia.

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Bishop, M; Greeff, A P

2015-09-01

Due to the extensive focus of the literature on the burden placed on families in which a member has been diagnosed with a mental illness such as schizophrenia, there is a need to identify factors that may help these families to be resilient and adapt to their crisis. The aim of this study was to identify family resilience qualities in families in which a member has been diagnosed with schizophrenia. The study comprised 42 families, represented by 33 parents and 9 siblings of the diagnosed family member. Families were recruited from three support groups within the Cape Metropolitan area, Western Cape, South Africa. Qualitative data were obtained through an open-ended question and quantitative data were collected with seven self-report questionnaires. The following family resilience qualities were identified: family income; finding support in their community; family togetherness; family communication style during crises; affirming and supportive communication patterns; family hardiness; commitment to the family; reframing crises as a challenge; and an internal locus of control within the family. The findings may be used by professionals and support group facilitators to enhance the resilience and functioning of families living with a member with schizophrenia. With approximately 1% of the world's population diagnosed with schizophrenia, it is clear that many families are affected when a member has been diagnosed. There is a need to identify factors that may help these families to be resilient. The aim of this study was to identify family resilience qualities in families in which a member has been diagnosed with schizophrenia. The following family resilience qualities were identified as resources that helped them to adapt to the many challenges put to them: family income, finding support in their community, the availability of hospitals, churches and professionals, family togetherness, family communication, family hardiness, commitment to the family, reframing crises

Factors of caregiver burden and family functioning among Taiwanese family caregivers living with schizophrenia.

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Hsiao, Chiu-Yueh; Tsai, Yun-Fang

2015-06-01

To assess the degree of caregiver burden and family functioning among Taiwanese primary family caregivers of people with schizophrenia and to test its association with demographic characteristics, family demands, sense of coherence and family hardiness. Family caregiving is a great concern in mental illness. Yet, the correlates of caregiver burden and family functioning in primary family caregivers of individuals with schizophrenia still remain unclear. A cross-sectional descriptive study. A convenience sample of 137 primary family caregivers was recruited from two psychiatric outpatient clinics in Taiwan. Measures included a demographic information sheet and the Chinese versions of the Family Stressors Index, Family Strains Index, 13-item Sense of Coherence Scale, 18-item Caregiver Burden Scale, Family Hardiness Index and Family Adaptability, Partnership, Growth, Affection, and Resolve Index. Data analysis included descriptive statistics, Pearson's product-moment correlation coefficients, t-test, one-way analysis of variance and a stepwise multiple linear regression. Female caregivers, additional dependent relatives, increased family demands and decreased sense of coherence significantly increased caregiver burden, whereas siblings as caregivers reported lower degrees of burden than parental caregivers. Family caregivers with lower family demands, increased family hardiness and higher educational level had significantly enhanced family functioning. Sense of coherence was significantly correlated with family hardiness. Our findings highlighted the importance of sense of coherence and family hardiness in individual and family adaptation. Special attention needs to focus on therapeutic interventions that enhance sense of coherence and family hardiness, thereby improving the perception of burden of care and family functioning. Given the nature of family caregiving in schizophrenia, understanding of correlates of caregiver burden and family functioning would help

Emotions, Ideas and Experiences of Caregivers of Patients With Schizophrenia About "Family to Family Support Program".

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Bademli, Kerime; Duman, Zekiye Çetinkaya

2016-06-01

"Family to Family Support Program" is a significant intervention program to assist families by informing them about treatment procedures and coping strategies, increasing their functionality, helping them to overcome the challenges of the disease. This study was particularly designed to investigate the emotions, thoughts, and experiences of caregivers of schizophrenia patients who participated in "Family to Family Support Program." The study was conducted with one of the qualitative research methods, phenomenological method. The study sample included caregivers who care for schizophrenia patients and participated in the "Family to Family Support Program". Twenty caregivers were included in the sample. The study was carried out in İzmir Schizophrenia Support Association. The study data were collected with four open ended questions. The average age of the participants was 56,77 ± 72,89, 10 male caregivers and 10 female caregivers, 9 caregivers were fathers, 6 caregivers were mothers, and 5 of them were siblings. The thematic analysis indicated that the emotions, thoughts and experiences of caregivers can be categorized in four groups: "I learned to deal with my problems", "I am conscious in my interaction with the patient and I know and I am not alone", "I feel much better", and "Schizophrenia is not the end of the road, knowledge sorts things out." Caregivers who participated in "Family to Family Support Program" expressed their satisfaction that they were benefited from the program, their coping skills were improved, they experienced less challenges when providing care, they understood the disease better, and it felt comfortable. Copyright © 2015 Elsevier Inc. All rights reserved.

'We didn't have a clue': Family caregivers' experiences of the communication of a diagnosis of schizophrenia.

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Outram, Sue; Harris, Gillian; Kelly, Brian; Bylund, Carma L; Cohen, Martin; Landa, Yulia; Levin, Tomer; Sandhu, Harsimrat; Vamos, Marina; Loughland, Carmel

2015-02-01

Despite widespread acceptance of the principle that patients should be informed about their diagnosis, many clinicians are reluctant to provide a diagnosis of schizophrenia. This study examines family caregivers' experiences of the communication of a schizophrenia diagnosis and related information. A generic qualitative methodological approach was used. In all, 13 family caregivers were recruited in regional New South Wales, Australia. Semi-structured interviews were used to explore their experiences and perceptions of discussing the diagnosis, prognosis and treatment of schizophrenia with mental health professionals. Interviews were recorded, transcribed, codes generated and thematic analysis undertaken. Family caregivers described long and difficult pathways to being given a diagnosis, haphazard means of finding out the diagnosis, high unmet needs for information, exclusion from the medical care process and problematic communication and general interactions with mental health clinicians. Caregivers were unanimous about the importance of receiving a timely diagnosis, for them and their relative with schizophrenia. Family caregivers are an integral part of the mental health-care system, and they should be included early in discussions of diagnosis and treatment of a person with schizophrenia. Their perspectives on communicating a diagnosis of schizophrenia provide important information for communication skills training of psychiatrists and other mental health professionals. © The Author(s) 2014.

LORETA current source density for duration mismatch negativity and neuropsychological assessment in early schizophrenia.

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Tomohiro Miyanishi

Full Text Available INTRODUCTION: Patients with schizophrenia elicit cognitive decline from the early phase of the illness. Mismatch negativity (MMN has been shown to be associated with cognitive function. We investigated the current source density of duration mismatch negativity (dMMN, by using low-resolution brain electromagnetic tomography (LORETA, and neuropsychological performance in subjects with early schizophrenia. METHODS: Data were obtained from 20 patients meeting DSM-IV criteria for schizophrenia or schizophreniform disorder, and 20 healthy control (HC subjects. An auditory odd-ball paradigm was used to measure dMMN. Neuropsychological performance was evaluated by the brief assessment of cognition in schizophrenia Japanese version (BACS-J. RESULTS: Patients showed smaller dMMN amplitudes than those in the HC subjects. LORETA current density for dMMN was significantly lower in patients compared to HC subjects, especially in the temporal lobes. dMMN current density in the frontal lobe was positively correlated with working memory performance in patients. CONCLUSIONS: This is the first study to identify brain regions showing smaller dMMN current density in early schizophrenia. Further, poor working memory was associated with decreased dMMN current density in patients. These results are likely to help understand the neural basis for cognitive impairment of schizophrenia.

An interaction between NDE1 and high birth weight increases schizophrenia susceptibility.

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Wegelius, Asko; Pankakoski, Maiju; Tomppo, Liisa; Lehto, Ulriika; Lönnqvist, Jouko; Suvisaari, Jaana; Paunio, Tiina; Hennah, William

2015-12-15

Pre- and perinatal environmental factors have been shown to increase schizophrenia risk particularly when combined with genetic liability. The investigation of specific gene environment interactions in the etiology of psychiatric disorders has gained momentum. We used multivariate GEE regression modeling to investigate the interaction between genes of the DISC1 pathway and birth weight, in relation to schizophrenia susceptibility in a Finnish schizophrenia family cohort. The study sample consisted of 457 subjects with both genotype and birth weight information. Gender and place of birth were adjusted for in the models. We found a significant interaction between birth weight and two NDE1 markers in relation to increased schizophrenia risk: a four SNP haplotype spanning NDE1 (b=1.26, SE=0.5, p=0.012) and one of its constituent SNPs rs4781678 (b=1.33, SE=0.51, p=0.010). Specifically, high birth weight (>4000g) was associated with increased schizophrenia risk among subjects homozygous for the previously identified risk alleles. The study was based on a family study sample with high genetic loading for schizophrenia and thus our findings cannot directly be generalized as representing the general population. Our results suggest that the functions mediated by NDE1 during the early stages of neurodevelopment are susceptible to the additional disruptive effects of pre- and perinatal environmental factors associated with high birth weight, augmenting schizophrenia susceptibility. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Familial and environmental influences on brain volumes in twins with schizophrenia.

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Picchioni, Marco M; Rijsdijk, Fruhling; Toulopoulou, Timothea; Chaddock, Christopher; Cole, James H; Ettinger, Ulrich; Oses, Ana; Metcalfe, Hugo; Murray, Robin M; McGuire, Philip

2017-03-01

Reductions in whole brain and grey matter volumes are robust features of schizophrenia, yet their etiological influences are unclear. We investigated the association between the genetic and environmental risk for schizophrenia and brain volumes. Whole brain, grey matter and white matter volumes were established from structural MRIs from twins varying in their zygosity and concordance for schizophrenia. Hippocampal volumes were measured manually. We conducted between-group testing and full genetic modelling. We included 168 twins in our study. Whole brain, grey matter, white matter and right hippocampal volumes were smaller in twins with schizophrenia. Twin correlations were larger for whole brain, grey matter and white matter volumes in monozygotic than dizygotic twins and were significantly heritable, whereas hippocampal volume was the most environmentally sensitive. There was a significant phenotypic correlation between schizophrenia and reductions in all the brain volumes except for that of the left hippocampus. For whole brain, grey matter and the right hippocampus the etiological links with schizophrenia were principally associated with the shared familial environment. Lower birth weight and perinatal hypoxia were both associated with lower whole brain volume and with lower white matter and grey matter volumes, respectively. Scan data were collected across 2 sites, and some groups were modest in size. Whole brain, grey matter and right hippocampal volume reductions are linked to schizophrenia through correlated familial risk (i.e., the shared familial environment). The degree of influence of etiological factors varies between brain structures, leading to the possibility of a neuroanatomically specific etiological imprint.

A study of hippocampal shape anomaly in schizophrenia and in families multiply affected by schizophrenia or bipolar disorder

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Connor, S.E.J. [Department of Neuroradiology, Kings Healthcare NHS Trust, King' s College Hospital, Denmark Hill, SE5 9RS, London (United Kingdom); Ng, V. [Department of Neuroimaging, Maudsley Hospital, London (United Kingdom); McDonald, C.; Schulze, K.; Morgan, K.; Dazzan, P.; Murray, R.M. [Division of Psychological Medicine, Institute of Psychiatry, London (United Kingdom)

2004-07-01

Hippocampal shape anomaly (HSA), characterised by a rounded hippocampus, has been documented in congenital malformations and epileptic patients. Subtle structural hippocampal abnormalities have been demonstrated in patients with schizophrenia. We tested the hypothesis that HSA is more frequent in schizophrenia, particularly in patients from families multiply affected by schizophrenia, and that HSA is transmitted within these families. We also aimed to define the anatomical features of the hippocampus and other cerebral structures in the HSA spectrum and to determine the prevalence of HSA in a control group. We reviewed the magnetic resonance imaging of a large number of subjects with schizophrenia and bipolar disorder, many of who came from multiply affected families, relatives of the affected probands, and controls. Quantitative measures of hippocampal shape and position and other qualitative anatomical measures were performed (including depth of dominant sulcus cortical cap, angle of dominant sulcus and hippocampal fissure, bulk of collateral white matter, prominence of temporal horn lateral recess and blurring of internal hippocampal architecture) on subjects with HSA. A spectrum of mild, moderate and severe HSA was defined. The prevalence of HSA was, 7.8% for the controls (n=218), 9.3% for all schizophrenic subjects (n=151) and 12.3% for familial schizophrenic subjects (n=57). There was a greater prevalence of moderate or severe forms of HSA in familial schizophrenics than controls. However, there was no increase in the prevalence of HSA in the unaffected first-degree relatives of schizophrenic patients or in patients with familial bipolar disorder. HSA was rarely transmitted in families. HSA was frequently associated with a deep, vertical collateral/occipito-temporal sulcus and a steep hippocampal fissure. Our data raise the possibility that HSA is linked to disturbances of certain neurodevelopmental genes associated with schizophrenia. However, the lack of

A study of hippocampal shape anomaly in schizophrenia and in families multiply affected by schizophrenia or bipolar disorder

International Nuclear Information System (INIS)

Connor, S.E.J.; Ng, V.; McDonald, C.; Schulze, K.; Morgan, K.; Dazzan, P.; Murray, R.M.

2004-01-01

Hippocampal shape anomaly (HSA), characterised by a rounded hippocampus, has been documented in congenital malformations and epileptic patients. Subtle structural hippocampal abnormalities have been demonstrated in patients with schizophrenia. We tested the hypothesis that HSA is more frequent in schizophrenia, particularly in patients from families multiply affected by schizophrenia, and that HSA is transmitted within these families. We also aimed to define the anatomical features of the hippocampus and other cerebral structures in the HSA spectrum and to determine the prevalence of HSA in a control group. We reviewed the magnetic resonance imaging of a large number of subjects with schizophrenia and bipolar disorder, many of who came from multiply affected families, relatives of the affected probands, and controls. Quantitative measures of hippocampal shape and position and other qualitative anatomical measures were performed (including depth of dominant sulcus cortical cap, angle of dominant sulcus and hippocampal fissure, bulk of collateral white matter, prominence of temporal horn lateral recess and blurring of internal hippocampal architecture) on subjects with HSA. A spectrum of mild, moderate and severe HSA was defined. The prevalence of HSA was, 7.8% for the controls (n=218), 9.3% for all schizophrenic subjects (n=151) and 12.3% for familial schizophrenic subjects (n=57). There was a greater prevalence of moderate or severe forms of HSA in familial schizophrenics than controls. However, there was no increase in the prevalence of HSA in the unaffected first-degree relatives of schizophrenic patients or in patients with familial bipolar disorder. HSA was rarely transmitted in families. HSA was frequently associated with a deep, vertical collateral/occipito-temporal sulcus and a steep hippocampal fissure. Our data raise the possibility that HSA is linked to disturbances of certain neurodevelopmental genes associated with schizophrenia. However, the lack of

The family economic status and outcome of people with schizophrenia in Xinjin, Chengdu, China: 14-year follow-up study.

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Ran, Mao-Sheng; Yang, Lawrence H; Liu, Yu-Jun; Huang, Debbie; Mao, Wen-Jun; Lin, Fu-Rong; Li, Jie; Chan, Cecilia Lai-Wan

2017-05-01

Little is known about whether family economic status might influence the long-term (e.g. over 10 years) outcome of persons with schizophrenia in the community. To examine the differences in outcome at 14-year follow-up of persons with schizophrenia from high versus low family economic status backgrounds in a Chinese rural area. A prospective 14-year follow-up study was conducted in six townships in Xinjin County, Chengdu, China. All participants with schizophrenia ( n = 510) were identified in an epidemiological investigation of 123,572 people aged 15 years and older and followed up from 1994 to 2008. Individuals from low family economic status (economic status (⩾mean; 3.2% and 76.6%, respectively). Individuals from low family economic status had significantly lower rates of marriage and complete remission, higher mean scores on Positive and Negative Syndrome Scale (PANSS) and lower mean score on Global Assessment of Functioning (GAF) than those from high family economic status in 2008. The predictors of low family economic status of individuals in 2008 encompassed the baseline low family economic status, poor families' attitude toward the patient, younger age, older age of first onset and longer duration of illness. Low family economic status is a predictive factor of poor long-term outcome of persons with schizophrenia in the rural community. Individuals' family economic status should be considered in making mental health policy and providing community-based mental health services.

The relationship between default mode network connectivity and social functioning in individuals at familial high-risk for schizophrenia

OpenAIRE

Dodell-Feder, David; DeLisi, Lynn E.; Hooker, Christine I.

2014-01-01

Unaffected first-degree relatives of individuals with schizophrenia (i.e., those at familial high-risk [FHR]), demonstrate social dysfunction qualitatively similar though less severe than that of their affected relatives. These social difficulties may be the consequence of genetically conferred disruption to aspects of the default mode network (DMN), such as the dMPFC subsystem, which overlaps with the network of brain regions recruited during social cognitive processes. In the present study,...

Higher gamma-aminobutyric acid neuron density in the white matter of orbital frontal cortex in schizophrenia.

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Joshi, Dipesh; Fung, Samantha J; Rothwell, Alice; Weickert, Cynthia Shannon

2012-11-01

In the orbitofrontal cortex (OFC), reduced gray matter volume and reduced glutamic acid decarboxylase 67kDa isoform (GAD67) messenger (m)RNA are found in schizophrenia; however, how these alterations relate to developmental pathology of interneurons is unclear. The present study therefore aimed to determine if increased interstitial white matter neuron (IWMN) density exists in the OFC; whether gamma-aminobutyric acid (GABA)ergic neuron density in OFC white matter was altered; and how IWMN density may be related to an early-expressed inhibitory neuron marker, Dlx1, in OFC gray matter in schizophrenia. IWMN densities were determined (38 schizophrenia and 38 control subjects) for neuronal nuclear antigen (NeuN+) and 65/67 kDa isoform of glutamic acid decarboxylase immunopositive (GAD65/67+) neurons. In situ hybridization was performed to determine Dlx1 and GAD67 mRNA expression in the OFC gray matter. NeuN and GAD65/67 immunopositive cell density was significantly increased in the superficial white matter in schizophrenia. Gray matter Dlx1 and GAD67 mRNA expression were reduced in schizophrenia. Dlx1 mRNA levels were negatively correlated with GAD65/67 IWMN density. Our study provides evidence that pathology of IWMNs in schizophrenia includes GABAergic interneurons and that increased IWMN density may be related to GABAergic deficits in the overlying gray matter. These findings provide evidence at the cellular level that the OFC is a site of pathology in schizophrenia and support the hypothesis that inappropriate migration of cortical inhibitory interneurons occurs in schizophrenia. Copyright © 2012 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Stigma toward schizophrenia among parents of junior and senior high school students in Japan

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Yoshii Hatsumi

2011-12-01

Full Text Available Abstract Background Stigma toward schizophrenia is a substantial barrier to accessing care and adhering to treatment. Provisions to combat stigma are important, but in Japan and other developed countries there are few such provisions in place that target parents of adolescents. The attitudes of parents are important to address as first schizophrenic episodes typically occur in adolescence. In overall efforts to develop an education program and provisions against stigma, here we examined the relationship between stigma toward schizophrenia and demographic characteristics of parents of junior and senior high school students in Japan. The specific hypothesis tested was that contact and communication with a person with schizophrenia would be important to reducing stigma. A questionnaire inquiring about respondent characteristics and which included a survey on stigma toward schizophrenia was completed by 2690 parents. Results The demographic characteristics significantly associated with the Devaluation- Discrimination Measure were family income, occupation, presence of a neighbor with schizophrenia, and participation in welfare activities for people with mental illness (p Conclusions Stigma toward schizophrenia among parents of junior and senior high school students was in fact significantly stronger among members of the general public who had had contact with individuals with schizophrenia. In addition, stigma was associated with family income.

Experiences of stigma and discrimination faced by family caregivers of people with schizophrenia in India.

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Koschorke, Mirja; Padmavati, R; Kumar, Shuba; Cohen, Alex; Weiss, Helen A; Chatterjee, Sudipto; Pereira, Jesina; Naik, Smita; John, Sujit; Dabholkar, Hamid; Balaji, Madhumitha; Chavan, Animish; Varghese, Mathew; Thara, R; Patel, Vikram; Thornicroft, Graham

2017-04-01

Stigma associated with schizophrenia significantly affects family caregivers, yet few studies have examined the nature and determinants of family stigma and its relationship to their knowledge about the condition. This paper describes the experiences and determinants of stigma reported by the primary caregivers of people living with schizophrenia (PLS) in India. The study used mixed methods and was nested in a randomised controlled trial of community care for people with schizophrenia. Between November 2009 and October 2010, data on caregiver stigma and functional outcomes were collected from a sample of 282 PLS-caregiver dyads. In addition, 36 in-depth-interviews were conducted with caregivers. Quantitative findings indicate that 'high caregiver stigma' was reported by a significant minority of caregivers (21%) and that many felt uncomfortable to disclose their family member's condition (45%). Caregiver stigma was independently associated with higher levels of positive symptoms of schizophrenia, higher levels of disability, younger PLS age, household education at secondary school level and research site. Knowledge about schizophrenia was not associated with caregiver stigma. Qualitative data illustrate the various ways in which stigma affected the lives of family caregivers and reveal relevant links between caregiver-stigma related themes ('others finding out', 'negative reactions' and 'negative feelings and views about the self') and other themes in the data. Findings highlight the need for interventions that address both the needs of PLS and their family caregivers. Qualitative data also illustrate the complexities surrounding the relationship between knowledge and stigma and suggest that providing 'knowledge about schizophrenia' may influence the process of stigmatisation in both positive and negative ways. We posit that educational interventions need to consider context-specific factors when choosing anti-stigma-messages to be conveyed. Our findings suggest

Peer support and peer-led family support for persons living with schizophrenia.

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Duckworth, Kenneth; Halpern, Lisa

2014-05-01

Peer support and peer-led family psychoeducation represent two distinct and complementary recovery-oriented models to support individuals who live with schizophrenia and their families, respectively. The goals of these models focus on improving knowledge, coping, self-care, social support, and self-management strategies. These models represent important capacity-building strategies for people who live with the illness and the people who love them. This brief article is intended to provide the practicing clinician, person living with schizophrenia, and policy maker with a working knowledge of the current state of the literature in these two related fields. Practitioners should consider these resources and integrate them into their care. A person living with schizophrenia could use this review to advocate for appropriate resources and to identify career opportunities. Policy makers could benefit from an understanding of the literature to mitigate financial and cultural barriers to adopting these practices. The last 5 years have seen a dramatic expansion of the application of randomized controlled trials (RCTs) to give evidence to match the experience of people in these programs. The field has seen Wellness Recovery Action Plan (WRAP) named as evidence-based practice by the National Registry of Evidence-Based Practices. A RCT was also conducted for another peer-developed and led program called Building Recovery of Individual Dreams & Goals through Education & Support. Family to Family, the largest peer-led family psychoeducation course, was also found to have significant impact after the study and also 6 months later in RCT. Family to Family has also been named as an evidence-based practice. The field of people who are living well with schizophrenia working as resources and supports to others living with the illness is an idea that is growing momentum. This momentum has been matched by the RCT evidence. Peer support as a professional role has an emerging literature

An investigation of family environmental alteration affecting short-term recovery from Schizophrenia in China.

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Rong-Min Chen, R M

1995-02-01

It has been hypothesised that change in the family environment affects short-term recovery from schizophrenia. Observation and study of 210 schizophrenic patients who were influenced by family environmental alteration show that the prognosis of schizophrenia caused suddenly by family environmental alteration is better than that of schizophrenia caused by a persistently unfavourable family environment. Hence, we think sudden family environmental alterations do not cause psychorrhoea, but slow family environmental alteration may cause change in the mental state of patients. The prognosis is worse in the countryside than in the city. From the study group, we conclude that the first cure rate was 28%, and that 26% of patients were able to work. This indicates that there were no typical cases of the core pattern of schizophrenia, and that there was a certain potential for recovery. In the future, the emphasis of prevention and treatment must be placed on the countryside, and attention should be paid to the improvement of living and working conditions there, to the correct administration of patients, and to the improvement of recovery measures and therapy. We advocate that efforts should be made in the countryside to raise the national educational and cultural level.

Sex-specific factors for bone density in patients with schizophrenia.

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Lin, Chieh-Hsin; Lin, Chun-Yuan; Huang, Tiao-Lai; Wang, Hong-Song; Chang, Yue-Cune; Lane, Hsien-Yuan

2015-03-01

Patients with schizophrenia are susceptible to low bone mineral density (BMD). Many risk factors have been suggested. However, it remains uncertain whether the risk factors differ between men and women. In addition, the study of bone density in men is neglected more often than that in women. This study aims to examine specific risk factors of low BMD in different sexes. Men (n=80) and women (n=115) with schizophrenia, similar in demographic and clinical characteristics, were enrolled in three centers. Clinical and laboratory variables (including blood levels of prolactin, sex and thyroid hormones, cortisol, calcium, and alkaline phosphatase) were collected. BMD was measured using a dual-energy X-ray absorptiometer. Men had lower BMD than women. Predictors for BMD in men included hyperprolactinemia (B=-0.821, P=0.009), body weight (B=0.024, P=0.046), and Global Assessment of Functioning score (B=0.027, P=0.043); in women, BMD was associated with menopause (B=-1.070, Pweight (B=0.027, P=0.003), and positive symptoms (B=0.094, Ploss in patients with schizophrenia. Physicians should pay particular attention to bone density in men with hyperprolactinemia and postmenopausal women. Further prospective studies in other populations are warranted to confirm these findings.

The DLGAP family

DEFF Research Database (Denmark)

Rasmussen, Andreas H; Rasmussen, Hanne B; Silahtaroglu, Asli

2017-01-01

downstream signalling in the neuron. The postsynaptic density, a highly specialized matrix, which is attached to the postsynaptic membrane, controls this downstream signalling. The postsynaptic density also resets the synapse after each synaptic firing. It is composed of numerous proteins including a family...... in the postsynapse, the DLGAP family seems to play a vital role in synaptic scaling by regulating the turnover of both ionotropic and metabotropic glutamate receptors in response to synaptic activity. DLGAP family has been directly linked to a variety of psychological and neurological disorders. In this review we...... focus on the direct and indirect role of DLGAP family on schizophrenia as well as other brain diseases....

[Family interventions in schizophrenia. From theory to the real world in Portugal today].

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Gonçalves-Pereira, Manuel; Xavier, Miguel; Neves, António; Barahona-Correa, Bernardo; Fadden, Gráinne

2006-01-01

In the field of pychoeducational interventions in schizophrenia, terminology is sometimes misleading and further efforts are needed to specify and operationalise terms such as psychoeducation or family intervention, especially wherever they are adapted, for example, for use in non-English speaking countries. On the other hand, in spite of growing evidence of their clinical effectiveness, family interventions for schizophrenia are still not routinely implemented in real life clinical settings. Furthermore, the current poverty of original literature or replication studies in Portugal in the field of family interventions is astonishing. Several high-quality review papers have been published in the last two decades, summarising or meta-analysing data concerning efficacy, effectiveness and efficiency of these family interventions worldwide, but mostly in Anglo-Saxon literature. These findings were indeed incorporated in several clinical guidelines, namely in the United Kingdom. But there seems to exist, in a considerable number of settings, a lack of will to implement scientific findings established for more than twenty years. In developed countries, this should be addressed as a true paradox.

Systematic chromosome examination of two families with schizophrenia and two families with manic depressive illness

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Friedrich, U.; Mors, O.; Ewald, H. [Aarhus Univ. (Denmark)

1996-02-16

Systematic and detailed chromosome analysis, combined with a semistructured interview, was performed in 2 families with schizophrenia and in 2 families with manic depressive illness. Prometaphase technique did not reveal any subtle structural chromosome abnormalities. However, in standard techniques, gain and loss of sex chromosomes were observed. This occurred in patients at a younger age than in unaffected persons. This gives rise to the suspicion that sex chromosome aneuploidy may somehow be related to the development of psychosis. But since the data set is small, especially with respect to schizophrenia, further studies are needed to elucidate this observation. In one family, cosegregation of the disease locus with a marker on chromosome 21 was seen. Therefore, further research should determine if chromosome 21 contains a gene for manic depressive illness. 10 refs., 3 figs., 2 tabs.

Schizophrenia: management and family burden | Sebit | Central ...

African Journals Online (AJOL)

Schizophrenia: management and family burden. MB Sebit. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/cajm.v53i9-12.62618 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

Comparisons of family environment between homeless and non-homeless individuals with schizophrenia in Xiangtan, Hunan.

Science.gov (United States)

Chen, Jinliang; Chen, Jindong; Li, Shuchun; Liu, Jun; Ouyang, Guohua; Luo, Wenxuan; Guo, Xiaofeng; Li, Ting; Li, Kaijie; Li, Zhenkuo; Wang, Gan

2015-06-25

Homelessness is an increasingly important problem for individuals with serious mental illness in China. Identify the characteristics of families that are associated with homelessness among individuals with schizophrenia. Participants were 1856 homeless individuals with schizophrenia (defined as those who had no place of residence or involved caregivers for 7 consecutive days) and 1728 non-homeless individuals with schizophrenia from Xiangtan, Hunan. The self-completion Family Environment Scale-Chinese Version (FES-CV) was administered to these participants after their acute psychotic symptoms resolved. Compared to individuals in the non-homeless group, those in the homeless group were older and more likely to be non-locals (i.e., from outside of Xiangtan), be residents of rural (versus urban) communities, have temporary (versus permanent) jobs, be married, and have a low level of education. After controlling for demographic differences using multivariate logistic regression models, homelessness was independently associated higher scores in the FES-CV intellectual-cultural orientation, organization, achievement orientation, and control subscales and with lower scores in the FES-CV cohesion, moralreligious emphasis, independence, and active-recreational orientation subscales. After controlling for sociodemographic factors, certain aspects of the family environment areassociated with being homeless among patients with schizophrenia in China. Further work is needed to identify interventions that can reduce the risk of homelessness in high-risk individuals.

Genome-Wide Association Study Reveals Greater Polygenic Loading for Schizophrenia in Cases With a Family History of Illness

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Bigdeli, Tim B.; Ripke, Stephan; Bacanu, Silviu-Alin; Lee, Sang Hong; Wray, Naomi R.; Gejman, Pablo V.; Rietschel, Marcella; Cichon, Sven; St Clair, David; Corvin, Aiden; Kirov, George; McQuillin, Andrew; Gurling, Hugh; Rujescu, Dan; Andreassen, Ole A.; Werge, Thomas; Blackwood, Douglas H.R.; Pato, Carlos N.; Pato, Michele T.; Malhotra, Anil K.; O’Donovan, Michael C.; Kendler, Kenneth S.; Fanous, Ayman H.

2018-01-01

Genome-wide association studies (GWAS) of schizophrenia have yielded more than 100 common susceptibility variants, and strongly support a substantial polygenic contribution of a large number of small allelic effects. It has been hypothesized that familial schizophrenia is largely a consequence of inherited rather than environmental factors. We investigated the extent to which familiality of schizophrenia is associated with enrichment for common risk variants detectable in a large GWAS. We analyzed single nucleotide polymorphism (SNP) data for cases reporting a family history of psychotic illness (N = 978), cases reporting no such family history (N = 4,503), and unscreened controls (N = 8,285) from the Psychiatric Genomics Consortium (PGC1) study of schizophrenia. We used a multinomial logistic regression approach with model-fitting to detect allelic effects specific to either family history subgroup. We also considered a polygenic model, in which we tested whether family history positive subjects carried more schizophrenia risk alleles than family history negative subjects, on average. Several individual SNPs attained suggestive but not genome-wide significant association with either family history subgroup. Comparison of genome-wide polygenic risk scores based on GWAS summary statistics indicated a significant enrichment for SNP effects among family history positive compared to family history negative cases (Nagelkerke’s R2 = 0.0021; P = 0.00331; P-value threshold history positive compared to family history negative cases (0.32 and 0.22, respectively; P = 0.031).We found suggestive evidence of allelic effects detectable in large GWAS of schizophrenia that might be specific to particular family history subgroups. However, consideration of a polygenic risk score indicated a significant enrichment among family history positive cases for common allelic effects. Familial illness might, therefore, represent a more heritable form of schizophrenia, as suggested by

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

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Rachael G. Grazioplene

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

Review: Burden on Family Caregivers Caring for Patients with Schizophrenia and Its Related Factors

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Imas Rafiyah

2011-01-01

Full Text Available Background: Family caregiver is the most important person who cares for patient with schizophrenia. However when care is provided for long time, he/she may experiences the burden.Purpose: The purpose was to review concept and factors related to burden on family caregivers caring for patients with schizophrenia.Method: A literatures were searched from databases: Pubmed, CINAHL, and Science Direct. Key words used to retrieve literature include caregiver burden and schizophrenia. Searching was limited in English language, full text, and the year of publication from 2000 to 2009 was used.Results: Twenty two studies were reviewed in this paper. The result showed that the caregivers caring for patients with schizophrenia experience burden. Burden was defined as a negative impact of caring for the impaired person experienced by caregiver on their activity (objective burden or feeling (subjective burden that involves emotional, physical health, social life, and financial status. Factors related to burden on family caregiver were grouped into: 1 caregiver‟s factors included age, gender, educational level, income, health status, and spent time per day, knowledge of schizophrenia, culture, and coping; 2 patient‟s factors included age, clinical symptoms, and disability in daily life; 3 environmental factors included mental health service and social support.Conclusion: Definition of burden have quite same meaning and mostly factors focus on the patient‟s symptoms, demographic factors of caregiver, and time spent per day. Most of studies cannot be generalized due to small sample used in the study and that too conducted in western countries. For further research, the correlation between burden and resources of family caregiver should be investigated particularly in eastern country.Key words: burden on family caregiver, caring, schizophrenia.

Auditory working memory impairments in individuals at familial high risk for schizophrenia.

Science.gov (United States)

Seidman, Larry J; Meyer, Eric C; Giuliano, Anthony J; Breiter, Hans C; Goldstein, Jill M; Kremen, William S; Thermenos, Heidi W; Toomey, Rosemary; Stone, William S; Tsuang, Ming T; Faraone, Stephen V

2012-05-01

The search for predictors of schizophrenia has accelerated with a growing focus on early intervention and prevention of psychotic illness. Studying nonpsychotic relatives of individuals with schizophrenia enables identification of markers of vulnerability for the illness independent of confounds associated with psychosis. The goal of these studies was to develop new auditory continuous performance tests (ACPTs) and evaluate their effects in individuals with schizophrenia and their relatives. We carried out two studies of auditory vigilance with tasks involving working memory (WM) and interference control with increasing levels of cognitive load to discern the information-processing vulnerabilities in a sample of schizophrenia patients, and two samples of nonpsychotic relatives of individuals with schizophrenia and controls. Study 1 assessed adults (mean age = 41), and Study 2 assessed teenagers and young adults age 13-25 (M = 19). Patients with schizophrenia were impaired on all five versions of the ACPTs, whereas relatives were impaired only on WM tasks, particularly the two interference tasks that maximize cognitive load. Across all groups, the interference tasks were more difficult to perform than the other tasks. Schizophrenia patients performed worse than relatives, who performed worse than controls. For patients, the effect sizes were large (Cohen's d = 1.5), whereas for relatives they were moderate (d = ~0.40-0.50). There was no age by group interaction in the relatives-control comparison except for participants schizophrenia.

Depressive disorders and family functioning among the caregivers of patients with schizophrenia.

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Osman, C B; Alipah, B; Tutiiryani, M D; Ainsah, O

2010-09-01

To determine the prevalence of depressive disorders among caregivers of patients with schizophrenia, its association with patient's and caregiver's socio-demographic characteristics and family functioning. This was a cross-sectional study of caregivers of patients with schizophrenia at the outpatient clinic, Hospital Permai Johor Bahru, Malaysia. The study was conducted between August and October 2008. A total of 243 caregivers who fulfilled the inclusion criteria were enrolled, of whom 232 completed the self-administered socio-demographic questionnaire, the General Health Questionnaire (GHQ-30) and the McMaster Family Assessment Device. A total of 33 caregivers with the GHQ-30 cut-off point of 7/8 were assessed further by the Mini International Neuropsychiatric Interview to diagnose depressive disorder. The prevalence of psychological distress in our study sample was 14% (n = 33) and that of depressive disorders was 6% (n = 14). There was no association between patients' and caregivers' socio-demographic characteristics with depressive disorders, but there were significant associations between depressive disorders and family functioning dimensions in terms of Communication and Roles. Although the causal link was not established, the results suggested that depression had a significant association with family functioning among caregivers of patients with schizophrenia.

Genetic vulnerability and premature death in schizophrenia spectrum disorders: a 28-year follow-up of adoptees in the Finnish Adoptive Family Study of Schizophrenia.

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Hakko, Helinä; Wahlberg, Karl-Erik; Tienari, Pekka; Räsänen, Sami

2011-09-01

Excess mortality is widely reported among schizophrenia patients, but rarely examined in adoption study settings. We investigated whether genetic background plays a role in the premature death of adoptees with schizophrenia. Mortality among 382 adoptees in the Finnish Adoptive Family Study of Schizophrenia was monitored from 1977 to 2005 through the national causes-of-death register. The sample covered 190 adoptees with a high genetic risk of schizophrenia (HR) and 192 with a low risk (LR). Overall mortality among the adoptees did not differ between the HR and LR groups, as 10% and 9% respectively had died during the follow-up, at mean ages of 45 and 46 years. Schizophrenia spectrum disorder was the most significant predictor of premature death in both groups, with dysfunction in the rearing family environment associated with mortality, unnatural deaths and suicides in the HR but not in the LR group. All the suicides involved HR cases. Mortality among the adoptees was not related to genetic factors but to environmental ones. The association of unnatural deaths and suicides with dysfunction in the rearing environment among the HR adoptees may indicate that they had a greater genetically determined vulnerability to environmental effects than their LR counterparts. The genetic and rearing environments can be disentangled in this setting because the biological parents give the offspring their genes and the adoptive parents give them their rearing environment. Our findings add to knowledge of the factors associated with the premature death of adoptees in mid-life.

The association between intelligence scores and family history of psychiatric disorder in schizophrenia patients, their siblings and healthy controls

NARCIS (Netherlands)

Verweij, Kim H. W.; Derks, Eske M.; Kahn, René S.; Linszen, Don; van Os, Jim; Wiersma, Durk; Bruggeman, Richard; Cahn, Wiepke; de Haan, Lieuwe; Krabbendam, Lydia; Myin-Germeys, Inez

2013-01-01

The degree of intellectual impairment in schizophrenia patients and their relatives has been suggested to be associated with the degree of familial loading for schizophrenia. Since other psychiatric disorders are also more present in relatives of schizophrenia patients, the definition of family

The relationship between default mode network connectivity and social functioning in individuals at familial high-risk for schizophrenia.

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Dodell-Feder, David; Delisi, Lynn E; Hooker, Christine I

2014-06-01

Unaffected first-degree relatives of individuals with schizophrenia (i.e., those at familial high-risk [FHR]), demonstrate social dysfunction qualitatively similar though less severe than that of their affected relatives. These social difficulties may be the consequence of genetically conferred disruption to aspects of the default mode network (DMN), such as the dMPFC subsystem, which overlaps with the network of brain regions recruited during social cognitive processes. In the present study, we investigate this possibility, testing DMN connectivity and its relationship to social functioning in FHR using resting-state fMRI. Twenty FHR individuals and 17 controls underwent fMRI during a resting-state scan. Hypothesis-driven functional connectivity analyses examined ROI-to-ROI correlations between the DMN's hubs, and regions of the dMPFC subsystem and MTL subsystem. Connectivity values were examined in relationship to a measure of social functioning and empathy/perspective-taking. Results demonstrate that FHR exhibit reduced connectivity specifically within the dMPFC subsystem of the DMN. Certain ROI-to-ROI correlations predicted aspects of social functioning and empathy/perspective-taking across all participants. Together, the data indicate that disruption to the dMPFC subsystem of the DMN may be associated with familial risk for schizophrenia, and that these intrinsic connections may carry measurable consequences for social functioning. Copyright © 2014 Elsevier B.V. All rights reserved.

The Therapeutic Alliance and Family Psychoeducation in the Treatment of Schizophrenia: An Exploratory Prospective Change Process Study

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Smerud, Phyllis E.; Rosenfarb, Irwin S.

2008-01-01

Although family psychoeducation has been shown to be highly efficacious in the treatment of schizophrenia, the mechanisms underlying the treatment's success are poorly understood. The therapeutic alliance in behavioral family management (BFM) was examined to determine whether the alliance plays a role in the efficacy of this treatment. One early…

Perception of family emotional climate by family members of persons with schizophrenia.

Science.gov (United States)

Gandhi, Sailaxmi; Pavalur, Rajitha; Thirthalli, Jagadisha; Phillip, Mariamma

2016-08-01

There is a dearth of instruments to assess schizophrenia persons' Family Emotional Climate (FEC). This study aims to explore the relation between family members' personality traits and FEC. We invited a convenience sample of 50 both gender family members who were accompanying the person with schizophrenia for out-patient department (OPD) consultation to provide data on a socio-demographic proforma and the researcher prepared 'Emotional climate assessment questionnaire - caregivers' version' (ECAQ-C) as well as the Eysenck personality questionnaire. Caregivers' extroversion traits (r = .427, p = .002) were positively correlated and neuroticism traits were negatively correlated (r = -.330, p = .019) with their positive perception of FEC. There was a higher perception of positive FEC (mean scores = 65.5 ± 10.5) while caregivers seemed to perceive less negative FEC (mean scores = 36.5 ± 10.2). Caregivers with education above 11th std perceived less (χ(2) = 8.6, p = .013) of negative FEC. The findings highlight that caregivers' personality traits seem to influence the FEC. While caregivers' perception of FEC is positive in this study, those in the higher education group seem to have a better perception of FEC indicating that education also may influence FEC. © The Author(s) 2016.

Expressed emotion, communication deviance, and culture in families of patients with schizophrenia: a review of the literature.

Science.gov (United States)

Kymalainen, Jennifer A; Weisman de Mamani, Amy G

2008-04-01

The aim of this article is to critically review the literature on expressed emotion (EE), communication deviance (CD), and culture in families of patients with schizophrenia. There is growing evidence that EE and CD are highly linked. Yet the two constructs together predict the development of schizophrenia and the associated symptoms better than either construct alone. In this article, the authors review data indicating that both the expression and the levels of high EE and CD vary by ethnicity. It may be especially difficult for family members to communicate coherently and in a less critical manner when focusing on patients' inability to sustain particular cultural norms and values that are endorsed by their family and ethnic background. The authors propose that more attention to the role of culture in EE and CD and greater focus on the proper assessment of these variables would further enhance our understanding of these constructs.

[Evoked potentials N200/P300 disorders and clinical phenotype in Cuban families with paranoid schizophrenia: a family-based association study].

Science.gov (United States)

Guerra López, Seidel; Martín Reyes, Migdyrai; Pedroso Rodríguez, María de Los Ángeles; Reyes Berazain, Adnelys; Mendoza Quiñones, Raúl; Bravo Collazo, Tania Martha; Días de Villarvilla, Thais; Machado Cano, María Julia; Bobés León, María Antonieta

2015-04-01

N200 and P300 event-related evoked potentials provide sensitive measurements of sensory and cognitive function and have been used to study information processing in patients with schizophrenia and their unaffected first-degree relatives. Reduced amplitude and increased latency of N200 and P300 potentials have been consistently reported in schizophrenia. Thus, event-related evoked potentials abnormalities are promising possible biological markers for genetic vulnerability to schizophrenia. To assess the association of changes in latency, amplitude and topographic distribution of potentials N200 and P300 of patients with paranoid schizophrenia and their healthy first-degree relatives, in families with schizophrenia multiplex. We measured latency and amplitude of the N200 and P300 component of evoked potentials using an auditory odd-ball paradigm in 25 schizophrenic patients (probands) from 60 families multiply affected with paranoid schizophrenia, 23 of their non-schizophrenic first-degree relatives and 25 unrelated healthy controls, through a study of family association. Schizophrenic patients and their relatives showed significant latency prolongation and amplitude reduction of the N200 and P300 waves compared to controls. Left-temporal as compared to right-temporal N200 and P300 were significantly smaller in schizophrenic patients and their non-schizophrenic first-degree relatives than in controls. Our results suggest that event-related evoked potentials abnormalities may serve as markers of genetic vulnerability in schizophrenia. Confirming results of other researchers, this present study suggests that latency prolongation and amplitude reduction of the N200 and P300 waves and an altered topography at temporal sites may be a trait “marker” of paranoid schizophrenia.

Violence Towards Family Caregivers by Their Relative with Schizophrenia in Japan.

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Kageyama, Masako; Solomon, Phyllis; Yokoyama, Keiko; Nakamura, Yukako; Kobayashi, Sayaka; Fujii, Chiyo

2018-06-01

There have been several violence-related deaths in Japan due to family violence by persons with severe mental illness against their caregivers. However, it is not often acknowledged that these violent acts are mainly directed at family members. This study aimed to clarify what acts of violence family caregivers experienced from their relative with schizophrenia, and how frequently these violent incidents occurred in their lifetime. We also examined caregivers' thoughts of death about themselves and their relatives, as well as their consultation efforts and escape from the violence perpetrated by their relative. Of the 277 caregivers, 87.7% had experienced psychological violence and 75.8% had experienced physical violence perpetrated by their relative. Of 210 caregivers who had experienced physical violence, 26.7% had thought of murder-suicide and 31.0% had wished for their relative's death. Family violence by persons with schizophrenia is not rare but a common occurrence in Japan and may have fatal consequences.

Beliefs about causation of schizophrenia: do Indian families believe in supernatural causes?

Science.gov (United States)

Srinivasan, T N; Thara, R

2001-03-01

Beliefs about the causation of schizophrenia could influence the attitudes patients' families adopt towards the patient and may also influence their help-seeking behaviour. Indian families have been typically described as often believing in causes like supernatural forces and therefore seeking help from magico-religious healers. In the changing mental health scenario in India, this impression needs verification. Key relatives living with 254 chronic schizophrenia patients were interviewed and asked to name the causes they believed were behind the illness. A list of possible causes was provided for the families to select from, and relatives were also encouraged to mention other possible causes, not featured in the list. The possible causes identified and the factors related to attributions made were analysed. A supernatural cause was named by only 12% of the families and as the only cause by 5%. Psychosocial stress was most commonly cited cause, followed by personality defect and heredity. A small number of families (14%) could not name any cause and 39% named more than one cause. Patient gender and education, duration of illness and the key relative's education and the nature of relationship were related to the type of causal attributions made. Families living with patients suffering chronic schizophrenia receiving treatment in urban India rarely subscribe to the idea of supernatural causation of the illness. The causal attributions made by them are fairly rational and understandable, given the relative lack of exposure to proper information about the illness.

Family Interventions for Schizophrenia and the Psychoses: A Review.

Science.gov (United States)

McFarlane, William R

2016-09-01

Family psychoeducation as a treatment for schizophrenia was developed 40 years ago almost simultaneously and independently by investigators who at the time were not family therapists. Although the original goal was to decrease high expressed emotion as a means of preventing relapse, later variations have gone beyond to focus on social and role functioning and family well-being. Explicitly disavowing the earlier assumptions that family pathology caused relapse and deterioration, family psychoeducation seeks to engage family members as more sophisticated partners, complementing interventions by clinicians with specialized interactions and coping skills that counter the neurologic deficits inherent to the disorder. It has proved to be one of the most consistently effective treatments available. Reports on outcome studies now number more than 100, while meta-analyses put relapse rate reduction at 50-60% over treatment as usual. The most recent application in first episode and prodromal psychosis, combined with other evidence-based interventions, is yielding perhaps the most promising results yet achieved-substantial return of functioning and avoidance of psychosis altogether. Reviewed here are its scientific, theoretical, and clinical sources, a description of the most commonly applied version-the multifamily group format, selected clinical trials spanning those four decades, international and ethnic adaptations, and studies on mechanisms of efficacy. © 2016 Family Process Institute.

Increased density of DISC1-immunoreactive oligodendroglial cells in fronto-parietal white matter of patients with paranoid schizophrenia.

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Bernstein, Hans-Gert; Jauch, Esther; Dobrowolny, Henrik; Mawrin, Christian; Steiner, Johann; Bogerts, Bernhard

2016-09-01

Profound white matter abnormalities have repeatedly been described in schizophrenia, which involve the altered expression of numerous oligodendrocyte-associated genes. Transcripts of the disrupted-in-schizophrenia 1 (DISC1) gene, a key susceptibility factor in schizophrenia, have recently been shown to be expressed by oligodendroglial cells and to negatively regulate oligodendrocyte differentiation and maturation. To learn more about the putative role(s) of oligodendroglia-associated DISC1 in schizophrenia, we analyzed the density of DISC1-immunoreactive oligodendrocytes in the fronto-parietal white matter in postmortem brains of patients with schizophrenia. Compared with controls (N = 12) and cases with undifferentiated/residual schizophrenia (N = 6), there was a significantly increased density of DISC1-expressing glial cells in paranoid schizophrenia (N = 12), which unlikely resulted from neuroleptic treatment. Pathophysiologically, over-expression of DISC1 protein(s) in white matter oligodendrocytes might add to the reduced levels of two myelin markers, 2',3'-cyclic-nucleotide 3'-phosphodiesterase and myelin basic protein in schizophrenia. Moreover, it might significantly contribute to cell cycle abnormalities as well as to deficits in oligodendroglial cell differentiation and maturation found in schizophrenia.

The Management of Schizophrenia in Family Practice

OpenAIRE

Pell, Bryan A.

1984-01-01

While the pattern of treatment for schizophrenia varies from province to province, in the past 20 years there has been a general shift away from treatment in psychiatric hospitals to general hospital psychiatric units. The emphasis is on a shorter hospital stay, and greater use of community resources on discharge. Family physicians are therefore more likely to see their schizophrenic patients soon after an admission or readmission to hospital and will be more directly involved in their on goi...

Genetics of Cognitive Endophenotypes in Schizophrenia : a Family-Based Study

NARCIS (Netherlands)

Aukes, M.F.

2009-01-01

Schizophrenia is a highly heritable, though complex disease; multiple genes and environmental factors influence its development. Most of these genes have small effects on schizophrenia. Therefore, the localization and identification of genes for schizophrenia has been difficult. An alternative

Living with schizophrenia: Health-related quality of life among primary family caregivers.

Science.gov (United States)

Hsiao, Chiu-Yueh; Lee, Chun-Te; Lu, Huei-Lan; Tsai, Yun-Fang

2017-12-01

To examine influencing factors of health-related quality of life in primary family caregivers of people with schizophrenia receiving inpatient psychiatric rehabilitation services. Families, particularly primary family caregivers, have become more important than ever in mental health care. Yet, research on health-related quality of life among primarily family caregivers is limited. A correlational study design was used. A convenience sample of 122 primary family caregivers participated in the study. Data were analysed with descriptive statistics, Pearson's product-moment correlation, t test, one-way analysis of variance and a hierarchical multiple regression analysis. Primary family caregivers who were parents, older, less educated, and had a lower monthly household income, increased affiliate stigma and decreased quality of family-centred care experienced poor health-related quality of life. Particularly, monthly household income, affiliate stigma and quality of family-centred care appeared to be the most critical determinants of health-related quality of life. Efforts to enhance satisfaction of life should focus on reducing affiliate stigma as well as increasing monthly household income and strengthening the quality of family-centred care. Findings may assist in the development of culturally integrated rehabilitation programmes to decrease affiliate stigma and increase family engagement as a means of promoting quality of life for primary family caregivers living with people who have schizophrenia. © 2017 John Wiley & Sons Ltd.

Family interventions in schizophrenia: Issues of relevance for Asian countries.

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Chakrabarti, Subho

2011-12-31

A growing body of research evidence has confirmed the efficacy of family-interventions as adjuncts to antipsychotics for the treatment of schizophrenia. Much of the recent evidence for such interventions derives from Asian, principally Chinese, studies. These trials have shown that relatively simple forms of family-interventions have wide ranging benefits, and can be implemented successfully in routine clinical settings. With the accumulation of this evidence in their favour, family-interventions for schizophrenia in Asia are poised to take the next critical step, that of wider implementation and improved accessibility for potential users. However, several issues merit consideration. Family-interventions need to be based on a culturally-informed theory, which incorporates cultural variables of relevance in these countries. While the ideal format for conducting family-interventions is still to be determined, it is quite evident that for such interventions to be useful they need to be simple, inexpensive, needs-based, and tailored to suit the socio-cultural realities of mental health systems in Asian countries. The evidence also suggests that delivery by non-specialist personnel is the best way to ensure that such services reach those who stand to benefit most from these treatments. However, there are several existing challenges to the process of dissemination of family-interventions. The major challenges include the achievement of a critical mass of trained professionals capable of delivering these interventions, and finding innovative solutions to make family-interventions more acceptable to families. If these hurdles are overcome, we could look forward to a genuine collaboration with families, who have always been the mainstay of care for the mentally ill in Asia.

Genome-wide association study reveals greater polygenic loading for schizophrenia in cases with a family history of illness

DEFF Research Database (Denmark)

Bigdeli, Tim B.; Ripke, Stephan; Bacanu, Silviu-Alin

2016-01-01

Genome-wide association studies (GWAS) of schizophrenia have yielded more than 100 common susceptibility variants, and strongly support a substantial polygenic contribution of a large number of small allelic effects. It has been hypothesized that familial schizophrenia is largely a consequence...... of inherited rather than environmental factors. We investigated the extent to which familiality of schizophrenia is associated with enrichment for common risk variants detectable in a large GWAS. We analyzed single nucleotide polymorphism (SNP) data for cases reporting a family history of psychotic illness (N...... history subgroup. Comparison of genome-wide polygenic risk scores based on GWAS summary statistics indicated a significant enrichment for SNP effects among family history positive compared to family history negative cases (Nagelkerke's R2=0.0021; P=0.00331; P-value threshold

Effect of systemic family therapy on rehabilitation in patients with schizophrenia

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Wei Zhang

2016-12-01

Full Text Available Objective: To explore the effect of systemic family therapy on the rehabilitation in patients with schizophrenia. Methods: A total of 86 patients with schizophrenia who were admitted in our hospital from February, 2011 to February, 2014 were included in the study and randomized into the observation group and the control group. A total of 43 healthy individuals for physical examinations were served as the healthy group. The patients in the control group were given risperidone in a single dose, and telephone follow-up. On this basis, the patients in the observation group were given systemic family therapy. The morning fasting venous blood before treatment and 3 months after treatment in the healthy group and patients with schizophrenia was collected. BDNF, NGF, GFAP, IL-6, and TNF-α were detected. After 6-month treatment, SCL-90 was used to evaluate the psychological state. Results: The serum BDNF and NGF levels before and after treatment in the observation group and the control group were significantly lower than those in the healthy group, while GFAP level was significantly higher than that in the healthy group (P0.05. The serum IL-6 and TNF-α levels before and after treatment in the observation group and the control group were significantly higher than those in the healthy group (P0.05. After 6-month treatment, the scores of somatization, interpersonal relationship, fear, anxiety, hostility, paranoid, depression, obsession, and mental disorder in the observation group were significantly reduced when compared with before treatment (P0.05. Conclusions: The systemic family therapy is an effective adjuvant method for the rehabilitation in patients with schizophrenia, and can effectively improve the mental health status; therefore, it deserves to be widely recommended in the clinic.

Effect of systemic family therapy on rehabilitation in patients with schizophrenia

Institute of Scientific and Technical Information of China (English)

Wei Zhang; Na Li; Ying-Ting Li; Shu-Qing Dong; Li-Mei Feng

2016-01-01

Objective:To explore the effect of systemic family therapy on the rehabilitation in patients with schizophrenia.Methods: A total of 86 patients with schizophrenia who were admitted in our hospital from February, 2011 to February, 2014 were included in the study and randomized into the observation group and the control group. A total of 43 healthy individuals for physical examinations were served as the healthy group. The patients in the control group were given risperidone in a single dose, and telephone follow-up. On this basis, the patients in the observation group were given systemic family therapy. The morning fasting venous blood before treatment and 3 months after treatment in the healthy group and patients with schizophrenia was collected. BDNF, NGF, GFAP, IL-6, and TNF-α were detected. After 6-month treatment, SCL-90 was used to evaluate the psychological state.Results: The serum BDNF and NGF levels before and after treatment in the observation group and the control group were significantly lower than those in the healthy group, while GFAP level was significantly higher than that in the healthy group (P0.05). The serum IL-6 and TNF-α levels before and after treatment in the observation group and the control group were significantly higher than those in the healthy group (P0.05). After 6-month treatment, the scores of somatization, interpersonal relationship, fear, anxiety, hostility, paranoid, depression, obsession, and mental disorder in the observation group were significantly reduced when compared with before treatment (P0.05).Conclusions:The systemic family therapy is an effective adjuvant method for the rehabilitation in patients with schizophrenia, and can effectively improve the mental health status; therefore, it deserves to be widely recommended in the clinic.

Heterogeneity of schizophrenia: Genetic and symptomatic factors.

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Takahashi, Sakae

2013-10-01

Schizophrenia may have etiological heterogeneity, and may reflect common symptomatology caused by many genetic and environmental factors. In this review, we show the potential existence of heterogeneity in schizophrenia based on the results of our previous studies. In our study of the NOTCH4 gene, there were no significant associations between any single nucleotide polymorphisms (SNPs) of NOTCH4 and schizophrenia. However, exploratory analyses suggested that the SNP, rs3134928 may be associated with early-onset schizophrenia, and that rs387071 may be associated with schizophrenia characterized by negative symptoms. In our highly familial schizophrenia study, the African-American cohort without environmental exposure showed a possible linkage at marker 8p23.1 in the dominant model and in the European-American cohort, a marker at 22q13.32 showed a probable linkage in the recessive model. In the less familial schizophrenia families, these linkages were not shown. Based on our eye movement study, a putative subtype of schizophrenia with severe symptoms related to excitement/hostility, negative symptoms and disorganization may be associated with chromosome 22q11. We consider that a sample stratification approach may clarify the heterogeneity of schizophrenia. Therefore, this approach may lead to a more straightforward way of identifying susceptibility genes of schizophrenia. © 2013 Wiley Periodicals, Inc.

Aberrant patterns of local and long-range functional connectivity densities in schizophrenia.

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Liu, Chuanxin; Zhang, Wei; Chen, Guangdong; Tian, Hongjun; Li, Jie; Qu, Hongru; Cheng, Langlang; Zhu, Jingjing; Zhuo, Chuanjun

2017-07-18

Schizophrenia is a disorder of brain dysconnectivity, and both the connection strength and connection number are disrupted in patients with schizophrenia. The functional connectivity density (FCD) can reflect alterations in the connection number. Alterations in the global FCD (gFCD) in schizophrenia were previously demonstrated; however, alterations in two other indices of the pathological characteristics of the brain, local FCD (lFCD) and long-range FCD (lrFCD), have not been revealed. To investigate lFCD and lrFCD alterations in patients with schizophrenia, 95 patients and 93 matched healthy controls were examined using structural and resting-state functional magnetic resonance imaging scanning. lFCD and lrFCD were measured using FCD mapping, and differences were identified using a two-sample t-test in a voxel-wise manner, with age and gender considered to increase variability. Multiple comparisons were performed using a false discovery rate method with a corrected threshold of Pschizophrenia is a disorder of brain dysconnectivity, particularly affecting the local functional connectivity network, and support the hypothesis that schizophrenia is associated with a widespread cortical functional connectivity/activity deficit, with hyper- and/or hypo-connectivity/activity coexisting in some cortical or subcortical regions.

The role of family therapy in the management of schizophrenia: challenges and solutions

Science.gov (United States)

Caqueo-Urízar, Alejandra; Rus-Calafell, Mar; Urzúa, Alfonso; Escudero, Jorge; Gutiérrez-Maldonado, José

2015-01-01

Family interventions for schizophrenia have been amply demonstrated to be effective and are recommended by most of the international clinical guidelines. However, their implementation in the clinical setting as well as in treatment protocols of patients with psychosis has not been fully achieved yet. With the increasing deinstitutionalization of patients, family has begun to assume the role of care performed by psychiatric hospitals, with a high emotional cost for caregivers as well as the recognition of burden experiences. Families have been the substitute in the face of the scarcity of therapeutic, occupational, and residential resources. For this reason, the viability of patients’ care by their families has become a challenge. This article aims to discuss the most important aspects of family interventions, their impact on families, and the most important challenges that need to be overcome in order to achieve well-being and recovery in both patients and caregivers. PMID:25609970

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

DEFF Research Database (Denmark)

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

2005-01-01

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

The role of family therapy in the management of schizophrenia: challenges and solutions

Directory of Open Access Journals (Sweden)

Caqueo-Urízar A

2015-01-01

Full Text Available Alejandra Caqueo-Urízar,1,* Mar Rus-Calafell,2,* Alfonso Urzúa,3 Jorge Escudero,1 José Gutiérrez-Maldonado4 1Departamento de Filosofía y Psicología, Universidad de Tarapacá, Arica, Chile; 2Department of Social Psychiatry, Institute of Psychiatry, King’s College London, London, UK; 3Alfonso Urzúa Morales, Escuela de Psicología, Universidad Católica del Norte, Antofagasta, Chile; 4Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universidad de Barcelona, Barcelona, Spain *These authors have contributed equally to this work Abstract: Family interventions for schizophrenia have been amply demonstrated to be effective and are recommended by most of the international clinical guidelines. However, their implementation in the clinical setting as well as in treatment protocols of patients with psychosis has not been fully achieved yet. With the increasing deinstitutionalization of patients, family has begun to assume the role of care performed by psychiatric hospitals, with a high emotional cost for caregivers as well as the recognition of burden experiences. Families have been the substitute in the face of the scarcity of therapeutic, occupational, and residential resources. For this reason, the viability of patients’ care by their families has become a challenge. This article aims to discuss the most important aspects of family interventions, their impact on families, and the most important challenges that need to be overcome in order to achieve well-being and recovery in both patients and caregivers. Keywords: family intervention, schizophrenia, caregivers, quality of life, therapy

Whole-genome sequencing of monozygotic twins discordant for schizophrenia indicates multiple genetic risk factors for schizophrenia

Institute of Scientific and Technical Information of China (English)

Jinsong Tang; Fan He; Fengyu Zhang; Yin Yao Shugart; Chunyu Liu; Yanqing Tang; Raymond C.K.Chan; Chuan-Yue Wang; Yong-Gang Yao; Xiaogang Chen; Yu Fan; Hong Li; Qun Xiang; Deng-Feng Zhang; Zongchang Li; Ying He; Yanhui Liao; Ya Wang

2017-01-01

Schizophrenia is a common disorder with a high heritability,but its genetic architecture is still elusive.We implemented whole-genome sequencing (WGS) analysis of 8 families with monozygotic (MZ) twin pairs discordant for schizophrenia to assess potential association of de novo mutations (DNMs) or inherited variants with susceptibility to schizophrenia.Eight non-synonymous DNMs (including one splicing site) were identified and shared by twins,which were either located in previously reported schizophrenia risk genes (p.V24689I mutation in TTN,p.S2506T mutation in GCN1L1,IVS3+1G ＞ T in DOCK1) or had a benign to damaging effect according to in silico prediction analysis.By searching the inherited rare damaging or loss-of-function (LOF) variants and common susceptible alleles from three classes of schizophrenia candidate genes,we were able to distill genetic alterations in several schizophrenia risk genes,including GAD1,PLXNA2,RELN and FEZ1.Four inherited copy number variations (CNVs;including a large deletion at 16p13.11) implicated for schizophrenia were identified in four families,respectively.Most of families carried both missense DNMs and inherited risk variants,which might suggest that DNMs,inherited rare damaging variants and common risk alleles together conferred to schizophrenia susceptibility.Our results support that schizophrenia is caused by a combination of multiple genetic factors,with each DNM/variant showing a relatively small effect size.

Effectiveness of family work interventions on schizophrenia: evidence from a multicentre study in Catalonia.

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Tomás, Esther Pousa; Hurtado, Gemma; Noguer, Sílvia; Domènech, Cristina; García, Montse; López, Nuria; Negredo, Maríacruz; Penadés, Rafael; Reinares, María; Serrano, Dolors; Dolz, Montse; Gallo, Pedro

2012-11-01

Despite their proven efficacy, family work interventions on families of patients with schizophrenia are not being implemented in routine clinical practice in contexts where expressed emotion levels among caregivers are relatively high. This study aimed to explore the effectiveness of a family work intervention in a Mediterranean environment in Catalonia, Spain. Participants were 23 patients and 35 key relatives in five different clinical settings. The family intervention was provided by 10 trained health care professionals during a nine-month period. A six-month follow-up was also conducted. Statistically significant improvements were found in patients' clinical status, global functioning and social functioning levels, as well as in caregivers' burden of care. These results were maintained during follow-up. This is the first study to explore the effectiveness of family intervention in a high-expressed emotion context in Catalonia. The findings add weight to the growing literature supporting these interventions in different cultural settings.

Exome sequences of multiplex, multigenerational families reveal schizophrenia risk loci with potential implications for neurocognitive performance.

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Kos, Mark Z; Carless, Melanie A; Peralta, Juan; Curran, Joanne E; Quillen, Ellen E; Almeida, Marcio; Blackburn, August; Blondell, Lucy; Roalf, David R; Pogue-Geile, Michael F; Gur, Ruben C; Göring, Harald H H; Nimgaonkar, Vishwajit L; Gur, Raquel E; Almasy, Laura

2017-12-01

Schizophrenia is a serious mental illness, involving disruptions in thought and behavior, with a worldwide prevalence of about one percent. Although highly heritable, much of the genetic liability of schizophrenia is yet to be explained. We searched for susceptibility loci in multiplex, multigenerational families affected by schizophrenia, targeting protein-altering variation with in silico predicted functional effects. Exome sequencing was performed on 136 samples from eight European-American families, including 23 individuals diagnosed with schizophrenia or schizoaffective disorder. In total, 11,878 non-synonymous variants from 6,396 genes were tested for their association with schizophrenia spectrum disorders. Pathway enrichment analyses were conducted on gene-based test results, protein-protein interaction (PPI) networks, and epistatic effects. Using a significance threshold of FDR < 0.1, association was detected for rs10941112 (p = 2.1 × 10 -5 ; q-value = 0.073) in AMACR, a gene involved in fatty acid metabolism and previously implicated in schizophrenia, with significant cis effects on gene expression (p = 5.5 × 10 -4 ), including brain tissue data from the Genotype-Tissue Expression project (minimum p = 6.0 × 10 -5 ). A second SNP, rs10378 located in TMEM176A, also shows risk effects in the exome data (p = 2.8 × 10 -5 ; q-value = 0.073). PPIs among our top gene-based association results (p < 0.05; n = 359 genes) reveal significant enrichment of genes involved in NCAM-mediated neurite outgrowth (p = 3.0 × 10 -5 ), while exome-wide SNP-SNP interaction effects for rs10941112 and rs10378 indicate a potential role for kinase-mediated signaling involved in memory and learning. In conclusion, these association results implicate AMACR and TMEM176A in schizophrenia risk, whose effects may be modulated by genes involved in synaptic plasticity and neurocognitive performance. © 2017 Wiley Periodicals, Inc.

The association between intelligence scores and family history of psychiatric disorder in schizophrenia patients, their siblings and healthy controls

NARCIS (Netherlands)

Verweij, K.; Derks, E.M.; Bruggeman, R.; Cahn, W.; de Haan, L.; Kahn, R.; Krabbendam, L.; Linzen, D.; Myin-Germeys, I.; van Os, J.; Wiersma, D.

2013-01-01

Background:The degree of intellectual impairment in schizophrenia patients and their relatives has been suggested to be associated with the degree of familial loading for schizophrenia. Since other psychiatric disorders are also more present in relatives of schizophrenia patients, the definition of

Modelling the contribution of family history and variation in single nucleotide polymorphisms to risk of schizophrenia

DEFF Research Database (Denmark)

Agerbo, Esben; Mortensen, Preben Bo; Wiuf, Carsten

2012-01-01

Epidemiological studies indicate that having any family member with schizophrenia increases the risk of schizophrenia in the probands. However, genome-wide association studies (GWAS) have accounted for little of this variation. The aim of this study was to use a population-based sample to explore...

Grey matter volume patterns in thalamic nuclei are associated with familial risk for schizophrenia.

Science.gov (United States)

Pergola, Giulio; Trizio, Silvestro; Di Carlo, Pasquale; Taurisano, Paolo; Mancini, Marina; Amoroso, Nicola; Nettis, Maria Antonietta; Andriola, Ileana; Caforio, Grazia; Popolizio, Teresa; Rampino, Antonio; Di Giorgio, Annabella; Bertolino, Alessandro; Blasi, Giuseppe

2017-02-01

Previous evidence suggests reduced thalamic grey matter volume (GMV) in patients with schizophrenia (SCZ). However, it is not considered an intermediate phenotype for schizophrenia, possibly because previous studies did not assess the contribution of individual thalamic nuclei and employed univariate statistics. Here, we hypothesized that multivariate statistics would reveal an association of GMV in different thalamic nuclei with familial risk for schizophrenia. We also hypothesized that accounting for the heterogeneity of thalamic GMV in healthy controls would improve the detection of subjects at familial risk for the disorder. We acquired MRI scans for 96 clinically stable SCZ, 55 non-affected siblings of patients with schizophrenia (SIB), and 249 HC. The thalamus was parceled into seven regions of interest (ROIs). After a canonical univariate analysis, we used GMV estimates of thalamic ROIs, together with total thalamic GMV and premorbid intelligence, as features in Random Forests to classify HC, SIB, and SCZ. Then, we computed a Misclassification Index for each individual and tested the improvement in SIB detection after excluding a subsample of HC misclassified as patients. Random Forests discriminated SCZ from HC (accuracy=81%) and SIB from HC (accuracy=75%). Left anteromedial thalamic volumes were significantly associated with both multivariate classifications (p<0.05). Excluding HC misclassified as SCZ improved greatly HC vs. SIB classification (Cohen's d=1.39). These findings suggest that multivariate statistics identify a familial background associated with thalamic GMV reduction in SCZ. They also suggest the relevance of inter-individual variability of GMV patterns for the discrimination of individuals at familial risk for the disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

Whole-genome sequencing of monozygotic twins discordant for schizophrenia indicates multiple genetic risk factors for schizophrenia.

Science.gov (United States)

Tang, Jinsong; Fan, Yu; Li, Hong; Xiang, Qun; Zhang, Deng-Feng; Li, Zongchang; He, Ying; Liao, Yanhui; Wang, Ya; He, Fan; Zhang, Fengyu; Shugart, Yin Yao; Liu, Chunyu; Tang, Yanqing; Chan, Raymond C K; Wang, Chuan-Yue; Yao, Yong-Gang; Chen, Xiaogang

2017-06-20

Schizophrenia is a common disorder with a high heritability, but its genetic architecture is still elusive. We implemented whole-genome sequencing (WGS) analysis of 8 families with monozygotic (MZ) twin pairs discordant for schizophrenia to assess potential association of de novo mutations (DNMs) or inherited variants with susceptibility to schizophrenia. Eight non-synonymous DNMs (including one splicing site) were identified and shared by twins, which were either located in previously reported schizophrenia risk genes (p.V24689I mutation in TTN, p.S2506T mutation in GCN1L1, IVS3+1G > T in DOCK1) or had a benign to damaging effect according to in silico prediction analysis. By searching the inherited rare damaging or loss-of-function (LOF) variants and common susceptible alleles from three classes of schizophrenia candidate genes, we were able to distill genetic alterations in several schizophrenia risk genes, including GAD1, PLXNA2, RELN and FEZ1. Four inherited copy number variations (CNVs; including a large deletion at 16p13.11) implicated for schizophrenia were identified in four families, respectively. Most of families carried both missense DNMs and inherited risk variants, which might suggest that DNMs, inherited rare damaging variants and common risk alleles together conferred to schizophrenia susceptibility. Our results support that schizophrenia is caused by a combination of multiple genetic factors, with each DNM/variant showing a relatively small effect size. Copyright © 2017 Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, and Genetics Society of China. All rights reserved.

Association of familial risk for schizophrenia with thalamic and medial prefrontal functional connectivity during attentional control.

Science.gov (United States)

Antonucci, Linda A; Taurisano, Paolo; Fazio, Leonardo; Gelao, Barbara; Romano, Raffaella; Quarto, Tiziana; Porcelli, Annamaria; Mancini, Marina; Di Giorgio, Annabella; Caforio, Grazia; Pergola, Giulio; Popolizio, Teresa; Bertolino, Alessandro; Blasi, Giuseppe

2016-05-01

Anomalies in behavioral correlates of attentional processing and related brain activity are crucial correlates of schizophrenia and associated with familial risk for this brain disorder. However, it is not clear how brain functional connectivity during attentional processes is key for schizophrenia and linked with trait vs. state related variables. To address this issue, we investigated patterns of functional connections during attentional control in healthy siblings of patients with schizophrenia, who share with probands genetic features but not variables related to the state of the disorder. 356 controls, 55 patients with schizophrenia on stable treatment with antipsychotics and 40 healthy siblings of patients with this brain disorder underwent the Variable Attentional Control (VAC) task during fMRI. Independent Component Analysis (ICA) is allowed to identify independent components (IC) of BOLD signal recorded during task performance. Results indicated reduced connectivity strength in patients with schizophrenia as well as in their healthy siblings in left thalamus within an attentional control component and greater connectivity in right medial prefrontal cortex (PFC) within the so-called Default Mode Network (DMN) compared to healthy individuals. These results suggest a relationship between familial risk for schizophrenia and brain functional networks during attentional control, such that this biological phenotype may be considered a useful intermediate phenotype in order to link genes effects to aspects of the pathophysiology of this brain disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

STUDY OF SUICIDE ATTEMPTS IN SCHIZOPHRENIA

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Jagadeesan Madras Sundararajan

2016-07-01

Full Text Available BACKGROUND Schizophrenia is a major mental illness whose sufferers have been found to have lesser longevity than general population. The most common cause for premature death in schizophrenia is suicide. There are very few Indian studies on suicide in persons suffering from schizophrenia. OBJECTIVES The objectives were to study the frequency of suicide attempt in schizophrenia to compare and study the clinical and sociodemographic profile of suicide attempters and non-attempters in schizophrenia and to analyse and study the various risk factors of suicide attempts in persons suffering from schizophrenia. METHODS A sample of 100 consecutive patients attending review OPD of a government tertiary care hospital in Chennai were selected. Those who had a diagnosis of schizophrenia were screened for past suicide attempts. They were divided into two groups as suicide attempters and non-attempters and analysed using the SAPS (Scale for Assessment of Positive Symptoms, SANS (Scale for Assessment of Negative Symptoms, Calgary depression scale, and Beck’s suicide intent scale. RESULTS People suffering from schizophrenia are at a high risk for making suicidal attempts (27% especially when the illness is acute and severe in early stages when accompanied by depressive symptoms. Demographic profile such as age, sex, education, occupation, socio-economic status, marital status, and family type were not significantly related to suicide attempts. Family history of suicide was a significant factor in patients with suicide attempts. Majority of the attempts were of medium-to-high intent, hanging being the commonest method, and were attributed to most commonly delusions and depressive symptoms.

High Risk for Schizophrenia from Conception to Young Adulthood.

Science.gov (United States)

King, Suzanne

1990-01-01

Summarizes and critiques Asarnow's 1988 review of 24 longitudinal studies identifying environmental factors and individual vulnerability important to development of schizophrenia. Found Asarnow's analysis well conducted but summary should have addressed longitudinal research design. Concludes that identifiable behavior and family interaction…

31P-MR spectroscopy in children and adolescents with a familial risk of schizophrenia

International Nuclear Information System (INIS)

Rzanny, R.; Reichenbach, J.R.; Pfleiderer, S.O.R.; Kaiser, W.A.; Klemm, S.; Blanz, B.; Schmidt, B.; Volz, H.-P.

2003-01-01

Based on a previous report [9] on alterations of membrane phosphorus metabolism in asymptomatic family members of schizophrenic patients, the aim of the present study was to extend and improve the evaluation and data processing of 31 P spectroscopic data obtained from a larger study population by including an analysis of the broad spectral component (BC) of membrane phospholipids (PL). Eighteen children and siblings of patients with schizophrenia and a gender- and age-matched control group of 18 healthy subjects without familial schizophrenia were investigated with phosphorus magnetic resonance spectroscopy ( 31 P-MRS) by using image selected in vivo spectroscopy (ISIS) in the dorsolateral prefrontal regions (DLPFR) of the brain. Spectral analysis was performed by using both the full and truncated FID to estimate metabolic peak ratios of different 31 P metabolites and the intensity and linewidth of the broad component. A significantly higher PDE level (p 31 P-metabolites. No differences were observed between the left and right hemispheres for different normalised 31 P-metabolic levels. Decreased intensities (p=0.03) and smaller linewidths (p=0.01) were obtained for the broad component in the high-risk group. Impairments of membrane metabolism that are typical for schizophrenic patients are partially observed in adolescent asymptomatic family members of schizophrenics, including increased levels of low molecular PDE compounds indicating increased membrane degradation processes, no changes for PME, and decreased intensities and linewidths of the BC indicating changes in the composition and fluidity of membrane phospholipids. Despite limitations to completely suppress fast-relaxing components by dismissing initial FID data points, the spectroscopic results indicate additional changes in the membrane metabolism of high-risk subjects beyond changes of synthesis and degradation. (orig.)

Rate of Family Violence Among Patients With Schizophrenia in Japan.

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

2015-09-01

Family violence is a serious concern in the era of deinstitutionalization in Japan. Consequently, we aimed to clarify the rate of family violence among patients with schizophrenia, and differences by sex and relationship to the patient. We asked households belonging to a family group association to complete a self-administered mail survey. Of 350 households that responded, data for 302 were analyzed. The rate of violence toward any family member was 60.9% over the lifetime and 27.2% in the past year. Order of lifetime rates for family members from highest to lowest was 51.0% for mothers, 47.0% for fathers, 30.7% for younger sisters, 23.8% for spouses, 19.5% for younger brothers, 18.2% for older sisters, 17.1% for older brothers, and none for children. Younger sisters were more likely to be victims compared to other siblings. Fathers and older brothers were likely to be victims when patients were male. © 2015 APJPH.

Population impact of familial and environmental risk factors for schizophrenia: a nationwide study.

Science.gov (United States)

Sørensen, Holger J; Nielsen, Philip R; Pedersen, Carsten B; Benros, Michael E; Nordentoft, Merete; Mortensen, Preben B

2014-03-01

Although several studies have examined the relative contributions of familial and environmental risk factors for schizophrenia, few have additionally examined the predictive power on the individual level and simultaneously examined the population impact associated with a wide range of familial and environmental risk factors. The authors present rate ratios (IRR), population-attributable risks (PAR) and sex-specific cumulative incidences of the following risk factors: parental history of mental illness, urban place of birth, advanced paternal age, parental loss and immigration status. We established a population-based cohort of 2,486,646million persons born in Denmark between 1 January 1955 and 31 December 1993 using Danish registers. We found that PAR associated with urban birth was 11.73%; PAR associated with one, respectively 2, parent(s) with schizophrenia was 2.67% and 0.12%. PAR associated with second-generation immigration was 0.70%. Highest cumulative incidence (CI=20.23%; 95% CI=18.10-22.62) was found in male offspring of 2 parents with schizophrenia. Cumulative incidences for male offspring or female offspring of a parent with schizophrenia were 9.53% (95% CI=7.71-11.79), and 4.89%, (95% CI 4.50-5.31). The study showed that risk factors with highest predictive power on the individual level have a relatively low population impact. The challenge in future studies with direct genetic data is to examine gene-environmental interactions that can move research beyond current approaches and seek to achieve higher predictive power on the individual level and higher population impact. Copyright © 2014 Elsevier B.V. All rights reserved.

Neurocognitive performance in family-based and case-control studies of schizophrenia

Science.gov (United States)

Gur, Ruben C.; Braff, David L.; Calkins, Monica E.; Dobie, Dorcas J.; Freedman, Robert; Green, Michael F.; Greenwood, Tiffany A.; Lazzeroni, Laura C.; Light, Gregory A.; Nuechterlein, Keith H.; Olincy, Ann; Radant, Allen D.; Seidman, Larry J.; Siever, Larry J.; Silverman, Jeremy M.; Sprock, Joyce; Stone, William S.; Sugar, Catherine A.; Swerdlow, Neal R.; Tsuang, Debby W.; Tsuang, Ming T.; Turetsky, Bruce I.; Gur, Raquel E.

2014-01-01

Background Neurocognitive deficits in schizophrenia (SZ) are established and the Consortium on the Genetics of Schizophrenia (COGS) investigated such measures as endophenotypes in family-based (COGS-1) and case-control (COGS-2) studies. By requiring family participation, family-based sampling may result in samples that vary demographically and perform better on neurocognitive measures. Methods The Penn computerized neurocognitive battery (CNB) evaluates accuracy and speed of performance for several domains and was administered across sites in COGS-1 and COGS-2. Most tests were included in both studies. COGS-1 included 328 patients with SZ and 497 healthy comparison subjects (HCS) and COGS-2 included 1195 patients and 1009 HCS. Results Demographically, COGS-1 participants were younger, more educated, with more educated parents and higher estimated IQ compared to COGS-2 participants. After controlling for demographics, the two samples produced very similar performance profiles compared to their respective controls. As expected, performance was better and with smaller effect sizes compared to controls in COGS-1 relative to COGS-2. Better performance was most pronounced for spatial processing while emotion identification had large effect sizes for both accuracy and speed in both samples. Performance was positively correlated with functioning and negatively with negative and positive symptoms in both samples, but correlations were attenuated in COGS-2, especially with positive symptoms. Conclusions Patients ascertained through family-based design have more favorable demographics and better performance on some neurocognitive domains. Thus, studies that use case-control ascertainment may tap into populations with more severe forms of illness that are exposed to less favorable factors compared to those ascertained with family-based designs. PMID:25432636

Neurocognitive performance in family-based and case-control studies of schizophrenia.

Science.gov (United States)

Gur, Ruben C; Braff, David L; Calkins, Monica E; Dobie, Dorcas J; Freedman, Robert; Green, Michael F; Greenwood, Tiffany A; Lazzeroni, Laura C; Light, Gregory A; Nuechterlein, Keith H; Olincy, Ann; Radant, Allen D; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Sprock, Joyce; Stone, William S; Sugar, Catherine A; Swerdlow, Neal R; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Gur, Raquel E

2015-04-01

Neurocognitive deficits in schizophrenia (SZ) are established and the Consortium on the Genetics of Schizophrenia (COGS) investigated such measures as endophenotypes in family-based (COGS-1) and case-control (COGS-2) studies. By requiring family participation, family-based sampling may result in samples that vary demographically and perform better on neurocognitive measures. The Penn computerized neurocognitive battery (CNB) evaluates accuracy and speed of performance for several domains and was administered across sites in COGS-1 and COGS-2. Most tests were included in both studies. COGS-1 included 328 patients with SZ and 497 healthy comparison subjects (HCS) and COGS-2 included 1195 patients and 1009 HCS. Demographically, COGS-1 participants were younger, more educated, with more educated parents and higher estimated IQ compared to COGS-2 participants. After controlling for demographics, the two samples produced very similar performance profiles compared to their respective controls. As expected, performance was better and with smaller effect sizes compared to controls in COGS-1 relative to COGS-2. Better performance was most pronounced for spatial processing while emotion identification had large effect sizes for both accuracy and speed in both samples. Performance was positively correlated with functioning and negatively with negative and positive symptoms in both samples, but correlations were attenuated in COGS-2, especially with positive symptoms. Patients ascertained through family-based design have more favorable demographics and better performance on some neurocognitive domains. Thus, studies that use case-control ascertainment may tap into populations with more severe forms of illness that are exposed to less favorable factors compared to those ascertained with family-based designs.

Impairments of motor function among children with a familial risk of schizophrenia or bipolar disorder at 7 years old in Denmark

DEFF Research Database (Denmark)

Burton, Birgitte Klee; Thorup, Anne A. E.; Jepsen, Jens Richardt

2017-01-01

BACKGROUND: Owing to the genetic overlap between schizophrenia and bipolar disorder, we aimed to assess domain-specific motor aberrations and disorder specificity among 7-year-old children with a familial risk of schizophrenia or bipolar disorder by comparing children in familial risk groups...... with each other and with children not in these risk groups. METHODS: In the Danish High Risk and Resilience Study, we established a cohort of 7-year-old children with no, one, or two parents with schizophrenia or bipolar disorder in Denmark between Jan 1, 2013, and Jan 31, 2016. We matched children......·19]; p=0·18). Children of parents with bipolar disorder did not show any significant difference in motor performance to children of parents without in the subdomains of manual dexterity (-0·69 [-1·44 to 0·07]; p=0·08), balance (-0·68 [-1·44 to 0·08]; p=0·08), and aiming and catching (-0·36 [-1·03 to 0...

Psychosis among "healthy" siblings of schizophrenia patients

Directory of Open Access Journals (Sweden)

Partonen Timo

2006-01-01

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

Comparison of the heritability of schizophrenia and endophenotypes in the COGS-1 family study.

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Light, Gregory; Greenwood, Tiffany A; Swerdlow, Neal R; Calkins, Monica E; Freedman, Robert; Green, Michael F; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Nuechterlein, Keith H; Olincy, Ann; Radant, Allen D; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Sprock, Joyce; Stone, William S; Sugar, Catherine A; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Braff, David L

2014-11-01

Twin and multiplex family studies have established significant heritability for schizophrenia (SZ), often summarized as 81%. The Consortium on the Genetics of Schizophrenia (COGS-1) family study was designed to deconstruct the genetic architecture of SZ using neurocognitive and neurophysiological endophenotypes, for which heritability estimates ranged from 18% to 50% (mean = 30%). This study assessed the heritability of SZ in these families to determine whether there is a "heritability gap" between the diagnosis and related endophenotypes. Nuclear families (N = 296) with a SZ proband, an unaffected sibling, and both parents (n = 1366 subjects; mean family size = 4.6) underwent comprehensive endophenotype and clinical characterization. The Family Interview for Genetic Studies was administered to all participants and used to obtain convergent psychiatric symptom information for additional first-degree relatives of interviewed subjects (N = 3304 subjects; mean family size = 11.2). Heritability estimates of psychotic disorders were computed for both nuclear and extended families. The heritability of SZ was 31% and 44% for nuclear and extended families. The inclusion of bipolar disorder increased the heritability to 37% for the nuclear families. When major depression was added, heritability estimates dropped to 34% and 20% for nuclear and extended families, respectively. Endophenotypes and psychotic disorders exhibit comparable levels of heritability in the COGS-1 family sample. The ascertainment of families with discordant sibpairs to increase endophenotypic contrast may underestimate diagnostic heritability relative to other studies. However, population-based studies also report significantly lower heritability estimates for SZ. Collectively, these findings support the importance of endophenotype-based strategies and the dimensional view of psychosis. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2014.

High levels of vitamin D in relation to reduced risk of schizophrenia with elevated C-reactive protein.

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Zhu, Dao-min; Liu, Yong; Zhang, Ai-guo; Chu, Zhao-xue; Wu, Qing; Li, Hui; Ge, Jin-fang; Dong, Yi; Zhu, Peng

2015-08-30

There is growing evidence on the novel role of vitamin D in reducing inflammation. This study aimed to examine the hypothesis that vitamin D is inversely associated with C-reactive protein (CRP) in patients with schizophrenia, and high levels of vitamin D may be linked to reduced risk of schizophrenia with elevated CRP. Ninety-three patients with schizophrenia and 93 family-matched controls were recruited in this cross-sectional study. Plasma concentrations of CRP and 25-hydroxyvitamin D [25(OH)D] were measured using commercial kits. Information about demographic characteristics and clinic data were obtained by interviews or medical records. Mean levels of CRP and 25(OH)D were 43.3% higher and 26.7% lower for patients compared to controls, respectively. 25(OH)D were inversely associated with CRP in the patients, but not in the controls. The proportions of patients significantly increased with increasing quartiles of CRP, while significantly decreased with increasing quartiles of 25(OH)D. Among individuals with high CRP, participants with high 25(OH)D have significantly lower proportion (adjusted OR =0.217, 95% CI 0.063, 0.751) of schizophrenia compared to those with low 25(OH)D. The evidence suggested that high levels of vitamin D may be linked to reduced risk of schizophrenia with elevated CRP. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Polygenic Risk Score, Parental Socioeconomic Status, Family History of Psychiatric Disorders, and the Risk for Schizophrenia: A Danish Population-Based Study and Meta-analysis.

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Agerbo, Esben; Sullivan, Patrick F; Vilhjálmsson, Bjarni J; Pedersen, Carsten B; Mors, Ole; Børglum, Anders D; Hougaard, David M; Hollegaard, Mads V; Meier, Sandra; Mattheisen, Manuel; Ripke, Stephan; Wray, Naomi R; Mortensen, Preben B

2015-07-01

Schizophrenia has a complex etiology influenced both by genetic and nongenetic factors but disentangling these factors is difficult. To estimate (1) how strongly the risk for schizophrenia relates to the mutual effect of the polygenic risk score, parental socioeconomic status, and family history of psychiatric disorders; (2) the fraction of cases that could be prevented if no one was exposed to these factors; (3) whether family background interacts with an individual's genetic liability so that specific subgroups are particularly risk prone; and (4) to what extent a proband's genetic makeup mediates the risk associated with familial background. We conducted a nested case-control study based on Danish population-based registers. The study consisted of 866 patients diagnosed as having schizophrenia between January 1, 1994, and December 31, 2006, and 871 matched control individuals. Genome-wide data and family psychiatric and socioeconomic background information were obtained from neonatal biobanks and national registers. Results from a separate meta-analysis (34,600 cases and 45,968 control individuals) were applied to calculate polygenic risk scores. Polygenic risk scores, parental socioeconomic status, and family psychiatric history. Odds ratios (ORs), attributable risks, liability R2 values, and proportions mediated. Schizophrenia was associated with the polygenic risk score (OR, 8.01; 95% CI, 4.53-14.16 for highest vs lowest decile), socioeconomic status (OR, 8.10; 95% CI, 3.24-20.3 for 6 vs no exposures), and a history of schizophrenia/psychoses (OR, 4.18; 95% CI, 2.57-6.79). The R2 values were 3.4% (95% CI, 2.1-4.6) for the polygenic risk score, 3.1% (95% CI, 1.9-4.3) for parental socioeconomic status, and 3.4% (95% CI, 2.1-4.6) for family history. Socioeconomic status and psychiatric history accounted for 45.8% (95% CI, 36.1-55.5) and 25.8% (95% CI, 21.2-30.5) of cases, respectively. There was an interaction between the polygenic risk score and family history

Income inequality and schizophrenia: increased schizophrenia incidence in countries with high levels of income inequality.

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Burns, Jonathan K; Tomita, Andrew; Kapadia, Amy S

2014-03-01

Income inequality is associated with numerous negative health outcomes. There is evidence that ecological-level socio-environmental factors may increase risk for schizophrenia. The aim was to investigate whether measures of income inequality are associated with incidence of schizophrenia at the country level. We conducted a systematic review of incidence rates for schizophrenia, reported between 1975 and 2011. For each country, national measures of income inequality (Gini coefficient) along with covariate risk factors for schizophrenia were obtained. Multi-level mixed-effects Poisson regression was performed to investigate the relationship between Gini coefficients and incidence rates of schizophrenia controlling for covariates. One hundred and seven incidence rates (from 26 countries) were included. Mean incidence of schizophrenia was 18.50 per 100,000 (SD = 11.9; range = 1.7-67). There was a significant positive relationship between incidence rate of schizophrenia and Gini coefficient (β = 1.02; Z = 2.28; p = .02; 95% CI = 1.00, 1.03). Countries characterized by a large rich-poor gap may be at increased risk of schizophrenia. We suggest that income inequality impacts negatively on social cohesion, eroding social capital, and that chronic stress associated with living in highly disparate societies places individuals at risk of schizophrenia.

Family caregiver burden in mental illnesses: The case of affective disorders and schizophrenia - a qualitative exploratory study.

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von Kardorff, Ernst; Soltaninejad, Ali; Kamali, Mohammad; Eslami Shahrbabaki, Mahin

2016-01-01

Caregivers of people with mental illnesses often experience a wide range of burdens. Although many studies have confirmed burdens among family caregivers of mentally ill relatives in general, specific knowledge regarding the concrete everyday hassle and existential sorrows from the caregiverś subjective reasoning perspective is lacking. Furthermore, there is little evidence on the possible different effects of affective disorders and schizophrenia on the quality of burden; this is also true with regard to the role of cultural traditions and lay beliefs. The aim of this study was to explore the specific burdens experienced by caregivers of patients with schizophrenia and affective disorders. A qualitative study was conducted by semi-structured interviews with 45 caregivers of patients with schizophrenia and affective disorders. Data were analysed by qualitative content analysis. Eleven encumbering themes resulted from the interviews including incertitude, unawareness, emotional burden, stigma and blame, financial burden, physical burden, restriction in routine, disruption in routine, dissatisfaction with family, relatives, and acquaintances, troubles with patients' adherence to medication, and problems with health services and governmental support. Caring for a person with mental illness affects caregivers emotionally, financially, physically, and it elicits some restrictions in their routine (daily hassles). Finally, it causes conflicts in family relationships. Despite some differences regarding perceived burden among caregivers of schizophrenia and affective disorders, a common pattern of burden could be identified. Thus, authorities should provide adequate financial, educational, and psychosocial supports for caregivers of mental illnesses.

Developmental Patterns of Doublecortin Expression and White Matter Neuron Density in the Postnatal Primate Prefrontal Cortex and Schizophrenia

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Fung, Samantha J.; Joshi, Dipesh; Allen, Katherine M.; Sivagnanasundaram, Sinthuja; Rothmond, Debora A.; Saunders, Richard; Noble, Pamela L.; Webster, Maree J.; Shannon Weickert, Cynthia

2011-01-01

Postnatal neurogenesis occurs in the subventricular zone and dentate gyrus, and evidence suggests that new neurons may be present in additional regions of the mature primate brain, including the prefrontal cortex (PFC). Addition of new neurons to the PFC implies local generation of neurons or migration from areas such as the subventricular zone. We examined the putative contribution of new, migrating neurons to postnatal cortical development by determining the density of neurons in white matter subjacent to the cortex and measuring expression of doublecortin (DCX), a microtubule-associated protein involved in neuronal migration, in humans and rhesus macaques. We found a striking decline in DCX expression (human and macaque) and density of white matter neurons (humans) during infancy, consistent with the arrival of new neurons in the early postnatal cortex. Considering the expansion of the brain during this time, the decline in white matter neuron density does not necessarily indicate reduced total numbers of white matter neurons in early postnatal life. Furthermore, numerous cells in the white matter and deep grey matter were positive for the migration-associated glycoprotein polysialiated-neuronal cell adhesion molecule and GAD65/67, suggesting that immature migrating neurons in the adult may be GABAergic. We also examined DCX mRNA in the PFC of adult schizophrenia patients (n = 37) and matched controls (n = 37) and did not find any difference in DCX mRNA expression. However, we report a negative correlation between DCX mRNA expression and white matter neuron density in adult schizophrenia patients, in contrast to a positive correlation in human development where DCX mRNA and white matter neuron density are higher earlier in life. Accumulation of neurons in the white matter in schizophrenia would be congruent with a negative correlation between DCX mRNA and white matter neuron density and support the hypothesis of a migration deficit in schizophrenia. PMID

Developmental patterns of doublecortin expression and white matter neuron density in the postnatal primate prefrontal cortex and schizophrenia.

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Samantha J Fung

Full Text Available Postnatal neurogenesis occurs in the subventricular zone and dentate gyrus, and evidence suggests that new neurons may be present in additional regions of the mature primate brain, including the prefrontal cortex (PFC. Addition of new neurons to the PFC implies local generation of neurons or migration from areas such as the subventricular zone. We examined the putative contribution of new, migrating neurons to postnatal cortical development by determining the density of neurons in white matter subjacent to the cortex and measuring expression of doublecortin (DCX, a microtubule-associated protein involved in neuronal migration, in humans and rhesus macaques. We found a striking decline in DCX expression (human and macaque and density of white matter neurons (humans during infancy, consistent with the arrival of new neurons in the early postnatal cortex. Considering the expansion of the brain during this time, the decline in white matter neuron density does not necessarily indicate reduced total numbers of white matter neurons in early postnatal life. Furthermore, numerous cells in the white matter and deep grey matter were positive for the migration-associated glycoprotein polysialiated-neuronal cell adhesion molecule and GAD65/67, suggesting that immature migrating neurons in the adult may be GABAergic. We also examined DCX mRNA in the PFC of adult schizophrenia patients (n = 37 and matched controls (n = 37 and did not find any difference in DCX mRNA expression. However, we report a negative correlation between DCX mRNA expression and white matter neuron density in adult schizophrenia patients, in contrast to a positive correlation in human development where DCX mRNA and white matter neuron density are higher earlier in life. Accumulation of neurons in the white matter in schizophrenia would be congruent with a negative correlation between DCX mRNA and white matter neuron density and support the hypothesis of a migration deficit in

Family Burden and Social Support in Mental Illness: A Comparative Study in Schizophrenia and Mood Disorders

OpenAIRE

JOSY KADAVIL THOMAS

2018-01-01

The present study was an attempt to assess and compare the global functioning of individuals affected with two major mental illnesses i.e. schizophrenia and mood disorders , social support perceived by them, and family burden and social support perceived by their caregivers. The individuals affected with schizophrenia were found to be more severely ill with a longer duration of illness, and perceived less social support as compared to those with mood disorders. The caregivers’ perceived socia...

Stability in MMPI among adoptees with high and low genetic risk for schizophrenia and with low Communication Deviance of their adoptive parents.

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Siira, Virva; Wahlberg, Karl-Erik; Hakko, Helinä; Tienari, Pekka

2013-11-30

Stability has been considered an important aspect of vulnerability to schizophrenia. The temporal stability of the scales in the Minnesota Multiphasic Personality Inventory (MMPI) was examined, using adoptees from the Finnish Adoptive Family Study of Schizophrenia. Adoptees who were high-risk (HR) offspring of biological mothers having a schizophrenia spectrum disorder (n=28) and low-risk (LR) controls (n=46) were evaluated using 15 MMPI scales at the initial assessment (HR, mean age 24 years; LR, mean age 23 years) and at the follow-up assessment after a mean interval of 11 years. Stability of the MMPI scales was also assessed in the groups of adoptees, assigned according to the adoptive parents'(n=44) communication style using Communication Deviance (CD) scale as an environmental factor. Initial Lie, Frequency, Correction, Psychopathic Deviate, Schizophrenia, Manifest Hostility, Hypomania, Phobias, Psychoticism, Religious Fundamentalism, Social Maladjustment, Paranoid Schizophrenia, Golden-Meehl Indicators, Schizophrenia Proneness and 8-6 scale scores significantly predicted the MMPI scores at the follow-up assessment indicating stability in the characteristics of thinking, affective expression, social relatedness and volition. Low CD in the family had an effect on the stabilization of personality traits such as social withdrawal and restricted affectivity assessed by Correction and Hostility. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Schizophrenia masquerading as Dissociative Identity Disorder

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Jegan Yogaratnam; Rajesh Jacob

2012-01-01

Dissociative symptoms can dominate the clinical picture in many psychiatric conditions and possess a huge challenge to the clinicians in management. We present a case report of a female with a strong family history of schizophrenia who initially presented with features suggestive of dissociative identity disorder, which is itself a rare clinical entity, was later diagnosed to have schizophrenia. Authors would like to emphasise that clinicians should have a high index of suspicion for schizoph...

Are the cause(s) responsible for urban-rural differences in schizophrenia risk rooted in families or individuals?

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Pedersen, Carsten Bøcker; Mortensen, Preben Bo

2006-01-01

Many studies have identified urban-rural differences in schizophrenia risk. Hypothetical underlying cause(s) may include toxic exposures, diet, infections, and selective migration. The authors investigated whether the underlying cause(s) responsible for the urban-rural differences were rooted...... evaluated whether the nearest older sibling's place of birth had an independent effect on schizophrenia risk. If the cause(s) responsible for the urban-rural differences are rooted in individuals only, the nearest older sibling's place of birth should have no independent effect. In this analysis....... Some of the cause(s) responsible for the urban-rural differences in schizophrenia risk are rooted in families, but some might also be rooted in individuals....

Contextual barriers to discussing a schizophrenia diagnosis with patients and families: need for leadership and teamwork training in psychiatry.

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Outram, Sue; Harris, Gillian; Kelly, Brian; Cohen, Martin; Bylund, Carma L; Landa, Yulia; Levin, Tomer T; Sandhu, Harsimrat; Vamos, Marina; Loughland, Carmel

2015-04-01

This research sought to gain insight into the processes used by clinicians to discuss a schizophrenia diagnosis with patients/families, with the aim of informing the development of a communications skills training program. A generic qualitative methodological approach was used. Sixteen mental health clinicians were recruited. Semi-structured individual interviews were used to explore their perceptions and experiences communicating a schizophrenia diagnosis. Interviews were recorded, transcribed, and thematic analysis undertaken. There were five key themes relating to the process of communication about a diagnosis of schizophrenia: (1) orientation to patient care, (2) planning of communication, (3) the impact of team leadership and inter/intra-professional functioning on communication tasks, (4) the roles of different clinicians in communicating about diagnosis and treatment, and (5) time and resource deficiencies. Despite expressing care and concern for vulnerable patients and embracing the concept of multidisciplinary teams, communicating diagnostic information to patients and families was generally unplanned for, with little consistency regarding leadership approaches, or how the team communicated diagnostic information to the patient and family. This contributed to tensions between different team members. The findings demonstrated a number of issues compromising good communication around a schizophrenia diagnosis, both in terms of clinician skill and clinical context, and support the importance of education and training for all members of the multidisciplinary team about their role in the communication process.

Concerns about Genetic Testing for Schizophrenia among Young Adults at Clinical High Risk for Psychosis.

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Lawrence, Ryan E; Friesen, Phoebe; Brucato, Gary; Girgis, Ragy R; Dixon, Lisa

Genetic tests for schizophrenia may introduce risks and benefits. Among young adults at clinical high-risk for psychosis, little is known about their concerns and how they assess potential risks. We conducted semi-structured interviews with 15 young adults at clinical high-risk for psychosis to ask about their concerns. Participants expressed concerns about test reliability, data interpretation, stigma, psychological harm, family planning, and privacy. Participants' responses showed some departure from the ethics literature insofar as participants were primarily interested in reporting their results to people to whom they felt emotionally close, and expressed little consideration of biological closeness. Additionally, if tests showed an increased genetic risk for schizophrenia, four clinical high-risk persons felt obligated to tell an employer and another three would "maybe" tell an employer, even in the absence of clinical symptoms. These findings suggest opportunities for clinicians and genetic counselors to intervene with education and support.

Population impact of familial and environmental risk factors for schizophrenia

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Sørensen, Holger J; Nielsen, Philip R; Pedersen, Carsten B

2014-01-01

Although several studies have examined the relative contributions of familial and environmental risk factors for schizophrenia, few have additionally examined the predictive power on the individual level and simultaneously examined the population impact associated with a wide range of familial...... 4.50-5.31). The study showed that risk factors with highest predictive power on the individual level have a relatively low population impact. The challenge in future studies with direct genetic data is to examine gene-environmental interactions that can move research beyond current approaches...... and environmental risk factors. The authors present rate ratios (IRR), population-attributable risks (PAR) and sex-specific cumulative incidences of the following risk factors: parental history of mental illness, urban place of birth, advanced paternal age, parental loss and immigration status. We established...

A comparison of symptoms and family history in schizophrenia with and without prior cannabis use: implications for the concept of cannabis psychosis.

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Boydell, J; Dean, K; Dutta, R; Giouroukou, E; Fearon, P; Murray, R

2007-07-01

There is considerable interest in cannabis use in psychosis. It has been suggested that the chronic psychosis associated with cannabis use, is symptomatically distinct from idiopathic schizophrenia. Several studies have reported differences in psychopathology and family history in people with schizophrenia according to whether or not they were cannabis users. We set out to test the hypotheses arising from these studies that cannabis use is associated with more bizarre behaviour, more thought disorder, fewer negative symptoms including blunted affect, more delusions of reference, more paranoid delusions and a stronger family history of schizophrenia. We used a case register that contained 757 cases of first onset schizophrenia, 182 (24%) of whom had used cannabis in the year prior to first presentation, 552 (73%) had not and 3% had missing data. We completed the OPCRIT checklist on all patients and investigated differences in the proportion of people with distractibility, bizarre behaviour, positive formal thought disorder, delusions of reference, well organised delusions, any first rank symptom, persecutory delusions, abusive/accusatory hallucinations, blunted affect, negative thought disorder, any negative symptoms (catatonia, blunted affect, negative thought disorder, or deterioration), lack of insight, suicidal ideation and a positive family history of schizophrenia, using chi square tests. Logistic regression modelling was then used to determine whether prior cannabis use affected the presence of the characteristics after controlling for age, sex and ethnicity. There was no statistically significant effect of cannabis use on the presence of any of the above. There remained however a non-significant trend towards more insight (OR 0.65 p=0.055 for "loss of insight") and a finding of fewer abusive or accusatory hallucinations (OR 0.65 p=0.049) of borderline significance amongst the cannabis users. These were in the hypothesised direction. There was no evidence of

[Psychoeducation in schizophrenia].

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Zapata Ospina, Juan Pablo; Rangel Martínez-Villalba, Andrés Mauricio; García Valencia, Jenny

2015-01-01

The treatment of schizophrenia includes the use of psychotropic drugs, psychotherapy, and psychosocial interventions that include psychoeducation. This strategy has been defined as the delivery of information about the disorder and its treatment in a systematic and structured way. To review the literature on the efficacy of psychoeducation in schizophrenia. A search in PubMed, SciELO, EMBASE and PsycINFO was made with the terms "psychoeducation", "schizophrenia" and "psychosocial intervention". Articles in Spanish and English language were reviewed. Psychoeducation can be applied to patients, family or both, and individually or in groups. The number of sessions can vary. There have been many studies that seek to determine the efficacy of psychoeducation in the clinical course, family dynamics and stigma, with results that favor its implementation, but so far it has not been possible to determine exactly how best to apply psychoeducation, mainly because of the great variability of designs. The studies on psychoeducation have shown efficacy. However, this might be an overestimation, as there is a high risk of bias. Consequently, there is not enough evidence. At least for now, it is reasonable to complement pharmacotherapy with psycoeducation. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

{sup 31}P-MR spectroscopy in children and adolescents with a familial risk of schizophrenia

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Rzanny, R.; Reichenbach, J.R.; Pfleiderer, S.O.R.; Kaiser, W.A. [Institut fuer Diagnostische und Interventionelle Radiologie, Abteilung MT, Klinikum der Friedrich-Schiller-Universitaet Jena, Philosophenweg 3, 07741 Jena (Germany); Klemm, S.; Blanz, B. [Klinik fuer Kinder- und Jugendpsychiatrie, Klinikum der Friedrich-Schiller-Universitaet Jena, Bachstrasse 18, 07741 Jena (Germany); Schmidt, B.; Volz, H.-P. [Klinik fuer Psychiatrie, Klinikum der Friedrich-Schiller-Universitaet Jena, Bachstrasse 18, 07741 Jena (Germany)

2003-04-01

Based on a previous report [9] on alterations of membrane phosphorus metabolism in asymptomatic family members of schizophrenic patients, the aim of the present study was to extend and improve the evaluation and data processing of {sup 31}P spectroscopic data obtained from a larger study population by including an analysis of the broad spectral component (BC) of membrane phospholipids (PL). Eighteen children and siblings of patients with schizophrenia and a gender- and age-matched control group of 18 healthy subjects without familial schizophrenia were investigated with phosphorus magnetic resonance spectroscopy ({sup 31}P-MRS) by using image selected in vivo spectroscopy (ISIS) in the dorsolateral prefrontal regions (DLPFR) of the brain. Spectral analysis was performed by using both the full and truncated FID to estimate metabolic peak ratios of different {sup 31}P metabolites and the intensity and linewidth of the broad component. A significantly higher PDE level (p<0.01) and increased linewidth of the PDE components were observed for the high-risk group compared with the control group (p=0.02). No significant differences were observed for PME as well as for other {sup 31}P-metabolites. No differences were observed between the left and right hemispheres for different normalised {sup 31}P-metabolic levels. Decreased intensities (p=0.03) and smaller linewidths (p=0.01) were obtained for the broad component in the high-risk group. Impairments of membrane metabolism that are typical for schizophrenic patients are partially observed in adolescent asymptomatic family members of schizophrenics, including increased levels of low molecular PDE compounds indicating increased membrane degradation processes, no changes for PME, and decreased intensities and linewidths of the BC indicating changes in the composition and fluidity of membrane phospholipids. Despite limitations to completely suppress fast-relaxing components by dismissing initial FID data points, the

At issue: siblings of patients with schizophrenia: sibling bond, coping patterns, and fear of possible schizophrenia heredity.

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Stålberg, Gabriella; Ekerwald, Hedvig; Hultman, Christina M

2004-01-01

Siblings of schizophrenia patients are from the patient's perspective important support providers, but most studies on family burden have focused on the parental role. This study aims to develop a detailed analysis of the psychological aspects of having a sibling with schizophrenia. We did a qualitative study with audiotaped semistructured interviews of 16 siblings. The reliability of the inductive categorization of data was high. A unifying theme appeared to be an emotional sibling bond characterized by feelings of love, sorrow, anger, envy, guilt, and shame. The major categories linked to coping with the situation were avoidance, isolation, normalization, caregiving, and grieving. A third major theme consisted of a fear of possible schizophrenia heredity. The siblings described concerns about the impact of a family history of psychiatric illness, a fear of becoming mentally ill, and reflections about "bad genes." Our findings support earlier findings of coping patterns but complement them by providing a model that includes awareness of genetic vulnerability as an important part of siblings' subjective burden.

Cultural adaptation and psychometric properties of the family questionnaire in a Brazilian sample of relatives of schizophrenia outpatients.

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Zanetti, Ana C G; Wiedemann, Georg; Dantas, Rosana A S; Hayashida, Miyeko; de Azevedo-Marques, João M; Galera, Sueli A F

2013-06-01

To evaluate the internal reliability and validity of the Brazilian Portuguese version of the Family Questionnaire among families of schizophrenia outpatients. The main studies about the family environment of schizophrenia patients are related to the concept of Expressed Emotion. There is currently no instrument to evaluate this concept in Brazil that is easily applicable and comparable with studies from other countries. Methodological and cross-sectional research design. A convenience sample of 130 relatives of schizophrenia outpatients was selected. The translation and cultural adaptation of the instrument involved experts in mental health and experts in the German language and included back translation, semantic evaluation of items and pretesting of the instrument with 30 relatives of schizophrenia outpatients. The psychometric properties of the instrument were studied with another 100 relatives, which fulfilled the requirements for the Brazilian Portuguese version of the instrument. The psychometric properties of the instrument were assessed by construct validity (using an analysis of its key components, comparisons between distinct groups-convergent validity with the Antonovsky's Sense of Coherence Scale) and reliability (checking the internal consistency of its items and its test-retest reproducibility). The analysis of main components confirmed dimensionality patterns that were comparable between the original and adapted versions. In two domains of the instrument, critical comments and emotional over-involvement had moderate and significant correlations, respectively, with Antonovsky's Sense of Coherence Scale, appropriate values of Cronbach's alpha and strong and significant correlations, respectively, in test-retest reproducibility. We observed significant differences between distinct groups of parents in the category of emotional over-involvement. We conclude that the Portuguese-adapted version of the Family Questionnaire is valid and reliable for the

Predictors of admission to a high-security hospital of people with intellectual disability with and without schizophrenia.

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Doody, G A; Thomson, L D; Miller, P; Johnstone, E C

2000-04-01

reduction in the number of admissions to high-security hospitals in the UK. In people with comorbid intellectual disability and schizophrenia, males with an early age of onset and no known family history are more likely to require care and treatment in a secure psychiatric setting. Such comorbid subjects may be suffering from a particular malignant form of schizophrenia, manifesting in childhood as cognitive impairment prior to the early onset of psychosis in teenage years.

Parental psychiatric hospitalisation and offspring schizophrenia

DEFF Research Database (Denmark)

Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

2009-01-01

The risk of schizophrenia has been linked with a family history of schizophrenia and less strongly with other psychiatric disorders in family members. Using data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Case Register, we studied the relationship between offspring risk...... of schizophrenia and a range of psychotic and non-psychotic psychiatric diagnoses in parents. Psychiatric admission data after 1969 were available for 7047 cohort members born between 1959 and 1961, and for 7006 mothers and 6993 fathers. Univariate analysis showed that neurosis, alcohol and substance dependence...... in both parents were associated with elevated risk of offspring schizophrenia; in addition, maternal schizophrenia, affective disorder and personality disorder were associated with elevated risk. Controlling for parental age, parental social status, and parental psychiatric co-diagnosis, offspring risk...

Emotion-cognition interaction in people at familial high risk for schizophrenia: the impact of sex differences.

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Phillips, Laura K; Giuliano, Anthony J; Lee, Erica H; Faraone, Stephen V; Tsuang, Ming T; Seidman, Larry J

2011-11-01

Cognitive deficits are fundamental to schizophrenia, and research suggests that negative emotion abnormally interferes with certain cognitive processes in those with the illness. To a lesser extent, cognitive impairment is found in persons at risk for schizophrenia, but there is limited research on the impact of emotion on cognitive processing in at-risk groups. It is unknown whether interference of negative emotion precedes illness and contributes to vulnerability for the disorder. We studied the extent to which negative emotional information interferes with working memory in 21 adolescent and young adult first-degree relatives of people with schizophrenia and 22 community controls. Groups were comparable in age, sex, education, ethnicity, and socioeconomic status. Primary measures were n-back tasks varying in cognitive load (1-back, 2-back, 3-back) with emotional faces (neutral, happy, fearful) as stimuli. The control group's response times (RTs) and the women's RTs, regardless of group, differed depending on the emotion condition. In contrast, the RTs of the relatives and of the men, regardless of group, did not differ by emotion. This study is the first to examine emotion-cognition interactions in relatives of individuals with schizophrenia. Reduced efficiency in processing emotional information may contribute to a greater vulnerability for schizophrenia that may be heightened in men. Additional research with larger samples of men and women is needed to test these preliminary findings.

Interleukin 1 beta gene and risk of schizophrenia: detailed case-control and family-based studies and an updated meta-analysis.

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Shibuya, Masako; Watanabe, Yuichiro; Nunokawa, Ayako; Egawa, Jun; Kaneko, Naoshi; Igeta, Hirofumi; Someya, Toshiyuki

2014-01-01

Interleukin-1 beta (IL-1β) has been implicated in the pathophysiology of schizophrenia. To assess whether the IL1B gene confers increased susceptibility to schizophrenia, we conducted case-control and family-based studies and an updated meta-analysis. We tested the association between IL1B and schizophrenia in 1229 case-control and 112 trio samples using 12 markers, including common tagging single nucleotide variations (SNVs) and a rare non-synonymous variation detected by resequencing the coding regions. We also performed a meta-analysis of rs16944 using a total of 8724 case-control and 201 trio samples from 16 independent populations. We found no significant associations between any of the 12 SNVs examined and schizophrenia in either case-control or trio samples. Moreover, our meta-analysis results showed no significant association between the common SNV, rs16944, and schizophrenia. The present study does not support a role for IL1B in schizophrenia susceptibility.

Economic burden of schizophrenia: empirical analyses from a survey in Thailand.

Science.gov (United States)

Phanthunane, Pudtan; Whiteford, Harvey; Vos, Theo; Bertram, Melanie

2012-03-01

Evidence consistently indicates that schizophrenia is a costly disease although it is not a high prevalence disorder. There are a few studies in developing countries but no study in Thailand reporting the cost of schizophrenia from a societal perspective. Health policy makers need to be aware of the cost of health care for people with schizophrenia as well as the economic burden on patients and families. This study aims to provide a detailed breakdown of the costs attributed to schizophrenia including the consumption of public health care resources by people with schizophrenia and the negative consequences on patients and families due to productivity losses. Data from a survey conducted in 2008 among people in treatment for schizophrenia were used to estimate annual medical costs for treatment including outpatient services, hospitalization and patient travel. Indirect costs were estimated for reported productivity losses of patients and families. Uncertainty analysis was performed using Monte Carlo simulation methods. We tested the sensitivity of varying assumptions about market wages to estimate productivity losses. All cost estimates are adjusted to 2008 using the Consumer Price Index and reported in Thai baht (THB). The average annual exchange rate of Thai baths to one US dollar was 33.5 in 2008. The annual overall cost of schizophrenia was estimated to be THB 87 000 (USD 2600) (95% CI: 83 000, 92 000) per person or THB 31 000 million (USD 925 million) (95% CI: 26 000, 37 000) for the entire population with schizophrenia in Thailand. Indirect costs due to high unemployment, absenteeism and presenteeism of patients and families accounted for 61% of the total economic burden of schizophrenia. The largest component of direct medical cost was for hospitalizations (50%), followed by outpatient services and drug costs. Sensitivity analyses suggest that using labor force survey and socioeconomic status survey provided similar results, while lost productivity when the

Schizophrenia in High-Risk Children: Sex Differences in Predisposing Factors.

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Mednick, Sarnoff A.; And Others

Reported is a research program to observe children at high risk for schizophrenia and explore possibilities of prevention. Characteristics of the high risk group (n=207) observed during 1962 are discussed, and a theory which suggests that schizophrenia is an evasion of life is explained. Among results of a diagnostic assessment conducted 10 years…

Neuropsychological Impairments in Schizophrenia and Psychotic Bipolar Disorder: Findings from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) Study

Science.gov (United States)

Hill, S. Kristian; Reilly, James L.; Keefe, Richard S.E.; Gold, James M.; Bishop, Jeffrey R.; Gershon, Elliot S.; Tamminga, Carol A.; Pearlson, Godfrey D.; Keshavan, Matcheri S.; Sweeney, John A.

2017-01-01

Objective Familial neuropsychological deficits are well established in schizophrenia but remain less well characterized in other psychotic disorders. This study from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) consortium 1) compares cognitive impairment in schizophrenia and bipolar disorder with psychosis, 2) tests a continuum model of cognitive dysfunction in psychotic disorders, 3) reports familiality of cognitive impairments across psychotic disorders, and 4) evaluates cognitive impairment among nonpsychotic relatives with and without cluster A personality traits. Method Participants included probands with schizophrenia (N=293), psychotic bipolar disorder (N=227), schizoaffective disorder (manic, N=110; depressed, N=55), their first-degree relatives (N=316, N=259, N=133, and N=64, respectively), and healthy comparison subjects (N=295). All participants completed the Brief Assessment of Cognition in Schizophrenia (BACS) neuropsychological battery. Results Cognitive impairments among psychotic probands, compared to healthy comparison subjects, were progressively greater from bipolar disorder (z=−0.77) to schizoaffective disorder (manic z=−1.08; depressed z=−1.25) to schizophrenia (z=−1.42). Profiles across subtests of the BACS were similar across disorders. Familiality of deficits was significant and comparable in schizophrenia and bipolar disorder. Of particular interest were similar levels of neuropsychological deficits in relatives with elevated cluster A personality traits across proband diagnoses. Nonpsychotic relatives of schizophrenia probands without these personality traits exhibited significant cognitive impairments, while relatives of bipolar probands did not. Conclusions Robust cognitive deficits are present and familial in schizophrenia and psychotic bipolar disorder. Severity of cognitive impairments across psychotic disorders was consistent with a continuum model, in which more prominent affective features and less

High C-reactive protein levels are associated with depressive symptoms in schizophrenia.

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Faugere, M; Micoulaud-Franchi, J-A; Faget-Agius, C; Lançon, C; Cermolacce, M; Richieri, R

2018-01-01

Depressive symptoms are frequently associated with schizophrenia symptoms. C - Reactive protein (CRP), a marker of chronic inflammation, had been found elevated in patients with schizophrenia and in patients with depressive symptoms. However, the association between CRP level and depressive symptoms has been poorly investigated in patients with schizophrenia. The only study conducted found an association between high CRP levels and antidepressant consumption, but not with depressive symptoms investigated with the Calgary Depression Rating Scale for Schizophrenia (CDSS). The aim of this study was to evaluate CRP levels and depressive symptoms in patients with schizophrenia, and to determine whether high CRP levels are associated with depressive symptoms and/or antidepressant consumption, independently of potential confounding factors, especially tobacco-smoking and metabolic syndrome. Three hundred and seven patients with schizophrenia were enrolled in this study (mean age = 35.74 years, 69.1% male gender). Depressive symptoms was investigated with the CDSS. Patients were classified in two groups: normal CRP level (≤ 3.0mg/L) and high CRP level (> 3.0mg/L). Current medication was recorded. 124 subjects (40.4%) were classified in the high CRP level group. After adjusting for confounding factors, these patients were found to have higher CDSS scores than those with normal CRP levels in multivariate analyses (p = 0.035, OR = 1.067, 95% CI = 1.004-1.132). No significant association between CRP levels and antidepressants consumption was found. The size sample is relatively small. The cut-off point for high cardiovascular risk was used to define the two groups. CRP was the sole marker of inflammation in this study and was collected at only one time point. The design of this study is cross-sectional and there are no conclusions about the directionality of the association between depression and inflammation in schizophrenia. This study found an association between high

Interdependent recovery of adults with schizophrenia: Asian American consumer perspectives of family involvement and influence.

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Lee, Karen Kyeunghae; Yamada, Ann-Marie; Kim, Min Ah; Dinh, Tam Q

2015-09-01

Family involvement is important in the recovery experience of culturally diverse adults with schizophrenia. However, little is known about the influence of family among consumers purported to have close family ties without regular contact. This study explored Asian American consumers' views about family relationships and participation in their recovery. Secondary analysis of qualitative data from a larger project was conducted to explore family related themes of 8 Asian Americans receiving services from recovery-focused programs in urban Southern California. Most consumers described their family support as adequate while simultaneously reporting limited family involvement. Asia-born and U.S.-born Asian consumers varied in describing family support, suggesting providers consider nativity in culturally responsive service delivery. Families need not be present to affect the perspectives of Asian Americans receiving recovery-oriented services. The extent of family influences on recovery, beyond the initial determination of current family contact, requires further exploration. (c) 2015 APA, all rights reserved).

Communication Deviance in parents of families with adoptees at a high or low risk of schizophrenia-spectrum disorders and its associations with attributes of the adoptee and the adoptive parents.

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Roisko, Riikka; Wahlberg, Karl-Erik; Hakko, Helinä; Wynne, Lyman; Tienari, Pekka

2011-01-30

Communication Deviance (CD) in rearing parents is a known indicator of a psychopathology risk in the offspring, but the direction of the effects of these two factors on each other has remained an unresolved question. The purpose of the present study was to clarify this issue by assessing the relationship of CD in adoptive parents with certain attributes of the adoptee and adoptive parents themselves. The subjects were 109 adoptees at a high or low risk of schizophrenia-spectrum disorders and their adoptive parents. Communication Deviance was measured in individual, spouse and family Rorschach situations. Thought disorders in the adoptees were assessed using the Thought Disorder Index. The variability of CD in the adoptive parents in individual Rorschach situations was not significantly explained by any characteristics of the child. The variability in parental CD in family Rorschach situations was most closely associated with the characteristics of the parents themselves. The results strongly support the hypotheses that the frequency of Communication Deviance is an enduring trait rather than a fluctuating state and that frequent CD in parent's speech may impair the growing child's cognitive development and predispose him/her to schizophrenia-spectrum disorders. Copyright © 2010 Elsevier Ltd. All rights reserved.

Auditory Vigilance and Working Memory in Youth at Familial Risk for Schizophrenia or Affective Psychosis in the Harvard Adolescent Family High Risk Study.

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Seidman, Larry J; Pousada-Casal, Andrea; Scala, Silvia; Meyer, Eric C; Stone, William S; Thermenos, Heidi W; Molokotos, Elena; Agnew-Blais, Jessica; Tsuang, Ming T; Faraone, Stephen V

2016-11-01

The degree of overlap between schizophrenia (SCZ) and affective psychosis (AFF) has been a recurring question since Kraepelin's subdivision of the major psychoses. Studying nonpsychotic relatives allows a comparison of disorder-associated phenotypes, without potential confounds that can obscure distinctive features of the disorder. Because attention and working memory have been proposed as potential endophenotypes for SCZ and AFF, we compared these cognitive features in individuals at familial high-risk (FHR) for the disorders. Young, unmedicated, first-degree relatives (ages, 13-25 years) at FHR-SCZ (n=41) and FHR-AFF (n=24) and community controls (CCs, n=54) were tested using attention and working memory versions of the Auditory Continuous Performance Test. To determine if schizotypal traits or current psychopathology accounted for cognitive deficits, we evaluated psychosis proneness using three Chapman Scales, Revised Physical Anhedonia, Perceptual Aberration, and Magical Ideation, and assessed psychopathology using the Hopkins Symptom Checklist -90 Revised. Compared to controls, the FHR-AFF sample was significantly impaired in auditory vigilance, while the FHR-SCZ sample was significantly worse in working memory. Both FHR groups showed significantly higher levels of physical anhedonia and some psychopathological dimensions than controls. Adjusting for physical anhedonia, phobic anxiety, depression, psychoticism, and obsessive-compulsive symptoms eliminated the FHR-AFF vigilance effects but not the working memory deficits in FHR-SCZ. The working memory deficit in FHR-SZ was the more robust of the cognitive impairments after accounting for psychopathological confounds and is supported as an endophenotype. Examination of larger samples of people at familial risk for different psychoses remains necessary to confirm these findings and to clarify the role of vigilance in FHR-AFF. (JINS, 2016, 22, 1026-1037).

The Burden of Schizophrenia on Caregivers

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Filiz Adana

2011-06-01

Full Text Available Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family such as the patients disturbing behaviors, economic difficulties, and loss of income, restricted social activities, distressed household atmosphere, and undesirable influences on physical and mental health of the family members. The subjective burden refers to the extent of emotional distress caused by the objective burden. The data in the pertinent literature suggest an association between caregivers’ burden and sex, ethnicity, culture, caregivers’ health and quality of life, social support, and the symptomatology as presented by the patient. In order to promote mental health of schizophrenia patients along with their caregivers, the mental health workers should strive to find the means of supporting, informing, and cooperating with the family members. Psychosocial interventions designed for families and psychosocial rehabilitations programs designed for schizophrenia patients are effective means of easing caregivers’ burden.

First episode schizophrenia | Khamker | South African Family Practice

African Journals Online (AJOL)

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

A Nationwide Study on the Risk of Autoimmune Diseases in Individuals With a Personal or a Family History of Schizophrenia and Related Psychosis

DEFF Research Database (Denmark)

Benros, Michael E; Pedersen, Marianne G; Rasmussen, Helle

2014-01-01

persons without hospital contacts for infections, the effect of having schizophrenia was smaller, with an increased incidence rate ratio of 1.32 (95% CI=1.22-1.43) for autoimmune diseases. For individuals with schizophrenia as well as hospital contacts for infections, the combined risk of autoimmune...... diseases was 2.70 (95% CI=2.51-2.89). A family history of schizophrenia slightly increased the overall risk of developing autoimmune diseases (incidence rate ratio=1.06, 95% CI=1.02-1.09). Autoimmune diseases developed subsequently in 3.6% of people with schizophrenia, and 3.1% of people with autoimmune...

Identifying aspects of neighbourhood deprivation associated with increased incidence of schizophrenia.

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Bhavsar, Vishal; Boydell, Jane; Murray, Robin; Power, Paddy

2014-06-01

Several studies have found an association between area deprivation and incidence of schizophrenia. However, not all studies have concurred and definitions of deprivation have varied between studies. Relative deprivation and inequality seem to be particularly important, but which aspects of deprivation or how this effect might operate is not known. The Lambeth Early Onset case register is a database of all cases of first episode psychosis aged 16 to 35years from the London Borough of Lambeth, a highly urban area. We identified 405 people with first onset schizophrenia who presented between 2000 and 2007. We calculated the overall incidence of first onset schizophrenia and tested for an association with area-level deprivation, using a multi-domain index of deprivation (IMD 2004). Specific analyses into associations with individual sub-domains of deprivation were then undertaken. Incidence rates, directly standardized for age and gender, were calculated for Lambeth at two geographical levels (small and large neighbourhood level). The Poisson regression model predicting incidence rate ratios for schizophrenia using overall deprivation score was statistically significant at both levels after adjusting for ethnicity, ethnic density, population density and population turnover. The incidence rate ratio for electoral ward deprivation was 1.03 (95% CI=1.004-1.04) and for the super output area deprivation was 1.04 (95% CI=1.02-1.06). The individual domains of crime, employment deprivation and educational deprivation were statistically significant predictors of incidence but, after adjusting for the other domains as well as age, gender, ethnicity and population density, only crime and educational deprivation, remained statistically significant. Low income, poor housing and deprived living environment did not predict incidence. In a highly urban area, an association was found between area-level deprivation and incidence of schizophrenia, after controlling for age, gender

Risk architecture of schizophrenia: the role of epigenetics.

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Svrakic, Dragan M; Zorumski, Charles F; Svrakic, Nenad M; Zwir, Igor; Cloninger, Claude R

2013-03-01

To systematize existing data and review new findings on the cause of schizophrenia and outline an improved mixed model of schizophrenia risk. Multiple and variable genetic and environmental factors interact to influence the risk of schizophrenia. Both rare variants with large effect and common variants with small effect contribute to genetic risk of schizophrenia, with no indication for differential impact on its clinical features. Accumulating evidence supports a genetic architecture of schizophrenia with multiple scenarios, including additive polygenic, heterogeneity, and mixed polygenic-heterogeneity. The epigenetic mechanisms that mediate gene-environment (GxE) interactions provide a framework to incorporate environmental factors into models of schizophrenia risk. Environmental pathogens with small effect on risk have robust effects in the context of family history of schizophrenia. Hence, genetic risk for schizophrenia may be expressed in part as sensitivity to environmental factors. We propose an improved mixed model of schizophrenia risk in which abnormal epigenetic states with large effects are superimposed on a polygenic liability to schizophrenia. This scenario can account for GxE interactions and shared family environment, which in many cases are not explained by a single structural variant of large effect superimposed on polygenes (the traditional mixed model).

The Effects of Group Psychoeducational Programme on Attitude toward Mental Illness in Families of Patients with Schizophrenia, 2014

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Farnaz Rahmani

2015-09-01

Full Text Available Introduction: Family members often play a vital role as caregivers in the lives of individuals with schizophrenia. Results of the studies showed that family invironment is the most important determinint of patients outcomes like as quality of life, relapse, adherence. This study aimed to determine the effect of group psychoeducational programme on attitude towards mental illness in families of patients with schizophrenia. Methods: In this quasi-experimental study, 74 families who have schizophrenic patients hospitalized in psychiatric wards during sampling were selected by convenience sampling method. Then the sample was randomly assigned to experimental and control groups. The families of experimental group received 8 continuous 90-minute 3 times a week psychoeducational sessions. Family attitude towards mental illness was measured using the questionnaire of Opinion about Mental Illnesses (OMI before and after intervention. Data analysis was conducted using 2 test, independent t-test, and paired t-test on SPSS software version 13. Results: The results showed that majority of the families had negative attitude towards mental illness (88.90%. In addition, the results showed that there was significant difference between different dimensions of attitude towards mental illness before and after psychoeducation in the experimental group. The mean score of families' post-test in the experimental group increased compared to control group 108.86 (14.9, vs. 88.86 (7.5. Conclusion: The results of this study indicate that psychoeducation improves family attitude towards mental illness. Training methods like group psych education for the families of mental patients can be effective on their attitudes towards mental illness.

Association between a disrupted-in-schizophrenia 1 (DISC1) single nucleotide polymorphism and schizophrenia in a combined Scandinavian case-control sample

DEFF Research Database (Denmark)

Saetre, Peter; Agartz, Ingrid; De Franciscis, Alessandra

2008-01-01

Disrupted-in-schizophrenia-1 (DISC1), located on chromosome 1q42.1, is linked to rare familial schizophrenia in a large Scottish family. The chromosomal translocation that segregates with the disease results in a truncated protein that impairs neurite outgrowth and proper development...... of the cerebral cortex, suggesting that lost DISC1 function may underlie neurodevelopmental dysfunction in schizophrenia. DISC1 has been associated with schizophrenia in multiple populations, but there is little evidence of convergence across populations. In the present case-control study three Scandinavian...... after correction for multiple testing. However, the minor allele of rs3737597 (frequency 2%) in the 3'-untranslated region (UTR), previously identified as a risk allele in Finnish families, was significantly and consistently associated with the disorder across the three samples, (p-value corrected...

Public Stigma Toward Mental Illness in Jordan: A Cross-Sectional Survey of Family Members of Individuals With Schizophrenia, Depression, and Anxiety.

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Hasan, Abd Al-Hadi; Musleh, Mahmoud

2017-06-01

Stigma affects family members of individuals with mental illness. A survey of 640 family members of individuals with mental illness was conducted. Three factors were found to influence stigma regarding schizophrenia, depression, and anxiety: (a) preconceived stereotypes, (b) a sense of personal responsibility or blame for the condition, and (c) perceptions of the patient's inability to recover from the condition. A stronger association between negative stereotypes and inability to recover was found with schizophrenia than depression or anxiety. Conversely, depression and anxiety were found to be correlated with personal responsibility or blame for the condition. The public perception of mental health conditions (e.g., depression, anxiety, schizophrenia) has a crucial role in deriving programs for reducing stigma and raising awareness. Personalized and efficacious treatment regimens may be facilitated by understanding these perceptions and the underlying explanations for why they exist. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 36-43.]. Copyright 2017, SLACK Incorporated.

An optimized voxel-based morphometry MRI study of the brain in patients with first episode schizophrenia

International Nuclear Information System (INIS)

Lv Su; Huang Xiaoqi; Tang Hehan; Gong Qiyong; Ouyang Luo; Deng Wei; Jiang Lijun; Li Tao

2007-01-01

Objective: To evaluate the structural differences between patients with first episode schizophrenia and normal controls using optimized voxel-based morphometry (VBM) study. Methods: High resolution T 1 weighted images were obtained using 3.0 T MR from 13 first-episode, untreated schizophrenia and 13 age, sex, handedness matched normal controls. Images were preprocessed by employing the optimized VBM and two sample t-test was used to detect differences between patients and normal controls with respect to both density and volume of gray matter in the brain. Results Patients with schizophrenia had significant lower gray matter density and gray matter volume generally distributed among bilateral hemispheres, especially in bilateral frontal and temporal lobes. However, no significant increase of gray matter density and gray matter volume was observed in these patients. Conclusions: Optimized voxel-based morphometry study is an automatic and effective method to study psychological diseases such as schizophrenia. Compared with normal controls, patients with schizophrenia had significantly lower gray matter density and gray matter volume across the bilateral hemispheres. (authors)

Psychosis among "healthy" siblings of schizophrenia patients

OpenAIRE

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

2006-01-01

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

Pharmacotherapy of Schizophrenia: Ploypharmacy Approaches

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Fatemeh Rahiminejad

2010-07-01

Full Text Available "nSchizophrenia is a debilitating illness, rating as one of the leading causes of lost years of quality of life. The illness imposes a disproportionate burden on patients and their families, healthcare systems and society. Pharmacological management is the cornerstone of treatment of schizophrenia, and antipsychotics, both first generation of antipsychotics and second generation of antipsychotics, are efficacious in reducing levels of psychopathology in acute episodes of schizophrenia. Clearly a need for innovative treatment strategies in schizophrenia that will ensure increased effectiveness against negative symptoms and cognitive dysfunction dysfunction. Therefore, in majority of cases polypharmacy is one of the effective approaches. This review focused on polypharmacy in the treatment of schizophrenia and in particular negative symptoms.

Efficacy of a family intervention program for prevention of hospitalization in patients with schizophrenia. A naturalistic multicenter controlled and randomized study in Spain.

Science.gov (United States)

Mayoral, Fermín; Berrozpe, Adela; de la Higuera, Jesús; Martinez-Jambrina, Juan José; de Dios Luna, Juan; Torres-Gonzalez, Francisco

2015-01-01

According to most relevant guidelines, family psycho-educational interventions are considered to be one the most effective psychosocial treatments for people with schizophrenia. The main outcome measure in controlled and randomized studies has been prevention of relapses and admissions, and encouragement of compliance, although some questions remain about its applicability and results in clinical practice. The aim of study was to evaluate the efficacy and implementation of a single family psychoeducational intervention in 'real' conditions for people diagnosed with schizophrenia. A total of 88 families were randomized in two groups. The family intervention group received a 12 months psychoeducational treatment, and the other group followed normal standard treatment. Assessments were made at baseline, at 12 and at 18 months. The main outcome measure was hospitalization, and secondary outcome measures were clinical condition (BPRS-E) and social disability (DAS-II). A total of 71 patients finished the study (34 family intervention group and 37 control group). Patients who received family intervention reduced the risk of hospitalization by 40% (P = .4018; 95%CI: 0.1833-0.6204). Symptomatology improved significantly at 12 months (P = .4018; 95%CI: 0.1833-0.6204), but not at 18 months (P = .4018; 95%CI: 0.1833-0.6204). Social disability was significantly reduced in the family intervention group at 12 months and 18 months. Family psychoeducational intervention reduces hospitalization risk and improves clinical condition and social functioning of people with schizophrenia. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

The phenotypic manifestations of rare CNVs in schizophrenia.

Science.gov (United States)

Merikangas, Alison K; Segurado, Ricardo; Cormican, Paul; Heron, Elizabeth A; Anney, Richard J L; Moore, Susan; Kelleher, Eric; Hargreaves, April; Anderson-Schmidt, Heike; Gill, Michael; Gallagher, Louise; Corvin, Aiden

2014-09-01

There is compelling evidence for the role of copy number variants (CNVs) in schizophrenia susceptibility, and it has been estimated that up to 2-3% of schizophrenia cases may carry rare CNVs. Despite evidence that these events are associated with an increased risk across categorical neurodevelopmental disorders, there is limited understanding of the impact of CNVs on the core features of disorders like schizophrenia. Our objective was to evaluate associations between rare CNVs in differentially brain expressed (BE) genes and the core features and clinical correlates of schizophrenia. The sample included 386 cases of Irish ancestry with a diagnosis of schizophrenia, at least one rare CNV impacting any gene, and a core set of phenotypic measures. Statistically significant associations between deletions in differentially BE genes were found for family history of mental illness (decreased prevalence of all CNVs and deletions, unadjusted and adjusted) and for paternal age (increase in deletions only, unadjusted, among those with later ages at birth of patient). The strong effect of a lack of a family history on BE genes suggests that CNVs may comprise one pathway to schizophrenia, whereas a positive family history could index other genetic mechanisms that increase schizophrenia vulnerability. To our knowledge, this is the first investigation of the association between genome-wide CNVs and risk factors and sub-phenotypic features of schizophrenia beyond cognitive function. Copyright © 2014 Elsevier B.V. All rights reserved.

Early environmental exposures influence schizophrenia expression even in the presence of strong genetic predisposition

OpenAIRE

Husted, Janice A.; Ahmed, Rashid; Chow, Eva W.C.; Brzustowicz, Linda M.; Bassett, Anne S.

2012-01-01

There are few studies of environmental factors in familial forms of schizophrenia. We investigated whether childhood adversity or environmental factors were associated with schizophrenia in a familial sample where schizophrenia is associated with the NOSA1P gene. We found that a cumulative adversity index including childhood illness, family instability and cannabis use was significantly associated with narrow schizophrenia, independent of NOSA1P risk genotype, previously measured childhood tr...

The Burden of Schizophrenia on Caregivers

OpenAIRE

Filiz Adana; Hulya Arslantas

2011-01-01

Caregivers’ burden in schizophrenia is a complex concept often with negative connotations. The concept refers to the impact of having a schizophrenia patient in the family including emotional, psychological, physical, economic distress and feelings of shame, embarrassment, guilt, and self-blame expe-rienced by the caregivers. There are objective and subjective aspects of care-givers’ burden. The objective burden refers to observed and verifiable impact of the diseased person in the family suc...

IQ and schizophrenia in a Swedish national sample: their causal relationship and the interaction of IQ with genetic risk.

Science.gov (United States)

Kendler, Kenneth S; Ohlsson, Henrik; Sundquist, Jan; Sundquist, Kristina

2015-03-01

The authors sought to clarify the relationship between IQ and subsequent risk for schizophrenia. IQ was assessed at ages 18-20 in 1,204,983 Swedish males born between 1951 and 1975. Schizophrenia was assessed by hospital diagnosis through 2010. Cox proportional hazards models were used to investigate future risk for schizophrenia in individuals as a function of their IQ score, and then stratified models using pairs of relatives were used to adjust for familial cluster. Finally, regression models were used to examine the interaction between IQ and genetic liability on risk for schizophrenia. IQ had a monotonic relationship with schizophrenia risk across the IQ range, with a mean increase in risk of 3.8% per 1-point decrease in IQ; this association was stronger in the lower than the higher IQ range. Co-relative control analyses showed a similar association between IQ and schizophrenia in the general population and in cousin, half-sibling, and full-sibling pairs. A robust interaction was seen between genetic liability to schizophrenia and IQ in predicting schizophrenia risk. Genetic susceptibility for schizophrenia had a much stronger impact on risk of illness for those with low than high intelligence. The IQ-genetic liability interaction arose largely from IQ differences between close relatives. IQ assessed in late adolescence is a robust risk factor for subsequent onset of schizophrenia. This association is not the result of a declining IQ associated with insidious onset. In this large, representative sample, we found no evidence for a link between genius and schizophrenia. Co-relative control analyses showed that the association between lower IQ and schizophrenia is not the result of shared familial risk factors and may be causal. The strongest effect was seen with IQ differences within families. High intelligence substantially attenuates the impact of genetic liability on the risk for schizophrenia.

The (CTGn polymorphism in the NOTCH4 gene is not associated with schizophrenia in Japanese individuals

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Okubo Takehito

2001-06-01

Full Text Available Abstract Background The human NOTCH4 gene is a candidate gene for schizophrenia due to its chromosomal location and neurobiological roles. In a British linkage study, NOTCH4 gene polymorphisms were highly associated with schizophrenia. In a Japanese case-control association study, however, these polymorphisms did not show significant associations with schizophrenia. We conducted a case-control study with Japanese subjects to explore an association between the triplet repeat polymorphism in the NOTCH4 gene and schizophrenia, including subtypes of schizophrenia, longitudinal disease course characteristics, and a positive family history for psychoses. Methods We examined the (CTGn repeat polymorphism in the NOTCH4 gene among 100 healthy Japanese individuals and 102 patients with schizophrenia (22 paranoid, 38 disorganized, 29 residual, 64 episodic, 31 continuous, 42 with prominent negative symptoms, and 46 with positive family histories using a polymerase chain reaction-based, single-strand conformational polymorphism analysis. Results Five different alleles consisting of 6, 9, 10, 11, and 13 repeats of CTG (Leu in patients with schizophrenia, and 4 alleles consisting of 6, 9, 10, and 11 repeats in controls were found. No significant differences in genotype or allele frequencies of repeat numbers were found between controls and patients. In addition, there were no associations between the polymorphism and schizophrenia subtypes, longitudinal disease course characteristics, or positive family history of the patients. Conclusions Our data suggest a lack of association between the NOTCH4 gene triplet repeat polymorphism and schizophrenia in Japanese individuals.

GABA level, gamma oscillation, and working memory performance in schizophrenia

OpenAIRE

Chen, Chi-Ming A.; Stanford, Arielle D.; Mao, Xiangling; Abi-Dargham, Anissa; Shungu, Dikoma C.; Lisanby, Sarah H.; Schroeder, Charles E.; Kegeles, Lawrence S.

2014-01-01

A relationship between working memory impairment, disordered neuronal oscillations, and abnormal prefrontal GABA function has been hypothesized in schizophrenia; however, in vivo GABA measurements and gamma band neural synchrony have not yet been compared in schizophrenia. This case–control pilot study (N = 24) compared baseline and working memory task-induced neuronal oscillations acquired with high-density electroencephalograms (EEGs) to GABA levels measured in vivo with magnetic resonance ...

Tensor-based morphometry of cannabis use on brain structure in individuals at elevated genetic risk of schizophrenia.

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Welch, K A; Moorhead, T W; McIntosh, A M; Owens, D G C; Johnstone, E C; Lawrie, S M

2013-10-01

Schizophrenia is associated with various brain structural abnormalities, including reduced volume of the hippocampi, prefrontal lobes and thalami. Cannabis use increases the risk of schizophrenia but reports of brain structural abnormalities in the cannabis-using population have not been consistent. We used automated image analysis to compare brain structural changes over time in people at elevated risk of schizophrenia for familial reasons who did and did not use cannabis. Magnetic resonance imaging (MRI) scans were obtained from subjects at high familial risk of schizophrenia at entry to the Edinburgh High Risk Study (EHRS) and approximately 2 years later. Differential grey matter (GM) loss in those exposed (n=23) and not exposed to cannabis (n=32) in the intervening period was compared using tensor-based morphometry (TBM). Cannabis exposure was associated with significantly greater loss of right anterior hippocampal (pcorrected=0.029, t=3.88) and left superior frontal lobe GM (pcorrected=0.026, t=4.68). The former finding remained significant even after the exclusion of individuals who had used other drugs during the inter-scan interval. Using an automated analysis of longitudinal data, we demonstrate an association between cannabis use and GM loss in currently well people at familial risk of developing schizophrenia. This observation may be important in understanding the link between cannabis exposure and the subsequent development of schizophrenia.

Early environmental exposures influence schizophrenia expression even in the presence of strong genetic predisposition.

Science.gov (United States)

Husted, Janice A; Ahmed, Rashid; Chow, Eva W C; Brzustowicz, Linda M; Bassett, Anne S

2012-05-01

There are few studies of environmental factors in familial forms of schizophrenia. We investigated whether childhood adversity or environmental factors were associated with schizophrenia in a familial sample where schizophrenia is associated with the NOSA1P gene. We found that a cumulative adversity index including childhood illness, family instability and cannabis use was significantly associated with narrow schizophrenia, independent of NOSA1P risk genotype, previously measured childhood trauma, covariates and familial clustering (adjusted odds ratio (95% confidence interval)=1.55 (1.01, 2.38)). The results provide further support that early environmental exposures influence schizophrenia expression even in the presence of strong genetic predisposition. Copyright © 2012 Elsevier B.V. All rights reserved.

THE EFFECT OF FAMILY THERAPY WITH SPIRITUAL APPROACH TOWARD FAMILY’S HEALTH BELIEF MODEL IN TAKING CARE OF PATIENT WITH SCHIZOPHRENIA

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Ah. Yusuf

2017-04-01

Full Text Available Introduction: Schizophrenia is the problem with kognitive, mal-adaptive thought and behavior. Family who have a member with mental disorder can experience serious conflict, become an objective and subjective burden, blame each other, get involved in hostility among family members. Various negative effect faced by family can caused by wrong family’s health belief model about Schizophrenia, hence the failure on choosing the treatment and taking care of patient at home. Someone with severe stress will seek comfort and strength from God. But so far, the most effective spiritual models to improve the health belief model of the family in caring for patients with schizophrenia has not been found. Method: Design used in this study was experimental (pre post test control group design. The population was every family of patient with mental disorder in Menur Mental Hospital along the year of 2010, chosen by alocation simple random. Samples were 13 persons in each treatment and control group. The intervention was given in 60–120 minute in 8 times meeting with average interval about 1 week. Data analysis was done using paired t-test and independent t-test. Results: There were significant changes in total of family’s health belief model (p=0,004, there was significantly change in aspects of (1 perceptions about bene fi ts (p=0,009, (2 perception about barriers (p=0,035 and perception about self efficacy (p=0,002. There were no significant changing in perception about susceptibility and severity (p=0,052. Discussion: Family believes that all events experienced by the patient and the family is God's will, hoping the patient can be more independent, and believe mental disorders can be changed for the better. The conclusion of this study is that family therapy with a spiritual approach can improve the health belief model of the family in caring for patients with mental disorders.

Acceptance and commitment therapy and family psycho education for clients with schizophrenia.

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Ema Komala, Encik Putri; Anna Keliat, Budi; Yulia Wardani, Ice

2018-02-01

This study aims to determine the effectiveness of combining acceptance and commitment therapy with family psycho education on increased insight, diminished symptoms, and the client's improved ability to control violent behavior. The design of this study was a quasi-experimental pretest-posttest utilizing intervention and control groups. The intervention group consisted of 33 people, and the control group was composed of 33 people. Data was collected before and after respondents received both acceptance and commitment therapy and family psycho education. The study showed that patient insight improved significantly, the signs and symptoms of violent behavior decreased, and the client's ability to control such behavior improved with a p value psycho education. In the control group, patient insight did not improved significantly, showing a p value > 0.05. Therefore, our study recommends that acceptance and commitment therapy and family psycho education should be given to patients with schizophrenia to improve insight into their disease, decrease signs and symptoms of violent behavior and improve their ability to control violent behavior. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Gray and white matter density changes in monozygotic and same-sex dizygotic twins discordant for schizophrenia using voxel-based morphometry

DEFF Research Database (Denmark)

Hulshoff Pol, HE; Schnack, HG; Mandl, RC

2006-01-01

Global gray matter brain tissue volume decreases in schizophrenia have been associated to disease-related (possibly nongenetic) factors. Global white matter brain tissue volume decreases were related to genetic risk factors for the disease. However, which focal gray and white matter brain regions...... best reflect the genetic and environmental risk factors in the brains of patients with schizophrenia remains unresolved. 1.5-T MRI brain scans of 11 monozygotic and 11 same-sex dizygotic twin-pairs discordant for schizophrenia were compared to 11 monozygotic and 11 same-sex dizygotic healthy control...... twin-pairs using voxel-based morphometry. Linear regression analysis was done in each voxel for the average and difference in gray and white matter density separately, in each twin-pair, with group (discordant, healthy) and zygosity (monozygotic, dizygotic) as between subject variables, and age, sex...

Genome-wide association study of multiplex schizophrenia pedigrees

DEFF Research Database (Denmark)

Levinson, Douglas F; Shi, Jianxin; Wang, Kai

2012-01-01

The authors used a genome-wide association study (GWAS) of multiply affected families to investigate the association of schizophrenia to common single-nucleotide polymorphisms (SNPs) and rare copy number variants (CNVs).......The authors used a genome-wide association study (GWAS) of multiply affected families to investigate the association of schizophrenia to common single-nucleotide polymorphisms (SNPs) and rare copy number variants (CNVs)....

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

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Hulshoff Pol, Hilleke; Gogtay, Nitin

2013-01-01

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

Cost of schizophrenia in England.

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Mangalore, Roshni; Knapp, Martin

2007-03-01

variety of secondary sources and some official data publicly available was not the latest. Schizophrenia continues to be a high cost illness because of the range of health needs that people have. Despite the shifting balance of care away from hospital-based care, the health care costs of treating and supporting people with schizophrenia remain high. Decision-makers need to recognise the breadth of economic impacts, well beyond the health system as conventionally defined. For example, as nearly 80% of schizophrenia patients remain unemployed, the cost of lost productivity is especially large. Better measurement of criminal justice services costs, private expenditures borne by families and valuation of lost quality of life could improve the estimates further.

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

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Omori Ataru

2012-11-01

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

Smoking in schizophrenia -- all is not biological.

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Srinivasan, T N; Thara, R

2002-07-01

High rate of tobacco smoking reported in schizophrenia has been related to the effect of nicotine on the neurobiology of schizophrenia. Nicotine is said to alleviate psychotic symptoms in some patients. The relationship between smoking and psychiatric status may not be simply a biological one as several sociocultural and economic factors could influence smoking behaviour. In this study in India on 286 urban male outpatients with schizophrenia, only 38% were found to be current smokers. This was significantly more than in other psychiatric patients studied (major affective disorders and non-psychotic disorders) but not medically ill controls and not higher than the rates for the general male population in India. Smokeless use of tobacco was infrequent in the study population. More than half of the patients did not experience any positive effects due to smoking. Lack of economic independence and restrictions imposed by the family appeared to be crucial factors that controlled the prevalence of smoking among schizophrenia patients. As smoking is a leading cause of preventable morbidity and mortality, there is a serious need to review the neurobiological issue of smoking in schizophrenia considering the influence culture and social practices could have upon the behaviour.

[Assessing beliefs and attitudes of relatives of patients with schizophrenia: a study in a Tunisian sample].

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Bouhlel, S; Ben Haouala, S; Klibi, A; Ghaouar, M; Chennoufi, L; Melki, W; El-Hechmi, Z

2013-06-01

Investigating and understanding family member's causal beliefs and attitudes about schizophrenia is an important step in the management of the illness. They likely influence the family's help-seeking decisions and affect both adherence with biomedical interventions and social integration of the patients. The aim of this study was to describe Tunisian families' beliefs about the causes, the symptoms and the treatments of schizophrenia. We led a transversal study including 91 relatives of patients with schizophrenia or schizoaffective disorder (DSM-IV). We excluded patients with mental retardation or neurological diseases. For family members, we excluded participants with a history of mental disorders or cognitive impairments. We collected basic socio-demographic data for both patients and relatives. We asked relatives to respond by "yes/no/I am not certain" to a three-part questionnaire including 27 items dealing with causal explanations, symptoms and optimal cures for schizophrenia. The mean age of the relatives was 49.8 (±13.7) years; 54.9% were men; 49.4% were parents, 8.8% spouses, 39.6% brothers or sisters; 25.3% had not attended school, 24.2% had attended primary school, 37.4% junior high school or high school and 13.2% had a university degree; 63.7% lived in an urban area; 33% had low economic status and 41.8% reported having another family member with mental disorder. Only 46.2% of participants had asked psychiatrists about the diagnosis of their sick relatives and only 16.5% were able to label the term "schizophrenia". Among the cited etiologies of schizophrenia, religious causes were found in 76.9% of cases, they first cited God's will or fate and secondly God's punishment. Magical explanations such as witchcraft and possession by "djinns" were found in 47.3% of cases. The biological causes were cited by 59.3% of participants. The majority of participants (95.6%) proved the need for drugs and 81.3% the utility of psychotherapies. However, 30.8% believed

Family motivational intervention for reducing cannabis use in recent-onset schizophrenia

NARCIS (Netherlands)

Smeerdijk, A.M.

2015-01-01

Cannabis use in highly prevalent among young adults with recent-onset schizophrenia and has been associated with an adverse course of the illness. Despite these association, the evidence for effective interventions for treating cannabis use in patients with psychosis is limited. This thesis focuses

CAREGIVERS’ NEEDS IN CARING FOR RELATIVES WITH SCHIZOPHRENIA IN MEDAN INDONESIA: A PHENOMENOLOGICAL STUDY

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Jenny Marlindawani Purba

2017-12-01

Full Text Available Background: A caregiver is a primary nurse and has a major role in providing care for people with schizophrenia. Caring for those with schizophrenia for a long period of time is a challenge for families, especially caregivers. Various needs ought to be studied by nurses to assist caregivers in providing optimal care for family members who experience schizophrenia. Objective: This qualitative study aims to explore the needs of caregivers in treating schizophrenia at home. Methods: The method used in this study is the method of purposive sampling with the number of participants as many as 10 people with criteria: 1 have family members diagnosed with schizophrenia, 2 directly involved in home care patients, 3 caring for schizophrenia for more than one year, 4 willing to be a participant by signing informed consent, 4 being able to identify what is needed in treating schizophrenia. Colaizzi is used to analyze interview data. Results: The results of the study found four themes of caregiver needs in caring for schizophrenia patients at home, namely: 1 seeking information about schizophrenia, 2 sought schizophrenic relatives’ recovery, 3 looking for appropriate rehabilitation for relatives with schizophrenias, and 4 utilizing mental health facilities. Conclusions: It is expected that nurses have the knowledge and skills in identifying and helping families, especially caregivers, to meet unmet needs so they can optimize home care.

Visual sensory processing deficits in patients with bipolar disorder revealed through high-density electrical mapping.

LENUS (Irish Health Repository)

Yeap, Sherlyn

2009-11-01

BACKGROUND: Etiological commonalities are apparent between bipolar disorder and schizophrenia. For example, it is becoming clear that both populations show similar electrophysiological deficits in the auditory domain. Recent studies have also shown robust visual sensory processing deficits in patients with schizophrenia using the event-related potential technique, but this has not been formally tested in those with bipolar disorder. Our goal here was to assess whether early visual sensory processing in patients with bipolar disorder, as indexed by decreased amplitude of the P1 component of the visual evoked potential (VEP), would show a similar deficit to that seen in those with schizophrenia. Since the P1 deficit has already been established as an endophenotype in schizophrenia, a finding of commonality between disorders would raise the possibility that it represents a measure of common genetic liability. METHODS: We visually presented isolated-check stimuli to euthymic patients with a diagnosis of bipolar disorder and age-matched healthy controls within a simple go\\/no-go task and recorded VEPs using high-density (72-channel) electroencephalography. RESULTS: The P1 VEP amplitude was substantially reduced in patients with bipolar disorder, with an effect size of f = 0.56 (large according to Cohen\\'s criteria). LIMITATIONS: Our sample size was relatively small and as such, did not allow for an examination of potential relations between the physiologic measures and clinical measures. CONCLUSION: This reduction in P1 amplitude among patients with bipolar disorder represents a dysfunction in early visual processing that is highly similar to that found repeatedly in patients with schizophrenia and their healthy first-degree relatives. Since the P1 deficit has been related to susceptibility genes for schizophrenia, our results raise the possibility that the deficit may in fact be more broadly related to the development of psychosis and that it merits further

Schizophrenia in Malaysian families: A study on factors associated with quality of life of primary family caregivers

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Yi Eng J

2011-06-01

Full Text Available Abstract Background Schizophrenia is a chronic illness which brings detrimental effects in the caregivers' health. This study was aimed at highlighting the socio-demographic, clinical and psychosocial factors associated with the subjective Quality of Life (QOL of Malaysian of primary family caregivers of subjects with schizophrenia attending an urban tertiary care outpatient clinic in Malaysia. Methods A cross-sectional study was performed to study patient, caregiver and illness factors associated with the QOL among 117 individuals involved with caregiving for schizophrenia patients. The study used WHOQOL-BREF to assess caregivers' QOL and Brief Psychiatric Rating Scale (BPRS to assess the severity of patients' symptoms. Social Readjustment Rating Scale (SRRS assessed the stress level due to life events. Results The mean scores of WHOQOL-BREF in physical, psychological, social and environmental domains were 66.62 (14.36, 61.32 (15.52, 62.77 (17.33, 64.02 (14.86 consecutively. From multiple regression analysis, factors found to be significantly associated with higher QOL were higher educational level among caregivers in social and environmental domains; caregivers not having medical problem/s in physical and psychological domains; later onset and longer illness duration of illness in social domains; patients not attending day care program in environmental domain; lower BPRS score in physical and environmental domains. SRRS score of caregivers was also found to have a significant negative correlation with QOL in environmental and psychological domains. Other factors were not significantly associated with QOL. Conclusion Caregivers with more social advantages such as higher educational level and physically healthier and dealing with less severe illness had significantly higher QOL in various aspects. Supporting the caregivers in some of these modifiable factors in clinical practice is important to achieve their higher level QOL.

Predicting Future High-Cost Schizophrenia Patients Using High-Dimensional Administrative Data

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Yajuan Wang

2017-06-01

Full Text Available BackgroundThe burden of serious and persistent mental illness such as schizophrenia is substantial and requires health-care organizations to have adequate risk adjustment models to effectively allocate their resources to managing patients who are at the greatest risk. Currently available models underestimate health-care costs for those with mental or behavioral health conditions.ObjectivesThe study aimed to develop and evaluate predictive models for identification of future high-cost schizophrenia patients using advanced supervised machine learning methods.MethodsThis was a retrospective study using a payer administrative database. The study cohort consisted of 97,862 patients diagnosed with schizophrenia (ICD9 code 295.* from January 2009 to June 2014. Training (n = 34,510 and study evaluation (n = 30,077 cohorts were derived based on 12-month observation and prediction windows (PWs. The target was average total cost/patient/month in the PW. Three models (baseline, intermediate, final were developed to assess the value of different variable categories for cost prediction (demographics, coverage, cost, health-care utilization, antipsychotic medication usage, and clinical conditions. Scalable orthogonal regression, significant attribute selection in high dimensions method, and random forests regression were used to develop the models. The trained models were assessed in the evaluation cohort using the regression R2, patient classification accuracy (PCA, and cost accuracy (CA. The model performance was compared to the Centers for Medicare & Medicaid Services Hierarchical Condition Categories (CMS-HCC model.ResultsAt top 10% cost cutoff, the final model achieved 0.23 R2, 43% PCA, and 63% CA; in contrast, the CMS-HCC model achieved 0.09 R2, 27% PCA with 45% CA. The final model and the CMS-HCC model identified 33 and 22%, respectively, of total cost at the top 10% cost cutoff.ConclusionUsing advanced feature selection leveraging detailed

Imaging dopamine transmission in schizophrenia

International Nuclear Information System (INIS)

Laruelle, M.

1998-01-01

Over the last ten years, several positron emission tomography (PET) and single photon computerized tomography (SPECT) studies of the dopamine (DA) system in patients with schizophrenia were performed to test the hypothesis that DA hyperactivity is associated with this illness. In this paper are reviewed the results of fifteen brain imaging studies comparing indices of DA function in drug naive or drug free patients with schizophrenia and healthy controls: thirteen studies included measurements of Da D 2 receptor density, two studies compared amphetamine-induced DA release, and two studies measured DOPA decarboxylase activity, an enzyme involved in DA synthesis. It was conducted a meta-analysis of the studies measuring D 2 receptor density parameters, under the assumption that all tracers labeled the same population of D 2 receptors. This analysis revealed that, compared to healthy controls, patients with schizophrenia present a significant but mild elevation of D 2 receptor density parameters and a significant larger variability of these indices. It was found no statistical evidence that studies performed with radiolabeled butyrophenones detected a larger increase in D 2 receptor density parameters than studies performed with other radioligands, such as benzamides. Studies of presynaptic activity revealed an increase in DA transmission response to amphetamine challenge, and an increase in DOPA decarboxylase activity. Together, these data are compatible with both pre- and post-synaptic alterations of DA transmission in schizophrenia. Future studies should aim at a better characterization of these alterations, and at defining their role in the pathophysiology of the illness

Evaluation of expressed emotion in schizophrenia: a comparison of Caucasians and Mexican-Americans.

Science.gov (United States)

Kopelowicz, Alex; Zarate, Roberto; Gonzalez, Veronica; Lopez, Steven R; Ortega, Paula; Obregon, Nora; Mintz, Jim

2002-05-01

Social desirability, while a recognized source of respondent bias among Mexican-Americans, has not been evaluated as an explanation for the lower rate of high expressed emotion (EE) found in the family members of Mexican-Americans versus Caucasians with schizophrenia. In this study, we tested the hypothesis that the lower rate of high EE (hostility and criticism) among Mexican-Americans was the result of cultural factors impacting on how information was reported by the Mexican-American relative of a patient with schizophrenia. We compared the ratings of EE between Caucasian (N = 17) and Mexican-American (N = 44) patients with schizophrenia or schizoaffective disorder and their key relatives using the level of expressed emotion (LEE) scale (paper and pencil instrument rated by the patient and relative separately) and the Five Minute Speech Sample (observational experimenter rated). The ability of the various measures to predict relapse over two years was also examined. Contrary to our hypothesis, there were no differences between patient and family measures within ethnic group. Mexican-American patients and relatives reported lower rates of high EE than Caucasians across all measures. High EE predicted relapse across measures for Caucasian participants, but did not predict relapse for Mexican-Americans on any of the measurement instruments. We discuss the implications of these findings on cross-cultural research and family interventions for individuals with psychotic disorders.

Social support and religion: mental health service use and treatment of schizophrenia.

Science.gov (United States)

Smolak, A; Gearing, R E; Alonzo, D; Baldwin, S; Harmon, S; McHugh, K

2013-08-01

The perceptions and religious beliefs held by family members, mental health and health care professionals, and the community may affect the treatment of individuals with schizophrenia. To better identify and understand the influence of families, professionals and community members on individual's treatment for schizophrenia, this review paper examines: (1) the religious perceptions of families, professionals, and the public towards schizophrenia; (2) religious perceptions of the etiology of schizophrenia; (3) how others perceive religion as a coping mechanism; and (4) how religion influences treatment engagement and help-seeking behaviors. MEDLINE and PsycInfo databases were systematically searched from 1980 to 2010 using the terms schizophrenia, schizoaffective, schizophreniform, psychotic disorder not otherwise specified and religion, religiosity, spirituality, and faith. Forty-three (n = 43) original research studies met the inclusion criteria. This study found that religious beliefs influence the treatment of schizophrenia in the following ways: Religious themes were positively associated with coping, treatment engagement and help-seeking behavior. Evidence of religious underpinnings was found in perceptions of etiology. The findings also indicate that there is often both a preference among family members and caregivers to utilize religious-based professionals and caution toward mental health professionals. Researchers and professionals may find avenues for improving treatment through examining the interaction of religious and schizophrenia at the social support level.

Schizophrenia and city life.

Science.gov (United States)

Lewis, G; David, A; Andréasson, S; Allebeck, P

1992-07-18

Prevalence of schizophrenia and rates of first admission to hospital for this disorder are higher in most modern industrialised cities, and in urban compared with rural areas. The "geographical drift" hypothesis (ie, most schizophrenics tend to drift into city areas because of their illness or its prodrome) has remained largely unchallenged. We have investigated the association between place of upbringing and the incidence of schizophrenia with data from a cohort of 49,191 male Swedish conscripts linked to the Swedish National Register of Psychiatric Care. The incidence of schizophrenia was 1.65 times higher (95% confidence interval 1.19-2.28) among men brought up in cities than in those who had had a rural upbringing. The association persisted despite adjustment for other factors associated with city life such as cannabis use, parental divorce, and family history of psychiatric disorder. This finding cannot be explained by the widely held notion that people with schizophrenia drift into cities at the beginning of their illness. We conclude that undetermined environmental factors found in cities increase the risk of schizophrenia.

Caregivers in schizophrenia: A cross Cultural Perspective.

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Talwar, Prashant; Matheiken, Shevonne Tresa

2010-01-01

Schizophrenia not only influences the lives of those affected but also those around them, especially the caregivers. This study examines the different determinants that are likely to contribute to the caregivers' perception of burden of care across different countries namely Malaysia and India, using the burden assessment schedule. The goals for this study were, to study the psychosocial and demographic aspects of patients suffering from schizophrenia, to study the levels of perceived burden of the Malaysian and Indian families caring for a relative with schizophrenia, and to study the determinants that contributes to the caregivers' perception of burden of care. The study was conducted in private hospitals, both in Malaysia as well as Mangalore after obtaining the necessary approval. 50 schizophrenia patients and their caregivers in Malaysia and India were chosen using the purposive sampling technique. The inclusion criteria were a minimum of 5 years since diagnosis of schizophrenia. Although the Indian caregivers perceived difficulties in several areas such as finance, family relationship, well-being and health, they still perceived burden to be lesser compared to Malaysian counterpart. Intensified community based care can reduce burden.

Key Elements of a Family Intervention for Schizophrenia: A Qualitative Analysis of an RCT.

Science.gov (United States)

Grácio, Jaime; Gonçalves-Pereira, Manuel; Leff, Julian

2018-03-01

Schizophrenia is a complex biopsychosocial condition in which expressed emotion in family members is a robust predictor of relapse. Not surprisingly, family interventions are remarkably effective and thus recommended in current treatment guidelines. Their key elements seem to be common therapeutic factors, followed by education and coping skills training. However, few studies have explored these key elements and the process of the intervention itself. We conducted a qualitative and quantitative analysis of the records from a pioneering family intervention trial addressing expressed emotion, published by Leff and colleagues four decades ago. Records were analyzed into categories and data explored using descriptive statistics. This was complemented by a narrative evaluation using an inductive approach based on emotional markers and markers of change. The most used strategies in the intervention were addressing needs, followed by coping skills enhancement, advice, and emotional support. Dealing with overinvolvement and reframing were the next most frequent. Single-family home sessions seemed to augment the therapeutic work conducted in family groups. Overall the intervention seemed to promote cognitive and emotional change in the participants, and therapists were sensitive to the emotional trajectory of each subject. On the basis of our findings, we developed a longitudinal framework for better understanding the process of this treatment approach. © 2016 Family Process Institute.

Schizophrenia and psychotic symptoms in families of two American Indian tribes

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Albaugh Bernard

2007-06-01

Full Text Available Abstract Background The risk of schizophrenia is thought to be higher in population isolates that have recently been exposed to major and accelerated cultural change, accompanied by ensuing socio-environmental stressors/triggers, than in dominant, mainstream societies. We investigated the prevalence and phenomenology of schizophrenia in 329 females and 253 males of a Southwestern American Indian tribe, and in 194 females and 137 males of a Plains American Indian tribe. These tribal groups were evaluated as part of a broader program of gene-environment investigations of alcoholism and other psychiatric disorders. Methods Semi-structured psychiatric interviews were conducted to allow diagnoses utilizing standardized psychiatric diagnostic criteria, and to limit cultural biases. Study participants were recruited from the community on the basis of membership in pedigrees, and not by convenience. After independent raters evaluated the interviews blindly, DSM-III-R diagnoses were assigned by a consensus of experts well-versed in the local cultures. Results Five of the 582 Southwestern American Indian respondents (prevalence = 8.6 per 1000, and one of the 331 interviewed Plains American Indians (prevalence = 3.02 per 1000 had a lifetime diagnosis of schizophrenia. The lifetime prevalence rates of schizophrenia within these two distinct American Indian tribal groups is consistent with lifetime expectancy rates reported for the general United States population and most isolate and homogeneous populations for which prevalence rates of schizophrenia are available. While we were unable to factor in the potential modifying effect that mortality rates of schizophrenia-suffering tribal members may have had on the overall tribal rates, the incidence of schizophrenia among the living was well within the normative range. Conclusion The occurrence of schizophrenia among members of these two tribal population groups is consistent with prevalence rates reported for

Patterns of stigma toward schizophrenia among the general population: a latent profile analysis.

Science.gov (United States)

Loch, Alexandre A; Wang, Yuan-Pang; Guarniero, Francisco B; Lawson, Fabio L; Hengartner, Michael P; Rössler, Wulf; Gattaz, Wagner F

2014-09-01

Our purpose was to assess stigma toward schizophrenia in a representative sample of the Brazilian general population. The sample consisted of 1015 individuals interviewed by telephone. A vignette describing someone with schizophrenia was read, and four stigma aspects regarding this hypothetical individual were assessed: stereotypes, restrictions, perceived prejudice and social distance. Latent profile analysis searched for stigma profiles among the sample. Multinomial logistic regression was used to find correlates of each class. Four stigma profiles were found; 'no stigma' individuals (n = 251) mostly displayed positive opinions. 'Labelers' (n = 222) scored high on social distance; they more often had familial contact with mental illness and more often labeled the vignette's disorder as schizophrenia. 'Discriminators', the group with the majority of individuals (n = 302), showed high levels of stigmatizing beliefs in all dimensions; discriminators were significantly older. 'Unobtrusive stigma' individuals (n = 240) seemed to demonstrate uncertainty or low commitment since they mostly answered items with the middle/impartial option. Some findings from the international literature were replicated; however, familial contact increased stigma, possibly denoting a locally modulated determinant. Hereby, our study also adds important cross-cultural data by showing that stigma toward schizophrenia is high in a Latin-American setting. We highlight the importance of analyzing the general population as a heterogeneous group, aiming to better elaborate anti-stigma campaigns. © The Author(s) 2013.

Candidate CSPG4 mutations and induced pluripotent stem cell modeling implicate oligodendrocyte progenitor cell dysfunction in familial schizophrenia

NARCIS (Netherlands)

F.M.S. Vrij (Femke); C.G. Bouwkamp (Christian); N. Gunhanlar (Nilhan); G. Shpak (Guy); B. Lendemeijer (Bert); Baghdadi, M. (Maarouf); Gopalakrishna, S. (Shreekara); M. Ghazvini (Mehrnaz); T. Li (Tracy); M. Quadri (Marialuisa); S. Olgiati (Simone); G.J. Breedveld (Guido); M.P.H. Coesmans (Michiel); E.J. Mientjes (Edwin); de Wit, T. (Ton); F.W. Verheijen (Frans); H.B. Beverloo (Berna); Cohen, D. (Dan); Kok, R.M. (Rob M.); P.R. Bakker (Roberto); Nijburg, A. (Aviva); A.T. Spijker (Anne); P.M.J. Haffmans (P.M. Judith); Hoencamp, E. (Erik); V. Bergink (Veerle); J.A.S. Vorstman; Wu, T. (Timothy); L.M. Olde Loohuis (Loes M.); Amin, N. (Najaf); C.D. Langen (Carolyn); Hofman, A. (Albert); W.J.G. Hoogendijk (Witte); van Duijn, C.M. (Cornelia M.); Ikram, M.A. (M. A.); M.W. Vernooij (Meike); H.W. Tiemeier (Henning); Uitterlinden, A.G. (André G.); Y. Elgersma (Ype); B. Distel (Ben); J.H. Gribnau (Joost); T.J.H. White (Tonya); V. Bonifati (Vincenzo); Kushner, S.A. (Steven A.)

2018-01-01

textabstractSchizophrenia is highly heritable, yet its underlying pathophysiology remains largely unknown. Among the most well-replicated findings in neurobiological studies of schizophrenia are deficits in myelination and white matter integrity; however, direct etiological genetic and cellular

[Prevention of schizophrenia: a review].

Science.gov (United States)

Balhara, Yatan Pal Singh

2013-01-01

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

Schizophrenia and Suicide

Directory of Open Access Journals (Sweden)

Ozlem Cetin

2011-12-01

Full Text Available Suicide is one of the major causes of premature death among patients with schizophrenia. Follow-up studies have estimated that 4-5% of these patients die by suicide. Reducing the high rates of suicide in schizophrenia is possible with understanding of predictive risk factors. Various studies have identified risk factors for suicide in schizophrenia patients. Clinical risk factors include previous suicide attempts, comorbid depression, feelings of hopelessness, concept of insight and substance abuse. Biopsychosocial factors, such as a high intelligence quotient and high level of premorbid functioning, have also been associated with an increased risk of suicide in patients with schizophrenia. The risk of suicide is considered to be highest in the early course of illness. Antipsychotic drugs, in particular clozapine and antidepressants may be helpful in reducing the risk of suicide in schizophrenia.

Potential Value of Genomic Copy Number Variations in Schizophrenia

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Chuanjun Zhuo

2017-06-01

Full Text Available Schizophrenia is a devastating neuropsychiatric disorder affecting approximately 1% of the global population, and the disease has imposed a considerable burden on families and society. Although, the exact cause of schizophrenia remains unknown, several lines of scientific evidence have revealed that genetic variants are strongly correlated with the development and early onset of the disease. In fact, the heritability among patients suffering from schizophrenia is as high as 80%. Genomic copy number variations (CNVs are one of the main forms of genomic variations, ubiquitously occurring in the human genome. An increasing number of studies have shown that CNVs account for population diversity and genetically related diseases, including schizophrenia. The last decade has witnessed rapid advances in the development of novel genomic technologies, which have led to the identification of schizophrenia-associated CNVs, insight into the roles of the affected genes in their intervals in schizophrenia, and successful manipulation of the target CNVs. In this review, we focus on the recent discoveries of important CNVs that are associated with schizophrenia and outline the potential values that the study of CNVs will bring to the areas of schizophrenia research, diagnosis, and therapy. Furthermore, with the help of the novel genetic tool known as the Clustered Regularly Interspaced Short Palindromic Repeats-associated nuclease 9 (CRISPR/Cas9 system, the pathogenic CNVs as genomic defects could be corrected. In conclusion, the recent novel findings of schizophrenia-associated CNVs offer an exciting opportunity for schizophrenia research to decipher the pathological mechanisms underlying the onset and development of schizophrenia as well as to provide potential clinical applications in genetic counseling, diagnosis, and therapy for this complex mental disease.

Intellectual functioning and the long-term course of schizophrenia-spectrum illness

DEFF Research Database (Denmark)

Carter, Jessica; Parnas, J; Urfer-Parnas, A

2010-01-01

BACKGROUND: Recent neurodevelopmental models of schizophrenia, together with substantial evidence of neurocognitive dysfunction among people with schizophrenia, have led to a widespread view that general cognitive deficits are a central aspect of schizophrenic pathology. However, the temporal...... with an evident family history of schizophrenia....

Lack of association between the pseudo deficiency mutation in the arylsulfatase A gene on chromosome 22 with schizophrenia

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Chang, P.L.; Chetty, V. [McMaster Univ., Ontario (Canada); Kasch, L. [Johns Hopkins Univ., Baltimore, MD (United States)] [and others

1994-09-01

Arylsulfatase-A deficiency causes the neurodegenerative lysosomal storage disease metachromatic leukodystrophy. In the late-onset variant, schizophrenia-like psychosis is a frequent finding and sometimes given as the initial diagnosis. A mutant allele, pseudo-deficiency, causes deficient enzyme activity but no apparent clinical effect. It occurs at a high frequency and consists of two tightly-linked A{r_arrow}G transitions: one causing the loss of a glycosylation site (PDg); and one causing the loss of a polyadenylation signal (PDa). Since this gene was mapped to chromosome 22q13-qter, a region implicated in a potential linkage with schizophrenia, we hypothesized that this common mutation may be a predisposing genetic factor for schizophrenia. We studied a random sample of schizophrenic patients for possible increase in frequency of the pseudo-deficiency mutations and in multiplex families to verify if the mutations are linked to schizophrenia. Among 50 Caucasian patients identified through out-patient and in-patient clinics, the frequencies for the three alleles PDg + PDa together, PDg or PDa alone were 11%, 5% and 0%, respectively. The corresponding frequencies among 100 Caucasian controls were 7.5%, 6% and 0%, respectively, the differences between the patients and controls being insignificant ({chi}{sup 2}tests: 0.10families with schizophrenia, 22 families had neither PDg nor PDa; 22 families had at least one (PDg + PDa) allele and 18 families at least one PDg allele. The (PDg + PDa) allele was found in 19 of the 135 affected individuals (14.1%) and 38 of the 301 unaffected (12.6%). The PDg mutation alone was seen in 41 of the 135 affected (30.4%) and 71 of the 301 unaffected (23.6%). In conclusion, although arylsulfatase-A deficiency may cause schizophrenia-like symptoms and the region of its locus is implicated in potential linkage to schizophrenia, its most common mutations are not linked to schizophrenia.

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

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Abdulkareem Jika Yusuf

2009-06-01

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

Some new approaches for prevention of schizophrenia spectrum disorders in patients exposed to exogenous stressors

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Nataliya Dzeruzhinska

2017-08-01

Full Text Available Background. Environment factors affect to the clinical phenotype of schizophrenia spectrum disorders. Aim. To develop recommendations for the prevention schizophrenia spectrum disorders considering the influence of environmental factors on the clinical pathomorphosis of the disease. Methods. It was conducted the psychopathological and psychodiagnostic survey of 186 patients with schizophrenia spectrum disorders with an assessment of clinical features and level of social functioning. It was identified factors that have the most significant pathological effects on the course of disorders on the basis of the received data: the using of a cannabinoid in a family history, mother`s infectious and somatic diseases during pregnancy, mother's using alcohol during pregnancy, consumption of alcohol in adolescent patients, fetal hypoxia or perinatal trauma of the patient at birth, problems with the group of primary support in the family of a child in childhood, maternal toxicosis, crisis relationships in the family, migration to different cultural environment. Results. Clinical pathomorphism of disorders of the spectrum of schizophrenia under the influence of environmental factors determines the features of psychotherapeutic interventions. In people with cannabinoids, it is important to eliminate the symptoms of anxiety through emotion-supportive measures, as well as to create a motivation to ask help in case of symptoms of schizophrenia spectrum disorders. In a group with perinatal complications, the emphasis should be put on cognitive methods in order to correct mental disorders and overcome hypochondria. Early measures to form a positive attitude towards themselves and the environment, supporting family relationships, overcoming depressive symptoms, and developing social activity are targets of psychotherapeutic interventions in people with schizophrenic spectrum disorders and psychological traumatic events. Conclusion. Minimization of environmental

Abnormal rich club organization and functional brain dynamics in schizophrenia.

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van den Heuvel, Martijn P; Sporns, Olaf; Collin, Guusje; Scheewe, Thomas; Mandl, René C W; Cahn, Wiepke; Goñi, Joaquín; Hulshoff Pol, Hilleke E; Kahn, René S

2013-08-01

The human brain forms a large-scale structural network of regions and interregional pathways. Recent studies have reported the existence of a selective set of highly central and interconnected hub regions that may play a crucial role in the brain's integrative processes, together forming a central backbone for global brain communication. Abnormal brain connectivity may have a key role in the pathophysiology of schizophrenia. To examine the structure of the rich club in schizophrenia and its role in global functional brain dynamics. Structural diffusion tensor imaging and resting-state functional magnetic resonance imaging were performed in patients with schizophrenia and matched healthy controls. Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, the Netherlands. Forty-eight patients and 45 healthy controls participated in the study. An independent replication data set of 41 patients and 51 healthy controls was included to replicate and validate significant findings. MAIN OUTCOME(S) AND MEASURES: Measures of rich club organization, connectivity density of rich club connections and connections linking peripheral regions to brain hubs, measures of global brain network efficiency, and measures of coupling between brain structure and functional dynamics. Rich club organization between high-degree hub nodes was significantly affected in patients, together with a reduced density of rich club connections predominantly comprising the white matter pathways that link the midline frontal, parietal, and insular hub regions. This reduction in rich club density was found to be associated with lower levels of global communication capacity, a relationship that was absent for other white matter pathways. In addition, patients had an increase in the strength of structural connectivity-functional connectivity coupling. Our findings provide novel biological evidence that schizophrenia is characterized by a selective

Korean sibling caregivers of individuals diagnosed with schizophrenia

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Mijung Park

2017-12-01

Full Text Available Siblings of individuals diagnosed with schizophrenia are an important source of family caregiving. Unfortunately, limited information is available about sibling caregivers because existing studies have focused on other family relationships such as parents, spouses, and children. To fill the knowledge gap, the purpose of this study is to describe Korean sibling caregivers’ experience with individuals diagnosed with schizophrenia. Guided by Colaizzi’s descriptive phenomenological methodology, we conducted in-depth, semi-structured, face-to-face interviews with eight individuals who have a sibling (1 diagnosed with schizophrenia and (2 hospitalized in an inpatient psychiatric unit. We discerned six key themes: sorrow, burnout, shame, different perspectives in life, acceptance, and responsibility. We categorized these themes into three groups: suffering, hope, and responsibility and obligation. Sibling caregivers of individuals with schizophrenia experience a mixture of several emotions. Participants loved their brother or sister with schizophrenia, but at the same time they felt shame and fear. While they were burdened by the responsibilities of caregiving, they remained loyal to their sibling with schizophrenia, continuing to help their siblings reach their full potential. Although participants were confused about the symptoms of schizophrenia, they were committed to learning more about the illness. Because we conducted the current study in Korea, the findings of this study may be unique to Korea culture. Further studies are needed to compare and contrast nuanced differences in sibling caregivers’ experience among different cultural groups.

The cost of schizophrenia in Japan

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Sado M

2013-05-01

Full Text Available Mitsuhiro Sado,1 Ataru Inagaki,2 Akihiro Koreki,1 Martin Knapp,3 Lee Andrew Kissane,4 Masaru Mimura,1 Kimio Yoshimura4 1Department of Neuropsychiatry, Keio University School of Medicine, 2Center for Clinical Psychopharmacology, Institute of Neuropsychiatry, Tokyo, Japan; 3Department of Social Policy, London School of Economics and Political Science, London, UK; 4Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan Introduction: Schizophrenia is a disorder that produces considerable burdens due to its often relapsing/remitting or chronic longitudinal course. This burden is felt not only by patients themselves, but also by their families and health care systems. Although the societal burden caused by this disorder has been evaluated in several countries, the magnitude of the societal cost of schizophrenia in Japan has never been estimated. The aim of this study is to clarify the societal burden of schizophrenia by estimating the cost of schizophrenia in Japan in 2008. Methods: A human capital approach was adopted to estimate the cost of schizophrenia. The total cost of schizophrenia was calculated as the sum of the direct, morbidity, and mortality costs. Schizophrenia was defined as disorders coded as F20.0–F20.9 according to the International Classification of Diseases-10. The data required to estimate the total cost was collected from publicly available statistics or previously reported studies. Results: The total cost of schizophrenia in Japan in 2008 was JPY 2.77 trillion (USD 23.8 billion. While the direct cost was JPY 0.770 trillion (USD 6.59 billion, the morbidity and mortality costs were JPY 1.85 trillion (USD 15.8 billion and JPY 0.155 trillion (USD 1.33 billion, respectively. Conclusion: The societal burden caused by schizophrenia is tremendous in Japan, similar to that in other developed countries where published data exist. Compared with other disorders, such as depression or anxiety disorders

Cardiovascular coupling analysis with high-resolution joint symbolic dynamics in patients suffering from acute schizophrenia

International Nuclear Information System (INIS)

Schulz, Steffen; Tupaika, Nadine; Voss, Andreas; Berger, Sandy; Bär, Karl-Jürgen; Haueisen, Jens

2013-01-01

Besides the well-known cardiac risk factors for schizophrenia, increasing concerns have been raised regarding the cardiac side-effects of antipsychotic medications. A bivariate analysis of autonomic regulation, based on cardiovascular coupling, can provide additional information about heart rate (HR) and blood pressure regulatory patterns within the complex interactions of the cardiovascular system. We introduce a new high-resolution coupling analysis method (HRJSD) based on joint symbolic dynamics (JSD), which is characterized by three symbols, a threshold (individual dynamic variability, physiological) for time series transformation and eight coupling pattern families. This is based on a redundancy reduction strategy used to quantify and characterize cardiovascular couplings. In this study, short-term (30 min) HR and systolic blood pressure (SP) time series of 42 unmedicated (UNMED) and 42 medicated patients (MED) suffering from acute schizophrenia were analysed to establish the suitability of the new method for quantifying the effects of antipsychotics on cardiovascular couplings. We were able to demonstrate that HRJSD, applying the threshold based on spontaneous baroreflex sensitivity (BRS) estimation, revealed eight significant pattern families that were able to quantify the anti-cholinergic effects of antipsychotics and the related changes of cardiovascular regulation (coupling) in MED in comparison to UNMED. This was in contrast to the simple JSD, BRS (sequence method) and only partly to standard linear HR variability indices. HRJSD provides strong evidence that autonomic regulation in MED seems to be, to some extent, predominated by invariable HR responses in combination with alternating SP values in contrast to UNMED, indicating an impairment of the baroreflex control feedback loop in MED. Surrogate data analysis was applied to test for the significance and nonlinearity of cardiovascular couplings in the original data due to medical treatment with

Improving clinician competency in communication about schizophrenia: a pilot educational program for psychiatry trainees.

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Loughland, Carmel; Kelly, Brian; Ditton-Phare, Philippa; Sandhu, Harsimrat; Vamos, Marina; Outram, Sue; Levin, Tomer

2015-04-01

Important gaps are observed in clinicians' communication with patients and families about psychiatric disorders such as schizophrenia. Communication skills can be taught, and models for education in these skills have been developed in other fields of medicine, such as oncology, providing a framework for training communication skills relevant to psychiatric practice. This study evaluated a pilot communication skills education program for psychiatry trainees, focusing on discussing schizophrenia diagnosis and prognosis. Communication skills training modules were developed based on an existing theoretical framework (ComSkil), adapted for discussing a schizophrenia diagnosis and prognosis. Pre-post training rating of self-reported confidence in a range of communication tasks was obtained, along with trainee views on the training methods. Thirty-eight participants completed the training. Significant improvements in confidence were reported post training for discussing schizophrenia prognosis, including an increased capacity to critically evaluate their own communication skills. Participants reported high levels of satisfaction with the program. This preliminary study provides support for the translation of a well-established educational model to psychiatric training addressing core clinical communication tasks and provides the foundation for the development of a more comprehensive evaluation and an extended curriculum regarding other aspects of care for patients with schizophrenia: ongoing management and recovery, dealing with conflict, and conducting a family interview.

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

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

2018-06-01

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

[Influence of paternal age in schizophrenia].

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Hubert, A; Szöke, A; Leboyer, M; Schürhoff, F

2011-06-01

Schizophrenia is an aetiologically heterogeneous syndrome, with a strong genetic component. Despite a reduced fertility in this disorder, its prevalence is maintained and could be explained by de novo genetic mutations. Advanced paternal age (APA) is a major source of new mutations in human beings and could thus be associated with an increased risk of developing schizophrenia in offspring. New mutations related to APA have been implicated as a cause of sporadic cases in several autosomal dominant diseases and also in neurodevelopmental diseases, autism, intellectual disabilities, and social functioning. The aim of the present study was to summarize the results of studies investigating the role of APA, and to discuss some interpretations. All relevant studies were identified through the National Library of Medicine (PubMed(®) database). Keywords used for research were "age" and "schizophrenia" linked to "paternal or father". We have identified and analysed eight cohort studies, five case-control studies, two meta-analyses, and one review concerning different father's mutations potentially transmitted, two studies comparing paternal age at conception between sporadic versus familial cases of schizophrenia. All studies selected have been published between 2000 and 2009. After controlling for several confounding factors including maternal age, the relative risk of schizophrenia increased from 1.84 to 4.62 in offspring of fathers with an older age of fatherhood. Mother's age showed no significant effects after adjusting for paternal age. There was a significant association between paternal age and risk of developing schizophrenia, there was a weaker association with psychosis. The results of these different studies are confirmed by two recent meta-analyses which found an increased risk of schizophrenia in offspring of fathers older than 35 years. Two main hypotheses could explain these results. The first one is based on the presence of new mutations in the

Recent advances in understanding schizophrenia.

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Haller, Chiara S; Padmanabhan, Jaya L; Lizano, Paulo; Torous, John; Keshavan, Matcheri

2014-01-01

Schizophrenia is a highly disabling disorder whose causes remain to be better understood, and treatments have to be improved. However, several recent advances have been made in diagnosis, etiopathology, and treatment. Whereas reliability of diagnosis has improved with operational criteria, including Diagnostic and Statistical Manual of Mental Disorders, (DSM) Fifth Edition, validity of the disease boundaries remains unclear because of substantive overlaps with other psychotic disorders. Recent emphasis on dimensional approaches and translational bio-behavioral research domain criteria may eventually help move toward a neuroscience-based definition of schizophrenia. The etiology of schizophrenia is now thought to be multifactorial, with multiple small-effect and fewer large-effect susceptibility genes interacting with several environmental factors. These factors may lead to developmentally mediated alterations in neuroplasticity, manifesting in a cascade of neurotransmitter and circuit dysfunctions and impaired connectivity with an onset around early adolescence. Such etiopathological understanding has motivated a renewed search for novel pharmacological as well as psychotherapeutic targets. Addressing the core features of the illness, such as cognitive deficits and negative symptoms, and developing hypothesis-driven early interventions and preventive strategies are high-priority goals for the field. Schizophrenia is a severe, chronic mental disorder and is among the most disabling disorders in all of medicine. It is estimated by the National Institute of Mental Health (NIMH) that 2.4 million people over the age of 18 in the US suffer from schizophrenia. This illness typically begins in adolescence and derails the formative goals of school, family, and work, leading to considerable suffering and disability and reduced life expectancy by about 20 years. Treatment outcomes are variable, and some people are successfully treated and reintegrated (i.e. go back to work

Neglect and hereditary risk: Their relative contribution to schizophrenia with negative symptomatology.

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Gallagher, Bernard J; Jones, Brian J

2016-05-01

There is evidence that genetic and environmental stressors contribute to the genesis of schizophrenia. However, the relevant impact of each factor remains unclear. We tested for an interactive effect between childhood neglect and family history of serious mental illness. Data were further analyzed for a possible connection to type of schizophrenic symptoms. Data for the study are taken from the medical records of 641 patients with schizophrenia from a large state hospital in the northeastern United States. Clinical assessments were divided into positive and negative symptomatology through application of the Scale for the Assessment of Negative Symptoms (SANS), the Scale for the Assessment of Positive Symptoms (SAPS) and the Positive and Negative Syndrome Scale (PANSS). Detailed information about childhood neglect and family history of serious mental illness was obtained through Social Service Assessment interviews at intake and during hospital stay. Among clients with no family history of mental illness, childhood neglect does not meaningfully affect the risk of negative versus positive schizophrenia. For clients with such history, on the other hand, neglect significantly raises the risk of schizophrenia with negative symptomatology. Our central finding is that risk for negative symptoms of schizophrenia are elevated by childhood neglect combined with a history of serious mental illness within the family. This is the only report to combine schizophrenic symptoms, familial risk and childhood neglect to date. Implications for primary prevention and treatment are discussed. © The Author(s) 2016.

Where now for schizophrenia research?

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Nutt, David J; Need, Anna C

2014-08-01

Schizophrenia continues to pose a serious challenge to neuroscience and psychiatry as well as to health care systems and to the patients and families who suffer this terrible and disabling illness. Major developments in the past few months in both genetics and drug development oblige us to consider novel drug discovery tactics for future schizophrenia research. Here we review what we consider to be the key issues and some suggested solutions. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Reconsidering Clinical Staging Model: A Case of Genetic High Risk for Schizophrenia

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Lee, Tae Young; Kim, Minah; Kim, Sung Nyun; Kwon, Jun Soo

2016-01-01

The clinical staging model is considered a useful and practical method not only in dealing with the early stage of psychosis overcoming the debate about diagnostic boundaries but also in emerging mood disorder. However, its one limitation is that it cannot discriminate the heterogeneity of individuals at clinical high risk for psychosis, but lumps them all together. Even a healthy offspring of schizophrenia can eventually show clinical symptoms and progress to schizophrenia under the influenc...

Robust differences in antisaccade performance exist between COGS schizophrenia cases and controls regardless of recruitment strategies.

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Radant, Allen D; Millard, Steven P; Braff, David L; Calkins, Monica E; Dobie, Dorcas J; Freedman, Robert; Green, Michael F; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Light, Gregory A; Meichle, Sean P; Nuechterlein, Keith H; Olincy, Ann; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Stone, William S; Swerdlow, Neal R; Sugar, Catherine A; Tsuang, Ming T; Turetsky, Bruce I; Tsuang, Debby W

2015-04-01

The impaired ability to make correct antisaccades (i.e., antisaccade performance) is well documented among schizophrenia subjects, and researchers have successfully demonstrated that antisaccade performance is a valid schizophrenia endophenotype that is useful for genetic studies. However, it is unclear how the ascertainment biases that unavoidably result from recruitment differences in schizophrenia subjects identified in family versus case-control studies may influence patient-control differences in antisaccade performance. To assess the impact of ascertainment bias, researchers from the Consortium on the Genetics of Schizophrenia (COGS) compared antisaccade performance and antisaccade metrics (latency and gain) in schizophrenia and control subjects from COGS-1, a family-based schizophrenia study, to schizophrenia and control subjects from COGS-2, a corresponding case-control study. COGS-2 schizophrenia subjects were substantially older; had lower education status, worse psychosocial function, and more severe symptoms; and were three times more likely to be a member of a multiplex family than COGS-1 schizophrenia subjects. Despite these variations, which were likely the result of ascertainment differences (as described in the introduction to this special issue), the effect sizes of the control-schizophrenia differences in antisaccade performance were similar in both studies (Cohen's d effect size of 1.06 and 1.01 in COGS-1 and COGS-2, respectively). This suggests that, in addition to the robust, state-independent schizophrenia-related deficits described in endophenotype studies, group differences in antisaccade performance do not vary based on subject ascertainment and recruitment factors. Published by Elsevier B.V.

Global economic burden of schizophrenia: a systematic review

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Chong HY

2016-02-01

Full Text Available Huey Yi Chong,1 Siew Li Teoh,1 David Bin-Chia Wu,1 Surachai Kotirum,1 Chiun-Fang Chiou,2 Nathorn Chaiyakunapruk1,3–5 1School of Pharmacy, Monash University Malaysia, Selangor, Malaysia; 2Janssen Pharmaceutical Companies Asia Pacific, Singapore; 3Center of Pharmaceutical Outcomes Research (CPOR, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand; 4School of Pharmacy, University of Wisconsin, Madison, WI, USA; 5School of Population Health, University of Queensland, Brisbane, Australia Background: Schizophrenia is one of the top 25 leading causes of disability worldwide in 2013. Despite its low prevalence, its health, social, and economic burden has been tremendous, not only for patients but also for families, caregivers, and the wider society. The magnitude of disease burden investigated in an economic burden study is an important source to policymakers in decision making. This study aims to systematically identify studies focusing on the economic burden of schizophrenia, describe the methods and data sources used, and summarize the findings of economic burden of schizophrenia. Methods: A systematic review was performed for economic burden studies in schizophrenia using four electronic databases (Medline, EMBASE, PsycINFO, and EconLit from inception to August 31, 2014. Results: A total of 56 articles were included in this review. More than 80% of the studies were conducted in high-income countries. Most studies had undertaken a retrospective- and prevalence-based study design. The bottom-up approach was commonly employed to determine cost, while human capital method was used for indirect cost estimation. Database and literature were the most commonly used data sources in cost estimation in high-income countries, while chart review and interview were the main data sources in low and middle-income countries. Annual costs for the schizophrenia population in the country ranged from US$94

Preventing Schizophrenia and Severe Mental Illness: A Grand Challenge for Social Work

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DeVylder, Jordan E.

2016-01-01

Schizophrenia is a leading cause of disability and health expenditure worldwide and is associated with homelessness, substance use, familial and social isolation, unemployment, involvement with the criminal justice system, stigma, and excess mortality. Prevention may be feasible through intervention with help-seeking "clinical high-risk"…

A mentally retarded patient with schizophrenia.

Science.gov (United States)

Rabia, K; Khoo, Em

2008-01-01

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

A MENTALLY RETARDED PATIENT WITH SCHIZOPHRENIA

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KHOO EM

2008-01-01

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

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

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Miralena I. Tomescu

2015-09-01

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

fMRI study of language activation in schizophrenia, schizoaffective disorder and in individuals genetically at high risk.

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Li, Xiaobo; Branch, Craig A; Ardekani, Babak A; Bertisch, Hilary; Hicks, Chindo; DeLisi, Lynn E

2007-11-01

Structural and functional abnormalities have been found in language-related brain regions in patients with schizophrenia. We previously reported findings pointing to differences in word processing between people with schizophrenia and individuals who are at high-risk for schizophrenia using a voxel-based (whole brain) fMRI approach. We now extend this finding to specifically examine functional activity in three language related cortical regions using a larger cohort of individuals. A visual lexical discrimination task was performed by 36 controls, 21 subjects at high genetic-risk for schizophrenia, and 20 patients with schizophrenia during blood oxygenation level dependent (BOLD) fMRI scanning. Activation in bilateral inferior frontal gyri (Brodmann's area 44-45), bilateral inferior parietal lobe (Brodmann's area 39-40), and bilateral superior temporal gyri (Brodmann's area 22) was investigated. For all subjects, two-tailed Pearson correlations were calculated between the computed laterality index and a series of cognitive test scores determining language functioning. Regional activation in Brodmann's area 44-45 was left lateralized in normal controls, while high-risk subjects and patients with schizophrenia or schizoaffective disorder showed more bilateral activation. No significant differences among the three diagnostic groups in the other two regions of interest (Brodmann's area 22 or areas 39-40) were found. Furthermore, the apparent reasons for loss of leftward language lateralization differed between groups. In high-risk subjects, the loss of lateralization was based on reduced left hemisphere activation, while in the patient group, it was due to increased right side activation. Language ability related cognitive scores were positively correlations with the laterality indices obtained from Brodmann's areas 44-45 in the high-risk group, and with the laterality indices from Brodmann's areas 22 and 44-45 in the patient group. This study reinforces previous

Illness perspectives of Thais diagnosed with schizophrenia.

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Sanseeha, Ladda; Chontawan, Ratanawadee; Sethabouppha, Hunsa; Disayavanish, Chamlong; Turale, Sue

2009-09-01

This study explored the perceptions of 18 people diagnosed with schizophrenia from 1-10 years to uncover how they perceived themselves and their illness. It also involved 12 family members who added their perceptions. The data were collected using in-depth interviews, reflective journaling, and observations. The data were analyzed through the lens of Heidegger's hermeneutic phenomenology. Four themes emerged: perceptions of mental illness, perceptions of the causes of illness, perceptions of discrimination, and attempting to live with schizophrenia. The findings included strong underlying cultural and spiritual beliefs, and attitudes unique to the Thai participants, including the causation of schizophrenia by supernatural powers, black magic, and bad karma stemming from past deeds. Understanding the perceptions of the participants might help health-care providers to be more sensitive to those living with schizophrenia in Thailand and elsewhere. In particular, the findings could be useful in informing psychiatric careproviders about developing better caring systems for clients diagnosed with schizophrenia. This should help the sufferers of schizophrenia to live their lives to their own satisfaction and as normally as possible.

[Risk factors for schizophrenia patients with type 2 diabetes: a metaanalysis].

Science.gov (United States)

Zhou, Min; Xiao, Chuan; Yang, Min; Yuan, Ping; Liu, Yuanyuan

2015-03-01

To investigate risk factors for schizophrenia patients with complication of type 2 diabetes mellitus and to provide scientific evidence for prevention and management of this disease. Relevant studies on schizophrenia with type 2 diabetes mellitus in China were searched through PubMed, Medline, CBM, CNKI and VIP from 1997 to 2014. Meta-analysis was performed using RevMan 5.2 soft ware. A total of 26 studies involving 6 373 participants (including 957 cases and 5 416 controls) were included. The results of Meta-analysis showed that the risk factors for schizophrenic patients with complication of type 2 diabetes mellitus were: gender (female) (OR=1.28, 95%CI: 1.09-1.50), age (≥ 40 year) (OR=6.02, 95%CI: 4.48-8.09), overweight (OR=2.32, 95%CI: 1.52-2.88), family history of diabetes (OR=6.12, 95%CI: 3.16-11.86), duration of schizophrenia (>10 years) (OR=3.60, 95%CI: 2.39-5.41), triglycerides (MD=0.38, 95%CI: 0.05-0.71). Male, old age, overweight, family history of diabetes, longer duration and high level of triglycerides are risk factors for schizophrenic patients with complication of diabetes mellitus.

Depression in Kraepelinian schizophrenia

African Journals Online (AJOL)

related problems and poorer social and family relationships, show a lower level of ... Furthermore, suicide terminates the lives of an estimated 10 - 15% ... deterioration of functioning in social, work and self-care domains. .... quality of life in outpatients with schizophrenia spectrum disorders? ... Acta Psychiatr Scand 2002;.

Hopes and Expectations Regarding Genetic Testing for Schizophrenia Among Young Adults at Clinical High-Risk for Psychosis.

Science.gov (United States)

Friesen, Phoebe; Lawrence, Ryan E; Brucato, Gary; Girgis, Ragy R; Dixon, Lisa

2016-11-01

Genetic tests for schizophrenia could introduce both risks and benefits. Little is known about the hopes and expectations of young adults at clinical high-risk for psychosis concerning genetic testing for schizophrenia, despite the fact that these youth could be among those highly affected by such tests. We conducted semistructured interviews with 15 young adults at clinical high-risk for psychosis to ask about their interest, expectations, and hopes regarding genetic testing for schizophrenia. Most participants reported a high level of interest in genetic testing for schizophrenia, and the majority said they would take such a test immediately if it were available. Some expressed far-reaching expectations for a genetic test, such as predicting symptom severity and the timing of symptom onset. Several assumed that genetic testing would be accompanied by interventions to prevent schizophrenia. Participants anticipated mixed reactions on finding out they had a genetic risk for schizophrenia, suggesting that they might feel both a sense of relief and a sense of hopelessness. We suggest that genetic counseling could play an important role in counteracting a culture of genetic over-optimism and helping young adults at clinical high-risk for psychosis understand the limitations of genetic testing. Counseling sessions could also invite individuals to explore how receiving genetic risk information might impact their well-being, as early evidence suggests that some psychological factors help individuals cope, whereas others heighten distress related to genetic test results.

Premorbid teacher-rated social functioning predicts adult schizophrenia-spectrum disorder: A high-risk prospective investigation

DEFF Research Database (Denmark)

Tsuji, Thomas; Kline, Emily; Sorensen, Holger J.

2013-01-01

Social functioning deficits are a core component of schizophrenia spectrum disorders, and may emerge years prior to the onset of diagnosable illness. The current study prospectively examines the relation between teacher-rated childhood social dysfunction and later mental illness among participants...... who were at genetic high-risk for schizophrenia and controls (n=244). The teacher-rated social functioning scale significantly predicted psychiatric outcomes (schizophrenia-spectrum vs. other psychiatric disorder vs. no mental illness). Poor premorbid social functioning appears to constitute a marker...

Structural and psychosocial correlates of birth order anomalies in schizophrenia and homicide.

Science.gov (United States)

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

2010-12-01

Birth order--a unique index of both neurodevelopmental and/or psychosocial factors in the pathogenesis of psychiatric disorder--remains largely unexplored in violent schizophrenia. We examined whether murderers with schizophrenia would demonstrate birth order anomalies, distinguishing them from both nonviolent schizophrenia patients and murderers without schizophrenia. Self-report birth order, psychosocial history data (i.e., maternal birth age, family size, parental criminality, parental SES), and structural magnetic resonance imaging data were collected from normal controls, nonviolent schizophrenia patients, murderers with schizophrenia, murderers without schizophrenia, and murderers with psychiatric conditions other than schizophrenia at a brain hospital in Nanjing, China. Results indicated that murderers with schizophrenia were characterized by significantly increased (i.e., later) birth order compared with both nonviolent schizophrenia patients and murderers without schizophrenia. Additionally, birth order was negatively correlated with gray matter volume in key frontal subregions for schizophrenic murderers, and was negatively correlated with parental SES. Findings may suggest biological, psychosocial, or interactional trajectories which may lead to a homicidally violent outcome in schizophrenia.

Prominent increased calcineurin immunoreactivity in the superior temporal gyrus in schizophrenia: A postmortem study.

Science.gov (United States)

Wada, Akira; Kunii, Yasuto; Matsumoto, Jyunya; Hino, Mizuki; Yang, Qiaohui; Niwa, Shin-Ichi; Yabe, Hirooki

2017-01-01

Many neuroimaging studies have demonstrated structural changes in the superior temporal gyrus (STG) in patients with schizophrenia. Several postmortem studies have reported on the pathogenesis of schizophrenia, but few reports have investigated alterations in molecules in the STG. In addition, several studies have suggested that calcineurin (CaN) inadequacy may be a risk factor for schizophrenia, but no reports about CaN expression in the STG in schizophrenia have been published. We compared the density of CaN-immunoreactive (CaN-IR) neurons in the STG from 11 patients with schizophrenia with that of 11 sex- and age-matched controls. We used immunohistochemical analysis with rabbit polyclonal antibodies against human CaN. In the STG, the density of CaN-IR neurons in layers II - VI in the group with schizophrenia was significantly higher than that in the control group. Our results confirmed pathological changes in the STG in patients with schizophrenia, suggesting that alterations in the CaN pathway play a role in the pathogenesis of schizophrenia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Antipsychotic medication non-adherence among schizophrenia ...

African Journals Online (AJOL)

2018-03-05

Mar 5, 2018 ... in reducing psychotic symptoms, preventing psychotic relapses and improving ... poverty, lack of family supports, duration of illness and stigma, ... schizophrenia at Amanuel Mental Specialized Hospital from April to May 2014.

Canadian Treatment Guidelines on Psychosocial Treatment of Schizophrenia in Children and Youth.

Science.gov (United States)

Lecomte, Tania; Abidi, Sabina; Garcia-Ortega, Iliana; Mian, Irfan; Jackson, Kevin; Jackson, Kim; Norman, Ross

2017-09-01

A panel of experts, including researchers, clinicians and people with lived experience, was brought together to develop the new Canadian schizophrenia guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders. The ADAPTE process, which relies on adapting existing high-quality guidelines, was used. Existing guidelines for children and youth (mostly from the National Institute for Health and Care Excellence [NICE]), as well as CPA adult guidelines, were reviewed and discussed in terms of their adaptability to the Canadian context and their level of recommendation for children and youth. New treatments were also considered when recent meta-analyses suggested their usefulness. The children and youth psychosocial guidelines include many cross-sectional recommendations in terms of clinical and interpersonal skills needed to work with this clientele, setting and collaboration issues and needed adaptations for specific subpopulations. In terms of specific treatments, the treatments most strongly recommended are family intervention and cognitive behavior therapy. Also recommended, although with different degrees of support, are supported employment/supported education programs, patient education, cognitive remediation, and social skills training. Novel and upcoming psychosocial treatments are also briefly discussed. These novel Canadian guidelines for the psychosocial treatment of children and youth with schizophrenia or psychotic disorders report evidence-based treatments as well as important considerations for providers who work with this clientele. More studies with children and youth with schizophrenia and psychotic disorders are warranted. If followed, these guidelines should facilitate the recovery of children and youth with schizophrenia or psychotic disorders as well as the recovery of their families.

Disorganization at the stage of schizophrenia clinical outcome: Clinical-biological study.

Science.gov (United States)

Nestsiarovich, A; Obyedkov, V; Kandratsenka, H; Siniauskaya, M; Goloenko, I; Waszkiewicz, N

2017-05-01

According to the multidimensional model of schizophrenia, three basic psychopathological dimensions constitute its clinical structure: positive symptoms, negative symptoms and disorganization. The latter one is the newest and the least studied. Our aim was to discriminate disorganization in schizophrenia clinical picture and to identify its distinctive biological and socio-psychological particularities and associated genetic and environmental factors. We used SAPS/SANS psychometrical scales, scales for the assessment of patient's compliance, insight, social functioning, life quality. Neuropsychological tests included Wisconsin Card Sorting Test (WCST), Stroop Color-Word test. Neurophysiological examination included registration of P300 wave of the evoked cognitive auditory potentials. Environmental factors related to patient's education, family, surrounding and nicotine use, as well as subjectively significant traumatic events in childhood and adolescence were assessed. Using PCR we detected SNP of genes related to the systems of neurotransmission (COMT, SLC6A4 and DRD2), inflammatory response (IL6, TNF), cellular detoxification (GSTM1, GSTT1), DNA methylation (MTHFR, DNMT3b, DNMT1). Disorganization is associated with early schizophrenia onset and history of psychosis in family, low level of insight and compliance, high risk of committing delicts, distraction errors in WCST, lengthened P300 latency of evoked cognitive auditory potentials, low-functional alleles of genes MTHFR (rs1801133) and DNMT3b (rs2424913), high level of urbanicity and psychotraumatic events at early age. Severe disorganization at the stage of schizophrenia clinical outcome is associated with the set of specific biological and social-psychological characteristics that indicate its epigenetic nature and maladaptive social significance. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

COMPARATIVE STUDY ON THE BURDEN OF BIPOLAR AFFECTIVE DISORDER AND SCHIZOPHRENIA

Directory of Open Access Journals (Sweden)

C. Jayakrishnaveni

2018-01-01

Full Text Available BACKGROUND Mental and behavioural disorders have a large impact on individuals, family and communities. There is a paucity of studies on burden and cost of illness of Bipolar Affective Disorder both internationally and in India. Such studies are important for clinical management and policy decisions. Aim of the study - The aim of the present study is to assess the magnitude of the cost of illness and family burden of Bipolar Affective Disorder and Schizophrenia and to find out the difference in the burden of the caregivers for both the groups. MATERIALS AND METHODS The study was conducted in the outpatient department of Institute of Mental Health, Chennai. Sixty patients in each group were included by stratified sampling. Caregivers living with patients for atleast one year are included in the study, and those with any comorbid illness, were excluded from the study. ICD -10 diagnostic and research criteria were used for diagnosis of BPAD and Schizophrenia, Questionnaire for Assessment of Cost of Illness was used to assess cost of illness and Family Burden Interview Schedule was used to assess burden of caregivers. RESULTS Schizophrenia patients are mostly from urban, nuclear family. The illness characters & sociodemographic profile of caregivers are comparable. Lifetime costs and loss of income over lifetime was more in schizophrenia. Loss of income in the past year was similar. The burden was comparable for caregivers of both groups in disruption of family routine, interaction with family members, effect on mental health. CONCLUSION Burden of both diseases were comparable except schizophrenics experience more financial burden.

Genetic counseling for schizophrenia: a review of referrals to a provincial medical genetics program from 1968–2007

Science.gov (United States)

Hunter, MJ; Hippman, Catriona; Honer, William G; Austin, Jehannine C.

2014-01-01

Purpose Recent studies have shown that individuals with schizophrenia and their family members are interested in genetic counseling, but few have received this service. We conducted an exploratory, retrospective study to describe (a) the population of individuals who were referred to the provincial program for genetic counseling for a primary indication of schizophrenia, and (b) trends in number of referrals between 1968 and 2007. Methods Referrals for a primary indication of schizophrenia were identified through the provincial program database. Charts were reviewed and the following information was recorded: discipline of referring physician, demographics, psychiatric diagnosis, referred individual’s and partner’s (if applicable) family history, and any current pregnancy history. Data were characterized using descriptive statistics. Results Between 1968 and 2007, 288 referrals were made for a primary indication of schizophrenia. Most referrals were made: (a) for individuals who had a first-degree family member with schizophrenia, rather than for affected individuals, (b) for preconception counseling, and (c) by family physicians (69%), with only 2% by psychiatrists. Conclusions In British Columbia, individuals affected with schizophrenia and their family members are rarely referred for psychiatric genetic counseling. There is a need to identify barriers to psychiatric genetic counseling and develop strategies to improve access. PMID:20034078

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

Science.gov (United States)

Gupta, Avirup; Craig, Tom K J

2009-01-01

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

Association Between Substance Use Disorder and Polygenic Liability to Schizophrenia.

Science.gov (United States)

Hartz, Sarah M; Horton, Amy C; Oehlert, Mary; Carey, Caitlin E; Agrawal, Arpana; Bogdan, Ryan; Chen, Li-Shiun; Hancock, Dana B; Johnson, Eric O; Pato, Carlos N; Pato, Michele T; Rice, John P; Bierut, Laura J

2017-11-15

There are high levels of comorbidity between schizophrenia and substance use disorder, but little is known about the genetic etiology of this comorbidity. We tested the hypothesis that shared genetic liability contributes to the high rates of comorbidity between schizophrenia and substance use disorder. To do this, polygenic risk scores for schizophrenia derived from a large meta-analysis by the Psychiatric Genomics Consortium were computed in three substance use disorder datasets: the Collaborative Genetic Study of Nicotine Dependence (ascertained for tobacco use disorder; n = 918 cases; 988 control subjects), the Collaborative Study on the Genetics of Alcoholism (ascertained for alcohol use disorder; n = 643 cases; 384 control subjects), and the Family Study of Cocaine Dependence (ascertained for cocaine use disorder; n = 210 cases; 317 control subjects). Phenotypes were harmonized across the three datasets and standardized analyses were performed. Genome-wide genotypes were imputed to the 1000 Genomes reference panel. In each individual dataset and in the mega-analysis, strong associations were observed between any substance use disorder diagnosis and the polygenic risk score for schizophrenia (mega-analysis pseudo-R 2 range 0.8-3.7%; minimum p = 4 × 10 -23 ). These results suggest that comorbidity between schizophrenia and substance use disorder is partially attributable to shared polygenic liability. This shared liability is most consistent with a general risk for substance use disorder rather than specific risks for individual substance use disorders and adds to increasing evidence of a blurred boundary between schizophrenia and substance use disorder. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Glutamate in schizophrenia: clinical and research implications.

Science.gov (United States)

Goff, D C; Wine, L

1997-10-30

The excitatory amino acids, glutamate and aspartate, are of interest to schizophrenia research because of their roles in neurodevelopment, neurotoxicity and neurotransmission. Recent evidence suggests that densities of glutamatergic receptors and the ratios of subunits composing these receptors may be altered in schizophrenia, although it is unclear whether these changes are primary or compensatory. Agents acting at the phencyclidine binding site of the NMDA receptor produce symptoms of schizophrenia in normal subjects, and precipitate relapse in patients with schizophrenia. The improvement of negative symptoms with agents acting at the glycine modulatory site of the NMDA receptor, as well as preliminary evidence that clozapine may differ from conventional neuroleptic agents in its effects on glutamatergic systems, suggest that clinical implications may follow from this model. While geriatric patients may be at increased risk for glutamate-mediated neurotoxicity, very little is known about the specific relevance of this model to geriatric patients with schizophrenia.

Association study between schizophrenia and dopamine D3 receptor gene polymorphism

Energy Technology Data Exchange (ETDEWEB)

Tanaka, Toshihisa; Takahashi, Makoto; Maeda, Masaya [Niigata Univ. (Japan)] [and others

1996-07-26

Crocq et al. reported the existence of an association between schizophrenia and homozygosity of a BalI polymorphism in the first exon of the dopamine D3 receptor (DRD3) gene. In response to this report, further studies were conducted; however, these studies yielded conflicting results. In the present study, we examined 100 unrelated Japanese schizophrenics and 100 normal controls to determine any association between this polymorphism and schizophrenia. Results suggest that neither allele nor genotype frequencies of the DRD3 gene in the schizophrenics as a whole are significantly different from those of the controls. Further, we found no association between any allele or genotype and any clinical subtype based on family history of schizophrenia and age-at-onset. A significantly high frequency of homozygosity of a dopamine D3 receptor gene allele was not observed in the schizophrenics as a whole, or in clinical subtypes. Our results suggest that an association between the dopamine D3 receptor gene and schizophrenia is unlikely to exist. 26 refs., 1 tab.

Disturbed functional connectivity of cortical activation during semantic discrimination in patients with schizophrenia and subjects at genetic high-risk.

Science.gov (United States)

Li, Xiaobo; Branch, Craig A; Nierenberg, Jay; Delisi, Lynn E

2010-03-01

Schizophrenia has a strong genetic component that is relevant to the understanding of the pathophysiology of the syndrome. Thus, recent investigations have shifted from studies of diagnosed patients with schizophrenia to examining their unaffected relatives. Previous studies found that during language processing, relatives thought to be at genetic high-risk for the disorder exhibit aberrant functional activation in regions of language processing, specifically in the left inferior frontal gyrus (Broca's area). However, functional connectivity among the regions involved in language pathways is not well understood. In this study, we examined the functional connectivity between a seed located in Broca's area and the remainder of the brain during a visual lexical decision task, in 20 schizophrenia patients, 21 subjects at genetic high risk for the disorder and 21 healthy controls. Both the high-risk subjects and patients showed significantly reduced activation correlations between seed and regions related to visual language processing. Compared to the high-risk subjects, the schizophrenia patients showed even fewer regions that were correlated with the seed regions. These results suggest that there is aberrant functional connectivity within cortical language circuitry in high-risk subjects and patients with schizophrenia. Broca's area, which is one of the important regions for language processing in healthy controls, had a significantly reduced role in the high-risk subjects and patients with schizophrenia. Our findings are consistent with the existence of an underlying biological disturbance that begins in genetically at risk individuals and progresses to a greater extent in those who eventually develop schizophrenia.

Schizophrenia through the carers' eyes: results of a European cross-sectional survey.

Science.gov (United States)

Svettini, A; Johnson, B; Magro, C; Saunders, J; Jones, K; Silk, S; Hargarter, L; Schreiner, A

2015-09-01

Schizophrenia is a serious mental disorder affecting approximately 29 million people worldwide. The ideal treatment and care of patients with schizophrenia should be provided by a multidisciplinary 'team' involving psychiatrists, nurses and other healthcare professionals, together with carers and patients. In light of the key role carers play in the care of patients with schizophrenia, the present survey was designed to assess the opinions of family members and friends of patients with schizophrenia across Europe and to ascertain their attitudes towards the illness, medication and adherence to medication. Among carers participating in this survey, there was widespread awareness of the issues involved in supporting patients with schizophrenia and the importance of their role in improving poor adherence to medication. Three differences in opinion emerged between the views of carers and psychiatrists; psychiatrists rely more on the patient themselves when assessing adherence than carers would recommend; in contrast to psychiatrists, many carers believe the illness itself contributes to non-adherence; two thirds of carers think that schizophrenia medication damages health (higher than estimated by psychiatrists). The findings from the present survey, taken together with the results from the Adherencia Terapéutica en la Esquizofrenia surveys of psychiatrists and nurses, support the need for a collaborative approach to the issue of treatment nonadherence. In particular, healthcare professionals should recognize the valuable contribution that family carers can make to improve treatment adherence and consequently clinical outcomes for patients with schizophrenia. Schizophrenia carries a significant burden for families providing care. The Adherencia Terapéutica en la Esquizofrenia (ADHES) carers' survey was designed to assess the opinions of family and friends of patients with schizophrenia across Europe and ascertain their attitudes towards the illness, medication and

The GABAA receptor α and β subunits but not the density of muscimol binding sites are altered in the auditory-linguistic association cortex of subjects with schizophrenia

International Nuclear Information System (INIS)

Farnbach-Pralong, D.; Bradbury, R.; Tomaskovic, E.; Copolov, D.; Dean, B.

1998-01-01

Full text: An increase in the density of postsynaptic GABA A receptors has recently been reported in the prefrontal cortex of subjects with schizophrenia. This increase has been hypothesised to represent an up-regulation in response a decrease in the density of GABAergic interneurons. In order to determine whether the GABA A receptor is also altered in the auditory-linguistic association cortex of the schizophrenic brain, we used quantitative autoradiography to measure the density of that receptor in tissue obtained at autopsy from 20 control subjects and 20 subjects with schizophrenia matched for sex and age. The density of GABA A receptors was measured as the difference in the binding of the specific ligand [ 3 H]muscimol (100 nM) in the presence or in the absence of 10 5 M SR95531. There was no significant difference in the density of [ 3 H]muscimol binding between tissue from schizophrenic (554.9±20,5 fmol/mg TE) and non-schizophrenic (580.1±26.2 fmol/mg TE) subjects. The abundance of the α and β subunits of the GABA A receptor was also measured in particulate membranes prepared from tissue from 6 control and 6 schizophrenic subjects using Western blots. Detection with monoclonal antibodies and chemiluminescence showed that in tissue from control subjects, there was a significant correlation between the levels of α and β subunits (r=0.817, p=0.047). However, there was no such correlation in tissue from schizophrenic subjects (r=0.265, p=0.61), where in 2 subjects large levels of β-subunit were not matched by similar levels of α subunit. These preliminary results suggest mat there may be a failure for up-regulated GABA A receptor subunits to assemble into functional receptors in this brain region for some subjects with schizophrenia. Copyright (1998) Australian Neuroscience Society

A comprehensive family-based replication study of schizophrenia genes

DEFF Research Database (Denmark)

Aberg, Karolina A; Liu, Youfang; Bukszár, Jozsef

2013-01-01

Schizophrenia (SCZ) is a devastating psychiatric condition. Identifying the specific genetic variants and pathways that increase susceptibility to SCZ is critical to improve disease understanding and address the urgent need for new drug targets....

Causes of schizophrenia reported by urban African American lay community members.

Science.gov (United States)

Compton, Michael T; Esterberg, Michelle L; Broussard, Beth

2008-01-01

Although mental health professionals' "etiologic beliefs" concerning schizophrenia have evolved in accordance with diathesis-stress and neurodevelopmental models, little is known about etiologic attributions in nonclinical general population samples in the United States. Yet, course and outcome for people with the illness may be indirectly influenced by beliefs about causes in the larger community. Because of very limited research in this area, especially among African Americans in particular, this descriptive study investigated the causes of schizophrenia reported by 127 urban African Americans from the general population. The aim of this study was to assess the most commonly reported causes of schizophrenia, as well as the frequency of endorsing items from a list of 30 factors, some of which are congruent with current psychiatric conceptualizations of schizophrenia, whereas others are not. Results of this report complement previously reported findings from the same setting involving family members of patients with schizophrenia [Esterberg ML, Compton MT. Causes of schizophrenia reported by family members of urban African American hospitalized patients with schizophrenia. Compr Psychiatry 2006;47:221-226]. The 5 most commonly reported causes were disturbance of brain biochemistry (49.6%), drug/alcohol abuse (42.5%), hereditary factors (40.9%), brain injury (40.2%), and avoidance of problems in life (37.8%). The mean number of likely or very likely causes endorsed by participants was 7.5 +/- 5.7. Some 47.9% reported one or more esoteric factors as a cause. Of the 6 esoteric factors, possession by evil spirits (28.3%), radiation (20.2%), and punishment by God (19.7%) were most common. Esoteric causes were more commonly chosen by male participants, those with 12 years of education or less, and participants who reported never having known someone with schizophrenia. Future research should seek to better understand how esoteric beliefs about causation affect attitudes

Subjective burden on spouses of schizophrenia patients

Directory of Open Access Journals (Sweden)

Surekha Kumari

2009-01-01

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

Disruption of the neurexin 1 gene is associated with schizophrenia.

NARCIS (Netherlands)

Rujescu, D.; Ingason, A.; Cichon, S.; Pietilainen, O.P.H.; Barnes, M.R.; Toulopoulou, T.; Picchioni, M.; Vassos, E.; Ettinger, U.; Bramon, E.; Murray, R.; Ruggeri, M.; Tosato, S.; Bonetto, C.; Steinberg, S.; Sigurdsson, E.; Sigmundsson, T.; Petursson, H.; Gylfason, A; Olason, P.; Hardarsson, G.; Jonsdottir, G.A.; Gustafsson, O.; Fossdal, R.; Giegling, I.; Moller, H.J.; Hartmann, A.M.; Hoffmann, P.; Crombie, C.; Fraser, G.; Walker, N.; Lonnqvist, J.; Suvisaari, J.; Tuulio-Henriksson, A.; Djurovic, S.; Melle, I.; Andreassen, O.A.; Hansen, T.; Werge, T.; Kiemeney, L.A.L.M.; Franke, B.; Veltman, J.A.; Buizer-Voskamp, J.E.; Sabatti, C.; Ophoff, R.A.; Rietschel, M.; Nothen, Markus; Stefansson, K.; Peltonen, L.; St Clair, D.; Stefansson, H.; Collier, D.A.

2009-01-01

Deletions within the neurexin 1 gene (NRXN1; 2p16.3) are associated with autism and have also been reported in two families with schizophrenia. We examined NRXN1, and the closely related NRXN2 and NRXN3 genes, for copy number variants (CNVs) in 2977 schizophrenia patients and 33 746 controls from

Disruption of the neurexin 1 gene is associated with schizophrenia

NARCIS (Netherlands)

Rujescu, Dan; Ingason, Andres; Cichon, Sven; Pietilainen, Olli P. H.; Barnes, Michael R.; Toulopoulou, Timothea; Picchioni, Marco; Vassos, Evangelos; Ettinger, Ulrich; Bramon, Elvira; Murray, Robin; Ruggeri, Mirella; Tosato, Sarah; Bonetto, Chiara; Steinberg, Stacy; Sigurdsson, Engilbert; Sigmundsson, Thordur; Petursson, Hannes; Gylfason, Arnaldur; Olason, Pall I.; Hardarsson, Gudmundur; Jonsdottir, Gudrun A.; Gustafsson, Omar; Fossdal, Ragnheidur; Giegling, Ina; Moeller, Hans-Jurgen; Hartmann, Annette M.; Hoffmann, Per; Crombie, Caroline; Fraser, Gillian; Walker, Nicholas; Lonnqvist, Jouko; Suvisaari, Jaana; Tuulio-Henriksson, Annamari; Djurovic, Srdjan; Melle, Ingrid; Andreassen, Ole A.; Hansen, Thomas; Werge, Thomas; Kiemeney, Lambertus A.; Franke, Barbara; Veltman, Joris; Buizer-Voskamp, Jacobine E.; Sabatti, Chiara; Ophoff, Roel A.; Rietschel, Marcella; Noehen, Markus M.; Stefansson, Kari; Peltonen, Leena; St Clair, David

2009-01-01

Deletions within the neurexin 1 gene (NRXN1; 2p16.3) are associated with autism and have also been reported in two families with schizophrenia. We examined NRXN1, and the closely related NRXN2 and NRXN3 genes, for copy number variants (CNVs) in 2977 schizophrenia patients and 33 746 controls from

Acceptance and expressed emotion in Mexican American caregivers of relatives with schizophrenia.

Science.gov (United States)

Dorian, Marina; Ramírez García, Jorge I; López, Steven R; Hernández, Brenda

2008-06-01

The relation between Expressed Emotion (EE) and caregiver acceptance was tested with the use of video-recorded interactions between 31 Mexican American family caregivers and their relatives with schizophrenia. Borrowing the concept from Integrative Behavioral Couple Therapy, acceptance was defined as caregiver's engagement with the ill relative along with low levels of expectations for behavioral change. Three aspects of caregiver acceptance were measured: global acceptance of the patient, unified detachment (i.e., nonblaming but engaged problem discussion), and low aversive responses to patient behavior (e.g., criticisms and demanding change). Relative to high EE caregivers, low EE caregivers were consistently more accepting of their ill relatives across the three measures of acceptance. Unified detachment was negatively associated with emotional overinvolvement and aversive responses were positively related to criticism. Warmth was not related to acceptance. The findings suggest that the study of acceptance in family caregivers is a heuristic avenue for future research due to its potential to shed light on specifically what family members do in caring for their ill relatives with schizophrenia.

Production of enzymatically active recombinant full-length barley high pI alpha-glucosidase of glycoside family 31 by high cell-density fermentation of Pichia pastoris and affinity purification

DEFF Research Database (Denmark)

Næsted, Henrik; Kramhøft, Birte; Lok, F.

2006-01-01

Recombinant barley high pI alpha-glucosidase was produced by high cell-density fermentation of Pichia pastoris expressing the cloned full-length gene. The gene was amplified from a genomic clone and exons (coding regions) were assembled by overlap PCR. The resulting cDNA was expressed under contr...... nM x s(-1), and 85 s(-1) using maltose as substrate. This work presents the first production of fully active recombinant alpha-glucosidase of glycoside hydrolase family 31 from higher plants. (c) 2005 Elsevier Inc. All rights reserved....

The Latent Taxonicity of Schizotypy in Biological Siblings of Probands With Schizophrenia

NARCIS (Netherlands)

Linscott, Richard J.; Morton, Sarah E.; Alizadeh, Berhooz Z.; Bartels-Velthuis, Agna A.; van Beveren, Nico J.; Bruggeman, Richard; Cahn, Wiepke; de Haan, Lieuwe; Delespaul, Philippe; Meijer, Carin J.; Myin-Germeys, Inez; Kahn, Rene S.; Schirmbeck, Frederike; Simons, Claudia J. P.; van Haren, Neeltje E.; van Os, Jim; van Winkel, Ruud

2017-01-01

If schizotypy is a taxonic liability for schizophrenia with a general population prevalence of ~10%, it should also be taxonic among biological siblings of probands with schizophrenia. Moreover, assuming this is so, siblings' schizotypy class membership should be predicted by probands' familial load

Family Decision Making and Self-Determination Among Consumers With Schizophrenia in China: Cross-Cultural Implications.

Science.gov (United States)

Chen, Ying; Lam, Chow S; Deng, Hong; Corrigan, Patrick W; Yau, Eva

2018-04-01

Self-determination is viewed as an important ingredient of successful recovery in psychiatric rehabilitation. The concept of autonomy, a key component of self-determination, may be of less importance in Chinese cultures, whereby an individual's choices may be in conflict with the family's expectations. This study aimed to develop an instrument to measure opinions about self-determination among Chinese consumers and their family members. A 27-item questionnaire, the Consumer and Family Decision Making Scale (CFDMS), was constructed to measure consumers' and family members' views of self-determination in various aspects of daily life. A total of 364 (182 consumers of psychiatric services with a diagnosis of schizophrenia and 182 of their family members) participated in the study. The CFDMS was found to possess good psychometric properties and appears to be a reliable and valid instrument for assessment of consumers' decision making. (The Cronbach's alphas of psychiatric care and treatment factor, personal and social function factor, community and daily living factor, and money management factor were as follows: .86, .89, .87 and .76. The respective test-retest reliabilities were as follows: .81, .89, .80, and .88). Chinese consumers preferred autonomous decision making in regard to personal and social functioning and community and daily living but preferred to defer decisions regarding psychiatric care and treatment and money management to others. Family members and consumers had similar views. Deferring decisions to family members is common in Chinese families. The emphasis on autonomy in Western health care may need to be reconsidered in the treatment of Chinese consumers. Chinese families have a strong influence on treatment decisions, and providers must respect this style and remain nonjudgmental when dealing with situations or decisions that may be contradictory to their own culture and values.

Some new approaches for prevention of schizophrenia spectrum disorders in patients exposed to exogenous stressors

Directory of Open Access Journals (Sweden)

Nataliya Dzeruzhinska

2017-08-01

Methods. It was conducted the psychopathological and psychodiagnostic survey  of 186 patients with schizophrenia spectrum disorders with an assessment of clinical features and level of social functioning. It was identified factors that have the most significant pathological effects on the course of disorders on the basis of the received data: the using of a cannabinoid in a family history, mother`s infectious and somatic diseases during pregnancy, mother's using alcohol during pregnancy, consumption of alcohol in adolescent patients, fetal hypoxia or perinatal trauma of the patient at birth, problems with the group of primary support in the family of a child in childhood, maternal toxicosis, crisis relationships in the family, migration to different cultural environment. Results. Clinical pathomorphism of disorders of the spectrum of schizophrenia under the influence of environment factors determines the features of psychotherapeutic interventions. In people with cannabinoids, it is important to eliminate the symptoms of anxiety through emotion-supportive measures, as well as to create a motivation to ask help in case of symptoms of schizophrenia spectrum disorders. In a group with perinatal complications, the emphasis should be put on cognitive methods in order to correct mental disorders and overcome hypochondria. Early measures to form a positive attitude towards themselves and the environment, supporting family relationships, overcoming depressive symptoms, and developing social activity are targets of psychotherapeutic interventions in people with schizophrenic spectrum disorders and psychological traumatic events. Conclusion. Minimization of environmental factors influence in high risk individuals would postpone early manifestation, reduce disability in patients with schizophrenia spectrum disorders, as evidenced by the statement of leading health experts.

Effects of high aerobic intensity training in patients with schizophrenia: a controlled trial.

Science.gov (United States)

Heggelund, Jørn; Nilsberg, Geir E; Hoff, Jan; Morken, Gunnar; Helgerud, Jan

2011-09-01

Patients with schizophrenia have a high risk of cardiovascular disease (CVD). High aerobic intensity training (HIT) improve peak oxygen uptake (VO(2peak)), net mechanical efficiency of walking and risk factors for CVD but has not been investigated in patients with schizophrenia. To investigate effects from HIT on VO(2peak), net mechanical efficiency of walking and risk factors for CVD in patients with schizophrenia. 25 inpatients (F20-29, ICD-10) were allocated to either HIT or playing computer games (CG), 3 days per week for 8 weeks. HIT consisted of 4 × 4-min intervals with 3-min break periods, at 85-95% and 70% of peak heart rate, respectively. 12 and seven patients completed HIT and CG, respectively. The baseline VO(2peak) in both groups combined (n = 19) was 36.8 ± 8.2 ml/kg/min and 3.12 ± 0.55 l/min. The HIT group improved VO(2peak) by 12% from 3.17 ± 0.59 to 3.56 ± 0.68 l/min (P Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS), did not improve in either group. VO(2peak) and net mechanical efficiency of walking improved significantly by 8 weeks of HIT. HIT should be included in rehabilitation in order to improve physical capacity and contribute risk reduction of CVD.

A survey of social outcome in schizophrenia in Tasmania.

Science.gov (United States)

Kirkby, K; Daniels, B; Jones, I; McInnes, M

1997-06-01

To survey the social outcome of patients with schizophrenia attending State mental health facilities in southern Tasmania. Using the Statewide Mental Health Register, patients using inpatient and outpatient facilities who received a diagnosis of schizophrenia between 1981 and 1988 were identified (n = 771), and demographic and illness measures, and admissions and length of inpatient stay were compiled. The Life Skills Profile (LSP) was completed by mental health personnel for the 247 who were regular attenders or inpatients in 1991. Social morbidity as indexed by the LSP was highest in psychiatric hospital inpatients and patients in long-term rehabilitation programs, and lower in patients attending community centres. The majority of patients in suburban settings and attending community centres lived with their families, whereas patients in the inner city or in the rehabilitation service were mainly in hostel accommodation or living alone. Patients with schizophrenia attending State services were of a similar age range but had a longer duration of illness and more admissions, and had spent more days in hospital than patients who were not in regular contact with the service. The distribution of social morbidity in schizophrenia confirms that the public health system is supporting a group with high social morbidity. Patients with the highest morbidity are receiving the highest levels of care and intervention.

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

Gender differences in first onset Schizophrenia spectrum psychoses.

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Talonen, Sanni; Väänänen, Juha; Kaltiala-Heino, Riittakerttu

2017-02-01

Mental health profiles differ between boys and girls from puberty onwards. It is not known whether differences also extend to symptom presentation in schizophrenia spectrum disorders. It may be that girls and boys are not treated entirely equally by the professionals. To study gender differences in symptom profiles, family adversities, pathway to care, and characteristics of inpatient treatment at the first episode of diagnosed schizophrenia spectrum disorder (F20-29) among adolescents aged 13-17. A retrospective chart review of all (n = 106) consecutive adolescents diagnosed for the first time with schizophrenia spectrum disorder (F20-29) in a specified catchment area. Girls and boys were compared with regard to sociodemographics, pathways to care, living arrangements, symptom profiles, and treatment received. During the study period more adolescent girls (n = 70, 66%) than boys (n = 36, 34%) were diagnosed with schizophrenia spectrum (F20-29) psychoses, most commonly F29. Girls were moreover younger (mean age = 15.46) than boys (mean age = 16.62) at admission. Girls more often displayed mood symptoms and boys aggressive behaviours, alcohol abuse problems, and isolation. Family adversities recorded as current stressors were more numerous among girls. Girls were more likely to be referred to specialized after-care than boys. The gender differences observed in symptoms presentation are reminiscent of differences encountered in the general adolescent population. Prior to transition to psychosis, girls and boys are equally in contact with psychiatric services due to other (possibly prodromal) symptoms/disorders. Family adversities may be more stressful for girls vulnerable to psychosis than to boys.

[The Role of Neurotrophins and Neurexins Genes in the Risk of Paranoid Schizophrenia in Russians and Tatars].

Science.gov (United States)

Gareeva, A E; Traks, T; Koks, S; Khusnutdinova, E K

2015-07-01

Schizophrenia affects about 1% of the population. Its etiology is not fully understood. Environmental conditions certainly contribute to the development of schizophrenia, but the determining factor is genetic predisposition: the coefficient of heritability of schizophrenia is about 80%, which is typical for the most highly heritable multifactorial diseases. Polymorphic loci of genes of enzymes and receptors involved in the processes of neuroprotection and neurotrophia play significant role in the development of this disease. In this paper we investigated 48 polymorphic variants of genes of the neurotrophins and neurexins family (BDNF, NTRK2, NTRK3, NGF, NXPH1, and NRXN1) in Russian and Tatar cases and in a control group living in the Republic of Bashkortostan. The results of this study confirm the important role of neurotrophin and neurexin genes in paranoid schizophrenia development.

Telepsychiatry and carer education for schizophrenia.

LENUS (Irish Health Repository)

Haley, C

2011-01-01

Despite the scientific evidence, most families of people with schizophrenia in Europe never receive a carer education programme. We evaluated whether a carer education course delivered by telepsychiatry was as effective as a carer education course delivered in situ.

The biological properties of iron oxide core high-density lipoprotein in experimental atherosclerosis

NARCIS (Netherlands)

Skajaa, Torjus; Cormode, David P.; Jarzyna, Peter A.; Delshad, Amanda; Blachford, Courtney; Barazza, Alessandra; Fisher, Edward A.; Gordon, Ronald E.; Fayad, Zahi A.; Mulder, Willem J. M.

2011-01-01

Lipoproteins are a family of plasma nanoparticles responsible for the transportation of lipids throughout the body. High-density lipoprotein (HDL), the smallest of the lipoprotein family, measures 7-13 nm in diameter and consists of a cholesteryl ester and triglyceride core that is covered with a

Characteristics of homicide offenders with Schizophrenia from the Russian Federation.

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Golenkov, Andrei; Large, Matthew; Nielssen, Olav; Tsymbalova, Alla

2011-12-01

It has been suggested that the characteristics of homicides committed by people with schizophrenia from regions with a high total homicide rate differ from the characteristics of homicides by people with schizophrenia from regions with low rates of homicide. Homicide offenders in the Chuvash Republic of the Russian Federation have been systematically examined for over 30 years. This study reports on a review of the documents from pre-trial psychiatric assessments and legal proceedings of all people charged with homicide offenses between 1981 and 2010 who were found to have schizophrenia. There were 133 people (120 men, 13 women) with an ICD-10 diagnosis of schizophrenia who committed a homicide offense in the 30 years of the study, including 15 repeat homicide offenders and 9 homicides with multiple victims. The odds ratio (OR) for homicide associated with schizophrenia was 13.5, 95% confidence interval (CI) (11.4-16.0). The mean age of the offenders was 34.8 (SD 9.6) and most had the paranoid subtype of schizophrenia (78%). The majority of victims were family members (51%) or acquaintances (43%). Delusions of persecution, auditory hallucinations and other positive symptoms were present in 58% of offenders at the time of the homicide. The remaining 42% exhibited negative symptoms such as emotional deficits, had antisocial attitudes or were regarded as having impaired self-control. Alcohol intoxication was reported at the time of 45% of homicides. Stabbing was the most common method and few of the homicides involved firearms. The characteristics of homicide offenders with schizophrenia from Chuvashia do not appear to differ greatly from those of homicide offenders with schizophrenia from regions with far lower rates of homicide. Copyright © 2011 Elsevier B.V. All rights reserved.

Galaxy halo expansions: a new biorthogonal family of potential-density pairs

Science.gov (United States)

Lilley, Edward J.; Sanders, Jason L.; Evans, N. Wyn; Erkal, Denis

2018-05-01

Efficient expansions of the gravitational field of (dark) haloes have two main uses in the modelling of galaxies: first, they provide a compact representation of numerically constructed (or real) cosmological haloes, incorporating the effects of triaxiality, lopsidedness or other distortion. Secondly, they provide the basis functions for self-consistent field expansion algorithms used in the evolution of N-body systems. We present a new family of biorthogonal potential-density pairs constructed using the Hankel transform of the Laguerre polynomials. The lowest order density basis functions are double-power-law profiles cusped like ρ ˜ r-2+1/α at small radii with asymptotic density fall-off like ρ ˜ r-3-1/(2α). Here, α is a parameter satisfying α ≥ 1/2. The family therefore spans the range of inner density cusps found in numerical simulations, but has much shallower - and hence more realistic - outer slopes than the corresponding members of the only previously known family deduced by Zhao and exemplified by Hernquist & Ostriker. When α = 1, the lowest order density profile has an inner density cusp of ρ ˜ r-1 and an outer density slope of ρ ˜ r-3.5, similar to the famous Navarro, Frenk & White (NFW) model. For this reason, we demonstrate that our new expansion provides a more accurate representation of flattened NFW haloes than the competing Hernquist-Ostriker expansion. We utilize our new expansion by analysing a suite of numerically constructed haloes and providing the distributions of the expansion coefficients.

Gray matter morphological anomalies in the cerebellar vermis in first-episode schizophrenia patients with cognitive deficits.

Science.gov (United States)

Wang, Jingjuan; Zhou, Li; Cui, Chunlei; Liu, Zhening; Lu, Jie

2017-11-22

Cognitive deficits are a core feature of early schizophrenia. However, the pathological foundations underlying cognitive deficits are still unknown. The present study examined the association between gray matter density and cognitive deficits in first-episode schizophrenia. Structural magnetic resonance imaging of the brain was performed in 34 first-episode schizophrenia patients and 21 healthy controls. Patients were divided into two subgroups according to working memory task performance. The three groups were well matched for age, gender, and education, and the two patient groups were also further matched for diagnosis, duration of illness, and antipsychotic treatment. Voxel-based morphometric analysis was performed to estimate changes in gray matter density in first-episode schizophrenia patients with cognitive deficits. The relationships between gray matter density and clinical outcomes were explored. Patients with cognitive deficits were found to have reduced gray matter density in the vermis and tonsil of cerebellum compared with patients without cognitive deficits and healthy controls, decreased gray matter density in left supplementary motor area, bilateral precentral gyrus compared with patients without cognitive deficits. Classifier results showed GMD in cerebellar vermis tonsil cluster could differentiate SZ-CD from controls, left supplementary motor area cluster could differentiate SZ-CD from SZ-NCD. Gray matter density values of the cerebellar vermis cluster in patients groups were positively correlated with cognitive severity. Decreased gray matter density in the vermis and tonsil of cerebellum may underlie early psychosis and serve as a candidate biomarker for schizophrenia with cognitive deficits.

California Verbal Learning Test-II performance in schizophrenia as a function of ascertainment strategy: Comparing the first and second phases of the Consortium on the Genetics of Schizophrenia (COGS)

OpenAIRE

Stone, WS; Mesholam-Gately, RI; Braff, DL; Calkins, ME; Freedman, R; Green, MF; Greenwood, TA; Gur, RE; Gur, RCC; Lazzeroni, LC; Light, GA; Nuechterlein, KH; Olincy, A; Radant, AD; Siever, LJ

2014-01-01

© 2014. The first phase of the Consortium on the Genetics of Schizophrenia (COGS-1) showed performance deficits in learning and memory on the California Verbal Learning Test, Second Edition (CVLT-II) in individuals with schizophrenia (SZ), compared to healthy comparison subjects (HCS). A question is whether the COGS-1 study, which used a family study design (i.e. studying relatively intact families), yielded “milder“ SZ phenotypes than those acquired subsequently in the COGS-2 case-control de...

California verbal learning test-ii performance in schizophrenia as a function of ascertainment strategy: Comparing the first and second phases of the consortium on the genetics of schizophrenia (COGS)

OpenAIRE

Stone, WS; Mesholam-Gately, RI; Braff, DL; Calkins, ME; Freedman, R; Green, MF; Greenwood, TA; Gur, RE; Gur, RC; Lazzeroni, LC; Light, GA; Nuechterlein, KH; Olincy, A; Radant, AD; Siever, LJ

2015-01-01

© 2014. The first phase of the Consortium on the Genetics of Schizophrenia (COGS-1) showed performance deficits in learning and memory on the California Verbal Learning Test, Second Edition (CVLT-II) in individuals with schizophrenia (SZ), compared to healthy comparison subjects (HCS). A question is whether the COGS-1 study, which used a family study design (i.e. studying relatively intact families), yielded "milder" SZ phenotypes than those acquired subsequently in the COGS-2 case-control de...

Association of the polygenic risk score for schizophrenia with mortality and suicidal behavior - A Danish population-based study.

Science.gov (United States)

Laursen, Thomas M; Trabjerg, Betina B; Mors, Ole; Børglum, Anders D; Hougaard, David M; Mattheisen, Manuel; Meier, Sandra M; Byrne, Enda M; Mortensen, Preben B; Munk-Olsen, Trine; Agerbo, Esben

2017-06-01

It is unknown whether an increased genetic liability to schizophrenia influences the risk of dying early. The aim of the study was to determine whether the genetic predisposition to schizophrenia is associated with the risk of dying early and experience a suicide attempt. Case control study, Denmark. The main measure was the mortality rate ratios (MRR) for deaths and odds ratios (OR) for multiple suicide attempts, associated with one standard deviations increase of the polygenic risk-score for schizophrenia (PRS). We replicated the high mortality MRR=9.01 (95% CI: 3.56-22.80), and high risk of multiple suicide attempts OR=33.16 (95% CI: 20.97-52.43) associated with schizophrenia compared to the general population. However, there was no effect of the PRS on mortality MRR=1.00 (95% CI 0.71-1.40) in the case-control setup or in cases only, MRR=1.05 (95% CI 0.73-1.51). Similar, no association between the PRS and multiple suicide attempts was found in the adjusted models, but in contrast, family history of mental disorders was associated with both outcomes. A genetic predisposition for schizophrenia, measured by PRS, has little influence on the excess mortality or the risk of suicide attempts. In contrast there is a strong significant effect of family history of mental disorders. Our findings could reflect that the common variants detected by recent PRS only explain a small proportion of risk of schizophrenia, and that future, more powerful PRS instruments may be able to predict excess mortality within this disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

STUDY OF FACTORS AFFECTING SUICIDE ATTEMPTS IN PERSONS WITH SCHIZOPHRENIA

Directory of Open Access Journals (Sweden)

Ottilingam Somasundaram Ravindran

2016-09-01

Full Text Available BACKGROUND Schizophrenia has been called a ‘Life-shortening disease’, because many sufferers die early than general population and suicide accounts for a significant proportion of those dying prematurely. Suicide attempts in schizophrenia has been an intriguing area of research work for mental health professionals. Indian research on suicide attempts in schizophrenia have been few. OBJECTIVES The objectives were to study the suicidal behaviour in schizophrenia, to compare and study the positive and negative symptoms, depressive symptoms, hopelessness and suicide intent in schizophrenic population with suicide attempt compared to nonattempters, along with socio-demographic parameters. METHODS A sample of 60 consecutive patients attending OPD of a Private tertiary care Hospital in Chennai were selected. Those who had a diagnosis of schizophrenia were screened for the presence of past suicide attempts. They were divided into two groups as suicide attempters and non-attempters, and analysed using the Positive and Negative Syndrome Scale (PANSS, Calgary Depression Scale for Schizophrenia (CDSS, Beck’s hopelessness scale (BHS, and Suicide intent scale (SIS. RESULTS Among the disorders schizophrenia is rated the second most common reason for suicide attempts (53.3%, especially when associated with positive symptoms, depressive features and significant hopelessness. Demographic parameters like age, sex, educational status, occupation, economic status, and marital status were not found to be significant factors linked to the suicide attempts, however family history of suicide had a significant association in schizophrenic suicide attempts. Suicidal intent severity was medium to high among most of the attempters; poisoning was the commonest method; and were found to be due to positive symptoms and depressive symptoms in the schizophrenic illness course.

Changes in cortical N-methyl-D-aspartate receptors and post-synaptic density protein 95 in schizophrenia, mood disorders and suicide.

Science.gov (United States)

Dean, Brian; Gibbons, Andrew S; Boer, Simone; Uezato, Akihito; Meador-Woodruff, James; Scarr, Elizabeth; McCullumsmith, Robert E

2016-03-01

In humans, depending on dose, blocking the N-methyl-D-aspartate receptor (NMDAR) with ketamine can cause psychomimetic or antidepressant effects. The overall outcome for drugs such as ketamine depends on dose and the number of its available binding sites in the central nervous system, and to understand something of the latter variable we measure NMDAR in the frontal pole, dorsolateral prefrontal, anterior cingulate and parietal cortices from people with schizophrenia, bipolar disorder, major depressive disorders and age/sex matched controls. We measured levels of NMDARs (using [(3)H]MK-801 binding) and NMDAR sub-unit mRNAs (GRINs: using in situ hybridisation) as well as post-synaptic density protein 95 (anterior cingulate cortex only; not major depressive disorders: an NMDAR post-synaptic associated protein) in bipolar disorder, schizophrenia and controls. Compared to controls, levels of NMDAR were lower in the outer laminae of the dorsolateral prefrontal cortex (-17%, p = 0.01) in people with schizophrenia. In bipolar disorder, levels of NMDAR binding (laminae IV-VI; -19%, p disorders, levels of GRIN2D mRNA were higher in frontal pole (+22%, p suicide completers, levels of GRIN2B mRNA were higher in parietal cortex (+20%, p disorders and suicide completion and may contribute to different responses to ketamine. © The Royal Australian and New Zealand College of Psychiatrists 2015.

The Vicious Cycle of Family Atmosphere, Interpersonal Self-concepts, and Paranoia in Schizophrenia-A Longitudinal Study.

Science.gov (United States)

Hesse, Klaus; Kriston, Levente; Mehl, Stephanie; Wittorf, Andreas; Wiedemann, Wolfgang; Wölwer, Wolfgang; Klingberg, Stefan

2015-11-01

Recent cognitive models of paranoid delusions highlight the role of self-concepts in the development and maintenance of paranoia. Evidence is growing that especially interpersonal self-concepts are relevant in the genesis of paranoia. In addition, negative interpersonal life-experiences are supposed to influence the course of paranoia. As dysfunctional family atmosphere corresponds with multiple distressing dyadic experiences, it could be a risk factor for the development and maintenance of paranoia. A total of 160 patients with a diagnosis of schizophrenia were assessed twice within 12 months. Standardized questionnaires and symptom rating scales were used to measure interpersonal self-concepts, perceived family atmosphere, and paranoia. Data were analyzed using longitudinal cross-lagged structural equation models. Perceived negative family atmosphere was associated with the development of more pronounced negative interpersonal self-concepts 12 months later. Moreover, paranoia was related to negative family atmosphere after 12 months as well. As tests revealed that reversed associations were not able to explain the data, we found evidence for a vicious cycle between paranoia, family atmosphere, and interpersonal self-concepts as suggested by theoretical/cognitive model of paranoid delusions. Results suggest that broader interventions for patients and their caretakers that aim at improving family atmosphere might also be able to improve negative self-concepts and paranoia. © 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.

High-level, but not low-level, motion perception is impaired in patients with schizophrenia.

Science.gov (United States)

Kandil, Farid I; Pedersen, Anya; Wehnes, Jana; Ohrmann, Patricia

2013-01-01

Smooth pursuit eye movements are compromised in patients with schizophrenia and their first-degree relatives. Although research has demonstrated that the motor components of smooth pursuit eye movements are intact, motion perception has been shown to be impaired. In particular, studies have consistently revealed deficits in performance on tasks specific to the high-order motion area V5 (middle temporal area, MT) in patients with schizophrenia. In contrast, data from low-level motion detectors in the primary visual cortex (V1) have been inconsistent. To differentiate between low-level and high-level visual motion processing, we applied a temporal-order judgment task for motion events and a motion-defined figure-ground segregation task using patients with schizophrenia and healthy controls. Successful judgments in both tasks rely on the same low-level motion detectors in the V1; however, the first task is further processed in the higher-order motion area MT in the magnocellular (dorsal) pathway, whereas the second task requires subsequent computations in the parvocellular (ventral) pathway in visual area V4 and the inferotemporal cortex (IT). These latter structures are supposed to be intact in schizophrenia. Patients with schizophrenia revealed a significantly impaired temporal resolution on the motion-based temporal-order judgment task but only mild impairment in the motion-based segregation task. These results imply that low-level motion detection in V1 is not, or is only slightly, compromised; furthermore, our data restrain the locus of the well-known deficit in motion detection to areas beyond the primary visual cortex.

Prioritizing schizophrenia endophenotypes for future genetic studies: An example using data from the COGS-1 family study.

Science.gov (United States)

Millard, Steven P; Shofer, Jane; Braff, David; Calkins, Monica; Cadenhead, Kristin; Freedman, Robert; Green, Michael F; Greenwood, Tiffany A; Gur, Raquel; Gur, Ruben; Lazzeroni, Laura C; Light, Gregory A; Olincy, Ann; Nuechterlein, Keith; Seidman, Larry; Siever, Larry; Silverman, Jeremy; Stone, William S; Sprock, Joyce; Sugar, Catherine A; Swerdlow, Neal R; Tsuang, Ming; Turetsky, Bruce; Radant, Allen; Tsuang, Debby W

2016-07-01

Past studies describe numerous endophenotypes associated with schizophrenia (SZ), but many endophenotypes may overlap in information they provide, and few studies have investigated the utility of a multivariate index to improve discrimination between SZ and healthy community comparison subjects (CCS). We investigated 16 endophenotypes from the first phase of the Consortium on the Genetics of Schizophrenia, a large, multi-site family study, to determine whether a subset could distinguish SZ probands and CCS just as well as using all 16. Participants included 345 SZ probands and 517 CCS with a valid measure for at least one endophenotype. We used both logistic regression and random forest models to choose a subset of endophenotypes, adjusting for age, gender, smoking status, site, parent education, and the reading subtest of the Wide Range Achievement Test. As a sensitivity analysis, we re-fit models using multiple imputations to determine the effect of missing values. We identified four important endophenotypes: antisaccade, Continuous Performance Test-Identical Pairs 3-digit version, California Verbal Learning Test, and emotion identification. The logistic regression model that used just these four endophenotypes produced essentially the same results as the model that used all 16 (84% vs. 85% accuracy). While a subset of endophenotypes cannot replace clinical diagnosis nor encompass the complexity of the disease, it can aid in the design of future endophenotypic and genetic studies by reducing study cost and subject burden, simplifying sample enrichment, and improving the statistical power of locating those genetic regions associated with schizophrenia that may be the easiest to identify initially. Published by Elsevier B.V.

Caring for persons with schizophrenia at home:examining the link between family caregivers’ role distress and quality of life.

Science.gov (United States)

Quah, Stella

2014-05-01

This article re-examines the link between role distress and quality of life of family caregivers of a loved one with schizophrenia by exploring the impact of role overload (defined as spending 7 or more hours daily looking after the care recipient). Role theory and symbolic interactionism provide the conceptual background to this study. The research question is: under what conditions does role distress reduce quality of life? The answer helps us identify circumstances under which caregivers may be able to carry out their stressful caregiving role while minimising a decline in their quality of life. The data are from a purposive sample of 47 family caregivers in Singapore who were interviewed in person using a semi-structured questionnaire. The data analysis includes non-parametric tests,exploratory factor analysis and relative risks estimates. The findings show that the inverse association between role distress and quality of life found in most studies of family caregivers changes when hours of care are taken into consideration.While role distress is found among all family caregivers it only reduces the family caregiver’s quality of life in situations of role overload. The implications for the situation of family caregivers are discussed.

A metaanalysis of perceptual organization in schizophrenia, schizotypy, and other high-risk groups based on variants of the Embedded Figures Task.

Directory of Open Access Journals (Sweden)

Kirsten Rebecca Panton

2016-02-01

Full Text Available Current research on perceptual organization in schizophrenia frequently employs shapes with regularly sampled contours (fragmented stimuli, in noise fields composed of similar elements, to elicit visual abnormalities. However, perceptual organization is multi-factorial and, in earlier studies, continuous contours have also been employed in tasks assessing the ability to extract shapes from a background. We conducted a systematic review and meta-analysis of studies using closed-contour stimuli, including the Embedded Figures Test (EFT and related tasks, both in people with schizophrenia and in healthy schizotypes and relatives, considered at increased risk for psychosis. Eleven studies met the selection criteria for inclusion in the meta-analysis, including six that used a between-groups study design (i.e. perceptual organization abilities of schizophrenia/high-risk groups were compared to healthy or clinical controls, and five that treated schizophrenia symptoms or schizotypy traits and indices of perceptual organization as continuous variables. Effect sizes and heterogeneity statistics were calculated, and the risk of publication bias was explored. A significant, moderate effect for EFT performance was found with studies that compared performance of schizophrenia/high-risk groups to a healthy or patient comparison group (d = -.523, p<.001. However, significant heterogeneity was also found amongst the schizotypy, but not schizophrenia studies, as well as studies using accuracy, but not reaction time as a measure of performance. A non-significant correlation was found for the studies that examined schizophrenia symptoms or schizotypy traits as continuous variables (r = .012, p = .825. These results suggest that deficits in perceptual organization of non-fragmented stimuli are found when differences between schizophrenia/high-risk groups and comparison groups are maximized. These findings should motivate further investigation of perceptual

Predictors of rapid high weight gain in schizophrenia: Longitudinal analysis of the French FACE-SZ cohort.

Science.gov (United States)

Godin, O; Leboyer, M; Schürhoff, F; Boyer, L; Andrianarisoa, M; Brunel, L; Bulzacka, E; Aouizerate, B; Berna, F; Capdevielle, D; D'Amato, T; Denizot, H; Dubertret, C; Dubreucq, J; Faget, C; Gabayet, F; Llorca, P M; Mallet, J; Misdrahi, D; Passerieux, C; Rey, R; Richieri, R; Schandrin, A; Urbach, M; Vidailhet, P; Costagliola, D; Fond, G

2017-11-01

Metabolic syndrome (MetS) is highly prevalent in schizophrenia. However very little is known about the time course of MetS and its components. The few longitudinal studies that have been carried out had small sample sizes and a short follow-up. The aim of our study was to evaluate the prevalence of MetS and its components, at baseline and one year later, and to investigate predictors of weight gain (WG) in a cohort of individuals with schizophrenia. We followed 167 schizophrenia patients from the FACE-SZ cohort for one year. The Structured Clinical Interview for DSM-IV (SCID) was used to confirm the diagnosis of schizophrenia. Data on socio-demographic and clinical characteristics, antipsychotic treatment, and comorbidities were collected, and a blood sample was drawn. We found that the prevalence of MetS increased from 21.0% to 26.6% after one year. Patients with baseline depressive symptoms had a 4.5-fold higher risk of WG at the one-year follow-up (p = 0.02) than those without depressive symptoms, after adjusting for confounding variables. WG also correlated with high levels of metabolic parameters and peripheral inflammation. These findings highlight the need to systematically diagnose depression in Schizophrenia. Future studies should determine whether specific pharmacological and non-pharmacological interventions for depression in SZ subjects are effective in preventing rapid high weight gain. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Science.gov (United States)

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

2015-12-30

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

Mental health literacy about schizophrenia and depression: a survey among Chinese caregivers of patients with mental disorder.

Science.gov (United States)

Chen, Shubao; Wu, Qiuxia; Qi, Chang; Deng, Huiqiong; Wang, Xuyi; He, Haoyu; Long, Jiang; Xiong, Yifan; Liu, Tieqiao

2017-03-09

To investigate the knowledge of schizophrenia and depression among caregivers of patients with mental disorder in China. A convenience sample of 402 caregivers at the Department of Psychiatry of a general hospital in China was investigated (response rate 95.7%), using vignettes based investigation methodology. The number of caregivers using the term "depression" to describe the depression vignette was 43.6%, which was significantly higher than the number of caregivers using the term "schizophrenia" to describe the schizophrenia one (28.5%). A high percentage of caregivers believed that "psychiatrist", "psychologist" and "close family members" would be helpful, and the top three most helpful interventions were "becoming more physically active", "getting out and learning more" and "receiving psychotherapy". The number of caregivers endorsed "antipsychotics" and "antidepressants" as helpful for the schizophrenia and the depression vignettes were 82.0 and 80.7%, respectively. Regarding the causes of mental illness, items related to psychosocial factors, including "daily problems" and "work or financial problems", and "weakness of character" were highly rated, with half considered genetic or chemical imbalance causes. Caregivers expressed a high knowledge about treatments and interventions of mental disorders. But there are still some areas, particularly regarding the recognition and causes of mental disorders, that are in need of improvement. This is particularly the case for schizophrenia.

[Supporting the Love, Marriage, and Child-Rearing of Persons with Schizophrenia].

Science.gov (United States)

Ikebuchi, Emi

2015-01-01

Persons with schizophrenia and their families have strong interests and hopes for love, marriage, pregnancy, and child-rearing. These experiences often lead to recovery from schizophrenia. There are many partners with schizophrenia who enjoy fruitful lives even with their disability. However, only some persons can enter into such lives in the real world in Japan and other countries. This leads persons with schizophrenia to develop a discouraged and disappointed attitude, and also causes professionals of mental health to develop indifference or pessimism about these issues. Schizophrenics are thought to have interests in love and sexual behavior just as strong as the general population. I discuss with my patients about these issues and working life early in the course of treatment. Because they lose their chance to learn adult behavior in social lives with peers due to the beginning of schizophrenia, they need an opportunity to participate in a social situation to learn knowledge and skills of dating and related behaviors, and systematic education such as psycho-education and social skills training should be provided. Continuing married life and child-rearing require more support from experts with rich experience and knowledge. Psychiatrists are required to participate in shared decision-making about medication during pregnancy and breast-feeding, as well as provide knowledge on the benefits and risks of antipsychotics. Net-working with the family, professionals of child welfare, and the community is necessary to support child-rearing. Urakawa Bethel's House was introduced as a pioneering concept to support love, marriage, and child-rearing. Finally, professionals' negative or indifferent attitudes toward these issues are discussed in the setting of treatment. I hope that professionals of mental health will think about these issues from the standpoints of persons with schizophrenia and their families.

Schizophrenia-Window-of-Hope.com: Development of a psycho ...

African Journals Online (AJOL)

Psycho-educational programmes for families of persons with schizophrenia have been shown to reduce relapse rates, subsequently reducing the burden on the family as well as health care systems. Although various South African helplines and psycho-educational websites exist, none of these focused specifically on ...

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

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Cassetta, Briana; Goghari, Vina

2014-08-15

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

Alterations in a Unique Class of Cortical Chandelier Cell Axon Cartridges in Schizophrenia.

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Rocco, Brad R; DeDionisio, Adam M; Lewis, David A; Fish, Kenneth N

2017-07-01

The axons of chandelier cells (ChCs) target the axon initial segment of pyramidal neurons, forming an array of boutons termed a cartridge. In schizophrenia, the density of cartridges detectable by gamma-aminobutyric acid (GABA) membrane transporter 1 immunoreactivity is lower, whereas the density of axon initial segments detectable by immunoreactivity for the α2 subunit of the GABA A receptor is higher in layers 2/superficial 3 of the prefrontal cortex. These findings were interpreted as compensatory responses to lower GABA levels in ChCs. However, we recently found that in schizophrenia, ChC cartridge boutons contain normal levels of the 67 kDa isoform of glutamic acid decarboxylase (GAD67) protein, the enzyme responsible for GABA synthesis in these boutons. To understand these findings we quantified the densities of ChC cartridges immunoreactive for vesicular GABA transporter (vGAT+), which is present in all cartridge boutons, and the subset of cartridges that contain calbindin (CB+). Prefrontal cortex tissue sections from 20 matched pairs of schizophrenia and unaffected comparison subjects were immunolabeled for vGAT, GAD67, and CB. The mean density of vGAT+/CB+ cartridges was 2.7-fold higher, exclusively in layer 2 of schizophrenia subjects, whereas the density of vGAT+/CB- cartridges did not differ between subject groups. Neither vGAT, CB, or GAD67 protein levels per ChC bouton nor the number of boutons per cartridge differed between subject groups. Our findings of a greater density of CB+ ChC cartridges in prefrontal cortex layer 2 from schizophrenia subjects suggests that the normal developmental pruning of these cartridges is blunted in the illness. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

TESTING HIGH-DIMENSIONAL COVARIANCE MATRICES, WITH APPLICATION TO DETECTING SCHIZOPHRENIA RISK GENES.

Science.gov (United States)

Zhu, Lingxue; Lei, Jing; Devlin, Bernie; Roeder, Kathryn

2017-09-01

Scientists routinely compare gene expression levels in cases versus controls in part to determine genes associated with a disease. Similarly, detecting case-control differences in co-expression among genes can be critical to understanding complex human diseases; however statistical methods have been limited by the high dimensional nature of this problem. In this paper, we construct a sparse-Leading-Eigenvalue-Driven (sLED) test for comparing two high-dimensional covariance matrices. By focusing on the spectrum of the differential matrix, sLED provides a novel perspective that accommodates what we assume to be common, namely sparse and weak signals in gene expression data, and it is closely related with Sparse Principal Component Analysis. We prove that sLED achieves full power asymptotically under mild assumptions, and simulation studies verify that it outperforms other existing procedures under many biologically plausible scenarios. Applying sLED to the largest gene-expression dataset obtained from post-mortem brain tissue from Schizophrenia patients and controls, we provide a novel list of genes implicated in Schizophrenia and reveal intriguing patterns in gene co-expression change for Schizophrenia subjects. We also illustrate that sLED can be generalized to compare other gene-gene "relationship" matrices that are of practical interest, such as the weighted adjacency matrices.

Excess Early Mortality in Schizophrenia

DEFF Research Database (Denmark)

Laursen, Thomas Munk; Nordentoft, Merete; Mortensen, Preben Bo

2014-01-01

Schizophrenia is often referred to as one of the most severe mental disorders, primarily because of the very high mortality rates of those with the disorder. This article reviews the literature on excess early mortality in persons with schizophrenia and suggests reasons for the high mortality...... as well as possible ways to reduce it. Persons with schizophrenia have an exceptionally short life expectancy. High mortality is found in all age groups, resulting in a life expectancy of approximately 20 years below that of the general population. Evidence suggests that persons with schizophrenia may...... not have seen the same improvement in life expectancy as the general population during the past decades. Thus, the mortality gap not only persists but may actually have increased. The most urgent research agenda concerns primary candidates for modifiable risk factors contributing to this excess mortality...

Schizophrenia and oxidative stress: glutamate cysteine ligase modifier as a susceptibility gene

DEFF Research Database (Denmark)

Tosic, Mirjana; Ott, Jurg; Barral, Sandra

2006-01-01

Oxidative stress could be involved in the pathophysiology of schizophrenia, a major psychiatric disorder. Glutathione (GSH), a redox regulator, is decreased in patients' cerebrospinal fluid and prefrontal cortex. The gene of the key GSH-synthesizing enzyme, glutamate cysteine ligase modifier (GCLM......) subunit, is strongly associated with schizophrenia in two case-control studies and in one family study. GCLM gene expression is decreased in patients' fibroblasts. Thus, GSH metabolism dysfunction is proposed as one of the vulnerability factors for schizophrenia....

Schizophrenia and oxidative stress: glutamate cysteine ligase modifier as a susceptibility gene

DEFF Research Database (Denmark)

Tosic, Mirjana; Ott, Jurg; Barral, Sandra

2006-01-01

Oxidative stress could be involved in the pathophysiology of schizophrenia, a major psychiatric disorder. Glutathione (GSH), a redox regulator, is decreased in patients' cerebrospinal fluid and prefrontal cortex. The gene of the key GSH-synthesizing enzyme, glutamate cysteine ligase modifier (GCL......) subunit, is strongly associated with schizophrenia in two case-control studies and in one family study. GCLM gene expression is decreased in patients' fibroblasts. Thus, GSH metabolism dysfunction is proposed as one of the vulnerability factors for schizophrenia....

Mental correlates of neuromotoric deviation in 6-year-olds at heightened risk for schizophrenia.

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McNeil, Thomas F; Cantor-Graae, Elizabeth; Blennow, Gösta

2003-04-01

The meaning and relevance of the increased rates of neuromotoric deviation (ND) observed in patients with schizophrenia and their biological relatives remain unclear. ND could represent free-floating, independent characteristics of individuals in these families vs. signs of an increased risk for current or future mental disorder. The co-temporaneous relationship between ND and mental disorder at 6 years of age was investigated among 31 children with an increased risk for schizophrenia and similar psychoses, defined as having a mother with a history of schizophrenia or unspecified functional psychosis. As compared with high-risk cases with a low level of ND, the subgroup of 10 high-risk offspring showing notably increased rates of ND had significantly more frequent psychiatric diagnoses (typically language disorders and enuresis), poor functioning on global assessment, poor interpersonal competency and high anxiety proneness. Neuromotoric items representing "overflow" (e.g., choreatic movements, tremor) were significantly positively related to each of these mental characteristics. Among high-risk offspring, an increased rate of ND is very clearly associated with increased rates of current mental disorder, and might potentially identify a subgroup with an especially high risk for serious mental disorder in the future.

First rank symptoms for schizophrenia.

Science.gov (United States)

Soares-Weiser, Karla; Maayan, Nicola; Bergman, Hanna; Davenport, Clare; Kirkham, Amanda J; Grabowski, Sarah; Adams, Clive E

2015-01-25

Early and accurate diagnosis and treatment of schizophrenia may have long-term advantages for the patient; the longer psychosis goes untreated the more severe the repercussions for relapse and recovery. If the correct diagnosis is not schizophrenia, but another psychotic disorder with some symptoms similar to schizophrenia, appropriate treatment might be delayed, with possible severe repercussions for the person involved and their family. There is widespread uncertainty about the diagnostic accuracy of First Rank Symptoms (FRS); we examined whether they are a useful diagnostic tool to differentiate schizophrenia from other psychotic disorders. To determine the diagnostic accuracy of one or multiple FRS for diagnosing schizophrenia, verified by clinical history and examination by a qualified professional (e.g. psychiatrists, nurses, social workers), with or without the use of operational criteria and checklists, in people thought to have non-organic psychotic symptoms. We conducted searches in MEDLINE, EMBASE, and PsycInfo using OvidSP in April, June, July 2011 and December 2012. We also searched MEDION in December 2013. We selected studies that consecutively enrolled or randomly selected adults and adolescents with symptoms of psychosis, and assessed the diagnostic accuracy of FRS for schizophrenia compared to history and clinical examination performed by a qualified professional, which may or may not involve the use of symptom checklists or based on operational criteria such as ICD and DSM. Two review authors independently screened all references for inclusion. Risk of bias in included studies were assessed using the QUADAS-2 instrument. We recorded the number of true positives (TP), true negatives (TN), false positives (FP), and false negatives (FN) for constructing a 2 x 2 table for each study or derived 2 x 2 data from reported summary statistics such as sensitivity, specificity, and/or likelihood ratios. We included 21 studies with a total of 6253 participants

Association of adoptive child's thought disorders and schizophrenia spectrum disorders with their genetic liability for schizophrenia spectrum disorders, season of birth and parental Communication Deviance.

Science.gov (United States)

Roisko, Riikka; Wahlberg, Karl-Erik; Hakko, Helinä; Tienari, Pekka

2015-04-30

Joint effects of genotype and the environment have turned out to be significant in the development of psychotic disorders. The purpose of the present study was to assess the association of an adoptive child׳s thought and schizophrenia spectrum disorders with genetic and environmental risk indicators and their interactions. A subgroup of the total sample used in the Finnish Adoptive Family Study was considered in the present study. The subjects were 125 adoptees at a high (n=53) or low (n=72) genetic risk of schizophrenia spectrum disorders and their adoptive parents. The risk factors evaluated were the adoptive child's genetic risk for schizophrenia spectrum disorders, winter or spring birth and parental Communication Deviance (CD). Thought disorders in the adoptees were assessed using the Thought Disorder Index and diagnoses were made according to DSM-III-R criteria. The adoptive child׳s Thought Disorder Index was only associated with parental Communication Deviance. The adoptive child's heightened genetic risk or winter or spring birth or parental CD or their interactions did not predict the adoptee's schizophrenia spectrum disorder. The results suggest that studies taking several risk indicators and their interactions into account may change views on the mutual significance of well-known risk factors. Copyright © 2015. Published by Elsevier Ireland Ltd.

A two-parameter family of double-power-law biorthonormal potential-density expansions

Science.gov (United States)

Lilley, Edward J.; Sanders, Jason L.; Evans, N. Wyn

2018-05-01

We present a two-parameter family of biorthonormal double-power-law potential-density expansions. Both the potential and density are given in closed analytic form and may be rapidly computed via recurrence relations. We show that this family encompasses all the known analytic biorthonormal expansions: the Zhao expansions (themselves generalizations of ones found earlier by Hernquist & Ostriker and by Clutton-Brock) and the recently discovered Lilley et al. (2017a) expansion. Our new two-parameter family includes expansions based around many familiar spherical density profiles as zeroth-order models, including the γ models and the Jaffe model. It also contains a basis expansion that reproduces the famous Navarro-Frenk-White (NFW) profile at zeroth order. The new basis expansions have been found via a systematic methodology which has wide applications in finding other new expansions. In the process, we also uncovered a novel integral transform solution to Poisson's equation.

Visual masking & schizophrenia

Directory of Open Access Journals (Sweden)

Michael H. Herzog

2015-06-01

Full Text Available Visual masking is a frequently used tool in schizophrenia research. Visual masking has a very high sensitivity and specificity and masking paradigms have been proven to be endophenotypes. Whereas masking is a powerful technique to study schizophrenia, the underlying mechanisms are discussed controversially. For example, for more than 25 years, masking deficits of schizophrenia patients were mainly attributed to a deficient magno-cellular system (M-system. Here, we show that there is very little evidence that masking deficits are magno-cellular deficits. We will discuss the magno-cellular and other approaches in detail and highlight their pros and cons.

Approaches to improve adherence to pharmacotherapy in patients with schizophrenia.

Science.gov (United States)

Shuler, Kimberly M

2014-01-01

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

Paternal age related schizophrenia (PARS): Latent subgroups detected by k-means clustering analysis.

Science.gov (United States)

Lee, Hyejoo; Malaspina, Dolores; Ahn, Hongshik; Perrin, Mary; Opler, Mark G; Kleinhaus, Karine; Harlap, Susan; Goetz, Raymond; Antonius, Daniel

2011-05-01

Paternal age related schizophrenia (PARS) has been proposed as a subgroup of schizophrenia with distinct etiology, pathophysiology and symptoms. This study uses a k-means clustering analysis approach to generate hypotheses about differences between PARS and other cases of schizophrenia. We studied PARS (operationally defined as not having any family history of schizophrenia among first and second-degree relatives and fathers' age at birth ≥ 35 years) in a series of schizophrenia cases recruited from a research unit. Data were available on demographic variables, symptoms (Positive and Negative Syndrome Scale; PANSS), cognitive tests (Wechsler Adult Intelligence Scale-Revised; WAIS-R) and olfaction (University of Pennsylvania Smell Identification Test; UPSIT). We conducted a series of k-means clustering analyses to identify clusters of cases containing high concentrations of PARS. Two analyses generated clusters with high concentrations of PARS cases. The first analysis (N=136; PARS=34) revealed a cluster containing 83% PARS cases, in which the patients showed a significant discrepancy between verbal and performance intelligence. The mean paternal and maternal ages were 41 and 33, respectively. The second analysis (N=123; PARS=30) revealed a cluster containing 71% PARS cases, of which 93% were females; the mean age of onset of psychosis, at 17.2, was significantly early. These results strengthen the evidence that PARS cases differ from other patients with schizophrenia. Hypothesis-generating findings suggest that features of PARS may include a discrepancy between verbal and performance intelligence, and in females, an early age of onset. These findings provide a rationale for separating these phenotypes from others in future clinical, genetic and pathophysiologic studies of schizophrenia and in considering responses to treatment. Copyright © 2011 Elsevier B.V. All rights reserved.

Markedly Lower Glutamic Acid Decarboxylase 67 Protein Levels in a Subset of Boutons in Schizophrenia.

Science.gov (United States)

Rocco, Brad R; Lewis, David A; Fish, Kenneth N

2016-06-15

Convergent findings indicate that cortical gamma-aminobutyric acid (GABA)ergic circuitry is altered in schizophrenia. Postmortem studies have consistently found lower levels of glutamic acid decarboxylase 67 (GAD67) messenger RNA (mRNA) in the prefrontal cortex (PFC) of subjects with schizophrenia. At the cellular level, the density of GABA neurons with detectable levels of GAD67 mRNA is ~30% lower across cortical layers. Knowing how this transcript deficit translates to GAD67 protein levels in axonal boutons is important for understanding the impact it might have on GABA synthesis. In addition, because reductions in GAD67 expression before, but not after, the maturation of GABAergic boutons results in a lower density of GABAergic boutons in mouse cortical cultures, knowing if GABAergic bouton density is altered in schizophrenia would provide insight into the timing of the GAD67 deficit. PFC tissue sections from 20 matched pairs of schizophrenia and comparison subjects were immunolabeled for the vesicular GABA transporter (vGAT) and GAD67. vGAT+ bouton density did not differ between subject groups, consistent with findings that vGAT mRNA levels are unaltered in the illness and confirming that the number of cortical GABAergic boutons is not lower in schizophrenia. In contrast, in schizophrenia subjects, the proportion of vGAT+ boutons with detectable GAD67 levels (vGAT+/GAD67+ boutons) was 16% lower and mean GAD67 levels were 14% lower in the remaining vGAT+/GAD67+ boutons. Our findings suggest that GABA production is markedly reduced in a subset of boutons in the PFC of schizophrenia subjects and that this reduction likely occurs after the maturation of GABAergic boutons. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Evaluation of European Schizophrenia GWAS Loci in Asian Populations via Comprehensive Meta-Analyses.

Science.gov (United States)

Xiao, Xiao; Luo, Xiong-Jian; Chang, Hong; Liu, Zichao; Li, Ming

2017-08-01

Schizophrenia is a severe and highly heritable neuropsychiatric disorder. Recent genetic analyses including genome-wide association studies (GWAS) have implicated multiple genome-wide significant variants for schizophrenia among European populations. However, many of these risk variants were not largely validated in other populations of different ancestry such as Asians. To validate whether these European GWAS significant loci are associated with schizophrenia in Asian populations, we conducted a systematic literature search and meta-analyses on 19 single nucleotide polymorphisms (SNPs) in Asian populations by combining all available case-control and family-based samples, including up to 30,000 individuals. We employed classical fixed (or random) effects inverse variance weighted methods to calculate summary odds ratios (ORs) and 95 % confidence intervals (CIs). Among the 19 GWAS loci, we replicated the risk associations of nine markers (e.g., SNPs at VRK2, ITIH3/4, NDST3, NOTCH4) surpassing significance level (two-tailed P Asian replication samples and initial European GWAS findings, and the successful replications of these GWAS loci in a different ethnic group provide stronger evidence for their clinical associations with schizophrenia. Further studies, focusing on the molecular mechanisms of these GWAS significant loci, will become increasingly important for understanding of the pathogenesis to schizophrenia.

Biomarker identification and effect estimation on schizophrenia –a high dimensional data analysis

Directory of Open Access Journals (Sweden)

Yuanzhang eLi

2015-05-01

Full Text Available Biomarkers have been examined in schizophrenia research for decades. Medical morbidity and mortality rates, as well as personal and societal costs, are associated with schizophrenia patients. The identification of biomarkers and alleles, which often have a small effect individually, may help to develop new diagnostic tests for early identification and treatment. Currently, there is not a commonly accepted statistical approach to identify predictive biomarkers from high dimensional data. We used space Decomposition-Gradient-Regression method (DGR to select biomarkers, which are associated with the risk of schizophrenia. Then, we used the gradient scores, generated from the selected biomarkers, as the prediction factor in regression to estimate their effects. We also used an alternative approach, classification and regression tree (CART, to compare the biomarker selected by DGR and found about 70% of the selected biomarkers were the same. However, the advantage of DGR is that it can evaluate individual effects for each biomarker from their combined effect. In DGR analysis of serum specimens of US military service members with a diagnosis of schizophrenia from 1992 to 2005 and their controls, Alpha-1-Antitrypsin (AAT, Interleukin-6 receptor (IL-6r and Connective Tissue Growth Factor (CTGF were selected to identify schizophrenia for males; and Alpha-1-Antitrypsin (AAT, Apolipoprotein B (Apo B and Sortilin were selected for females. If these findings from military subjects are replicated by other studies, they suggest the possibility of a novel biomarker panel as an adjunct to earlier diagnosis and initiation of treatment.

Approaches to improve adherence to pharmacotherapy in patients with schizophrenia

Directory of Open Access Journals (Sweden)

Shuler KM

2014-05-01

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

[Schizophrenia and informed consent to research].

Science.gov (United States)

Fovet, T; Amad, A; Thomas, P; Jardri, R

2015-10-01

Informed consent to research remains a complex issue, while sometimes staying difficult to obtain, even in the general population. This problem may be maximized with patients suffering from schizophrenia. This paper summarizes available data in the literature about informed consent for research involving patients suffering from schizophrenia. Medline and Google Scholar searches were conducted using the following MESH terms: schizophrenia, informed consent and research. Studies using dedicated standardized scales (e.g. MacCAT-CR) revealed a decrease in the capacity to consent of patients with schizophrenia when compared with healthy individuals. Keeping in mind that schizophrenia is an heterogeneous disorder, patients with the lowest insight as well as those with the most severe cognitive symptoms appeared more impaired in their capacity to consent. Such a poor capacity to understand and consent to trials was shown linked with alterations in decision-making. For these specific patients, interventions may be set up to increase their capacity to consent. Various strategies were proposed: enhanced consent forms, extended discussion, test/feedback method or multimedia interventions. Among them, interventions relying on communication and the growing field of information technologies (e.g. web-based tools) seem promising. Finally, associations grouping families and patients (like the French Association UNAFAM) may facilitate the involvement of patients in research programs with safer conditions. Patients suffering from schizophrenia appear able to consent to research programs when suitable interventions are proposed. Further studies are now needed to optimize and individualize such interventions. Copyright © 2014 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

Neuropsychological performance and family history in children at age 7 who develop adult schizophrenia or bipolar psychosis in the New England Family Studies.

Science.gov (United States)

Seidman, L J; Cherkerzian, S; Goldstein, J M; Agnew-Blais, J; Tsuang, M T; Buka, S L

2013-01-01

Persons developing schizophrenia (SCZ) manifest various pre-morbid neuropsychological deficits, studied most often by measures of IQ. Far less is known about pre-morbid neuropsychological functioning in individuals who later develop bipolar psychoses (BP). We evaluated the specificity and impact of family history (FH) of psychosis on pre-morbid neuropsychological functioning. We conducted a nested case-control study investigating the associations of neuropsychological data collected systematically at age 7 years for 99 adults with psychotic diagnoses (including 45 SCZ and 35 BP) and 101 controls, drawn from the New England cohort of the Collaborative Perinatal Project (CPP). A mixed-model approach evaluated full-scale IQ, four neuropsychological factors derived from principal components analysis (PCA), and the profile of 10 intelligence and achievement tests, controlling for maternal education, race and intra-familial correlation. We used a deviant responder approach (children who later develop SCZ, especially in the SCZ FH+ subgroup, but less so in BP, suggesting especially impaired neurodevelopment underlying cognition in pre-SCZ children. Future work should assess genetic and environmental factors that explain this FH effect.

High-Power-Density, High-Energy-Density Fluorinated Graphene for Primary Lithium Batteries

Directory of Open Access Journals (Sweden)

Guiming Zhong

2018-03-01

Full Text Available Li/CFx is one of the highest-energy-density primary batteries; however, poor rate capability hinders its practical applications in high-power devices. Here we report a preparation of fluorinated graphene (GFx with superior performance through a direct gas fluorination method. We find that the so-called “semi-ionic” C-F bond content in all C-F bonds presents a more critical impact on rate performance of the GFx in comparison with sp2 C content in the GFx, morphology, structure, and specific surface area of the materials. The rate capability remains excellent before the semi-ionic C-F bond proportion in the GFx decreases. Thus, by optimizing semi-ionic C-F content in our GFx, we obtain the optimal x of 0.8, with which the GF0.8 exhibits a very high energy density of 1,073 Wh kg−1 and an excellent power density of 21,460 W kg−1 at a high current density of 10 A g−1. More importantly, our approach opens a new avenue to obtain fluorinated carbon with high energy densities without compromising high power densities.

[Diagnostic process and management of schizophrenia in Spain: the ACEE project].

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Baca Baldomero, E; Leal Cercós, C; Varela, C; Riesgo, Y; Roca, M

2006-01-01

Although schizophrenia has a great impact on the health care, social and family levels, there is little epidemiological information on patients with schizophrenia, its diagnosis and treatment in Spain. The ACEE (Abordaje Clínico de la Esquizofrenia en España; Clinical Approach to Schizophrenia in Spain) study was designed with the primary objective of defining the management of schizophrenia in Spain from the perspective of current clinical practice. ACEE is a descriptive cross-sectional multicenter observational study with data collected in the setting of current clinical practice by means of a specifically designed questionnaire. A total of 1,937 patients have been studied (83% pertaining to the public sector and 17% to private one). Most subjects had paranoid schizophrenia in the stabilization phase, and did not work because of their illness. Most (96%) were receiving antipsychotic treatment and 55% also received some non-drug treatment. Negative symptoms were more frequent than positive symptoms (88% versus 63%). Significant differences were observed for type of patients and diagnostic procedures involved between the public and private health care sectors. The ACEE study shows that schizophrenic patients attending Spanish psychiatric centers are mainly single, non-working males who are living in their family setting. Treatment basically consists of antipsychotics combined with other drugs, and few complementary examinations are performed.

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

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Dorofeikova, Mariia; Neznanov, Nikolay; Petrova, Nataliia

2018-04-01

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

Relationship between Mental Health and Burden among Primary Caregivers of Outpatients with Schizophrenia.

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Yu, Wenjun; Chen, Jia; Hu, Jize; Hu, JingChu

2018-01-24

There is growing recognition that caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health for caregivers. A quantitative cross-sectional design and standardized instruments were used to collect data from 355 primary caregivers of adults in outpatient care with schizophrenia in China. Structural equation modeling was used to examine the association between caregiver burden and mental health among primary caregivers and whether this association is influenced by personality, coping style, and family functioning, based on a diathesis-stress perspective. Goodness-of-fit indices (χ 2 /df = 1.406, GFI = 0.919, CFI = 0.957, etc.) confirmed that the modified model fit the data well. In line with the diathesis-stress model, and with this study's hypotheses, we found that caregiver burden was significantly related to mental health outcomes directly. The final model showed that personality traits, coping style, and family function influenced the relationship between caregiver burden and mental health. The neuroticism personality traits have a direct effect on caregiver burden and family functioning in this sample. Coping style had a direct effect on the caregiver burden, and family functioning had a direct effect on the caregiver burden. Our final model about primary caregivers can be applied clinically to predict mental health outcomes from caregiver burden. © 2018 Family Process Institute.

A two fold risk of metabolic syndrome in a sample of patients with schizophrenia: do consanguinity and family history increase risk?

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Bener, Abdulbari; Al-Hamaq, Abdulla O A A; Dafeeah, Elnour E

2014-01-01

Patients with schizophrenia are at greater risk for metabolic syndrome (MetS) and other cardiovascular risk factors. The objective of the study was to examine the prevalence of metabolic syndrome (MetS) and its criteria among patients with schizophrenia (Sz) according to the revised criteria of NCEP ATP III and assess which component contributed to the increased risk of the MetS in schizophrenia patients. This was a matched case-control study. Outpatient clinics of the Psychiatry department and Primary Health Care (PHC) Centers of the Supreme Council of Health, State of Qatar. The study was carried out among patients with schizophrenia (SZ) and healthy subjects above 20 years old. The study based on matched by age and gender of 233 cases and 466 controls. The survey was conducted from June 2010 to May 2011. Face to face interviews were conducted using a structured questionnaire followed by laboratory tests. Metabolic syndrome was defined using the National Cholesterol Education Program - Third Adult Treatment Panel (ATP III). The prevalence of metabolic syndrome among schizophrenic patients (36.5%) were significantly higher than healthy subjects (18.7%) (pmetabolic abnormalities compared to men. The study indicated that metabolic syndrome was highly prevalent in patients with schizophrenia. The female gender was significantly associated with a higher prevalence of metabolic syndrome. The identification and clinical management of this high risk group is of great importance. Copyright © 2013 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Risk factors for violent crime in Schizophrenia: a national cohort study of 13,806 patients.

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Fazel, Seena; Grann, Martin; Carlström, Eva; Lichtenstein, Paul; Långström, Niklas

2009-03-01

To determine risk factors for and prevalence of violent crime in patients with schizophrenia, and in particular, to explore the contribution of familial risk factors. We designed a cohort study that followed up patients with 2 or more hospitalizations for schizophrenia (ICD-8, ICD-9, and ICD-10 criteria) and investigated the risk for a violent conviction using Cox proportional hazards models. All 13,806 patients with 2 hospital discharge diagnoses of schizophrenia from January 1, 1973, through December 31, 2004, in Sweden were followed until violent conviction, emigration, death, or end of follow-up (December 31, 2004), and associations with sociodemographic, individual (substance abuse comorbidity, and previous violence), and familial (parental violent crime and parental alcohol abuse) factors were examined. Over an average follow-up period of 12 years, 17.1% (N = 1519) of the men and 5.6% (N = 273) of the women with 2 or more hospitalizations for schizophrenia had a violent conviction after discharge from hospital. Familial risk factors had moderate effects, increasing the risk for violent convictions by 50% to 150%. After adjustment for sociodemographic and individual risk factors, the associations between parental violent crime and risk of violent convictions remained in men (adjusted hazard ratio [HR] = 1.65, 95% CI = 1.33 to 2.04) and in women (adjusted HR = 1.83, 95% CI = 1.11 to 3.01), whereas parental alcohol abuse was no longer significantly associated with violent crime. Parental violent crime had moderate associations with violent crime in male and female offspring with at least 2 hospitalizations for schizophrenia, which were mostly stronger than the better documented sociodemographic risk factors. This suggests that familial (genetic or early environmental) risk factors have an important role in the etiology of violent offending among individuals with schizophrenia and should be considered in violence risk assessment. ©Copyright 2009 Physicians

Is family size related to adolescence mental hospitalization?

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Kylmänen, Paula; Hakko, Helinä; Räsänen, Pirkko; Riala, Kaisa

2010-05-15

The aim of this study was to investigate the association between family size and psychiatric disorders of underage adolescent psychiatric inpatients. The study sample consisted of 508 adolescents (age 12-17) admitted to psychiatric impatient care between April 2001 and March 2006. Diagnostic and Statistical Manual of Mental Disorders, fourth edition-based psychiatric diagnoses and variables measuring family size were obtained from the Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL). The family size of the general Finnish population was used as a reference population. There was a significant difference between the family size of the inpatient adolescents and the general population: 17.0% of adolescents came from large families (with 6 or more children) while the percentage in the general population was 3.3. A girl from a large family had an about 4-fold risk of psychosis other than schizophrenia. However, large family size was not associated with a risk for schizophrenia. Large family size was overrepresented among underage adolescents admitted for psychiatric hospitalization in Northern Finland. Copyright 2009 Elsevier Ltd. All rights reserved.

Ethnic density of neighborhoods and incidence of psychotic disorders among immigrants

NARCIS (Netherlands)

Veling, Wim; Susser, Ezra; van Os, Jim; Mackenbach, Johan P; Selten, Jean-Paul; Hoek, Hans W

OBJECTIVE: A high incidence of psychotic disorders has been reported in immigrant ethnic groups in Western Europe. Some studies suggest that ethnic density may influence the incidence of schizophrenia. The authors investigated whether this increased incidence among immigrants depends on the ethnic

DNA methyl transferase (DNMT gene polymorphisms could be a primary event in epigenetic susceptibility to schizophrenia.

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Koramannil Radha Saradalekshmi

Full Text Available DNA methylation has been implicated in the etiopathology of various complex disorders. DNA methyltransferases are involved in maintaining and establishing new methylation patterns. The aim of the present study was to investigate the inherent genetic variations within DNA methyltransferase genes in predisposing to susceptibility to schizophrenia. We screened for polymorphisms in DNA methyltransferases, DNMT1, DNMT3A, DNMT3B and DNMT3L in 330 schizophrenia patients and 302 healthy controls for association with Schizophrenia in south Indian population. These polymorphisms were also tested for subgroup analysis with patient's gender, age of onset and family history. DNMT1 rs2114724 (genotype P = .004, allele P = 0.022 and rs2228611 (genotype P = 0.004, allele P = 0.022 were found to be significantly associated at genotypic and allelic level with Schizophrenia in South Indian population. DNMT3B rs2424932 genotype (P = 0.023 and allele (P = 0.0063 increased the risk of developing schizophrenia in males but not in females. DNMT3B rs1569686 (genotype P = 0.027, allele P = 0.033 was found to be associated with early onset of schizophrenia and also with family history and early onset (genotype P = 0.009. DNMT3L rs2070565 (genotype P = 0.007, allele P = 0.0026 confers an increased risk of developing schizophrenia at an early age in individuals with family history. In-silico prediction indicated functional relevance of these SNPs in regulating the gene. These observations might be crucial in addressing and understanding the genetic control of methylation level differences from ethnic viewpoint. Functional significance of genotype variations within the DNMTs indeed suggest that the genetic nature of methyltransferases should be considered while addressing epigenetic events mediated by methylation in Schizophrenia.

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

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Miranda-Castillo Claudia

2009-09-01

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

Analysis of variables affecting drug compliance in schizophrenia

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Shakeel Ansari

2014-01-01

Full Text Available Context: As compliance of the patient during management of schizophrenia is crucial, the current study was conducted to find out the factors that affected compliance. Aims: The aim of the study was to analyze the prevalence of noncompliance and to find out different factors affecting compliance in schizophrenic patients. Materials and Methods: Observational cross-sectional study was conducted on 100 adult schizophrenic patients. Noncompliance was assessed using the rating of medication influence (ROMI scale. Severity of illness was measured using positive and negative syndrome scale (PANSS. Results: Prevalence of noncompliance was 37%. Using ROMI scale; positive relationship with psychiatrist, family pressure for taking medications, stigma, and substance abuse were found to be significant factors. Severity of illness was also found as determining factor. Conclusion: To improve the compliance in schizophrenia patients, roles of both psychiatrists and family members are crucial.

Update in the treatment of schizophrenia.

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Katz, I; Kac, M

1993-04-01

The large number of drugs available to treat schizophrenia and the emergence of atypical and newer agents that provide efficiency with lessening of side effects may not only serve to provide more amelioration against this disease, but may also help us to unravel the neurochemical defects of the disorder. Despite these encouraging trends, the reality is that schizophrenia is still a devastating illness for a sizeable minority affected with the condition, that a 'cure' is not yet possible, and that drug therapies alone will not provide all that is required in acute or continuing management. Supporting care in the community for patient and family are just as important as pharmacotherapy in managing this problem.

Clinical characteristics and premorbid variables in childhood-onset schizophrenia: a descriptive study of twelve cases from a schizophrenia founder population.

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Maydell, R J; van der Walt, C; Roos, J L; Scribante, L; Ladikos, A

2009-05-01

To analyze clinical and demographic data of childhood-onset (12 years and younger) schizophrenia patients collected for a genetic study in schizophrenia, undertaken nationally in South Africa, using multiple parameters. Patients with an onset of schizophrenia at 12 years or younger, were included. From the Diagnostic Interview for Genetic Studies (DIGS), patients' information and summary report data was tabulated and analyzed. Specific subgroups were further compared. This sub-population of 12 subjects was further compared with a group of the adult sample. Of the 12 patients recruited, prominent results were: male to female ratio of 1:1; all had insidious onset of psychosis; a third had all 3 multidimensional impairment (MDI) symptoms; all patients that received ADHD treatment had ADHD treatment failure; two thirds had milestone delay; 58% had birth complications; a third were predominantly bottle fed; 42% had family history of schizophrenia; a third had family history of other major psychiatric conditions; all patients had at least one non-psychotic deviant behaviour (NPDB); no patient used cannabis; all delusions were paranoid; 92% had school achievement difficulty and a third had treatment resistance. Gender comparison included: earlier onset of psychosis in females; all females had aggression versus a third of males; more females had school achievement difficulty than males; males had more treatment resistance. Patients with MDI, compared to the sample average had: earlier onset of non-psychotic deviant behaviour; lower school drop-out rate; less social difficulty and no treatment resistance. The results compare well to previous research on this topic. The new concepts introduced by the present study require further investigation.

Schizophrenia, substance abuse, and violent crime.

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Fazel, Seena; Långström, Niklas; Hjern, Anders; Grann, Martin; Lichtenstein, Paul

2009-05-20

Persons with schizophrenia are thought to be at increased risk of committing violent crime 4 to 6 times the level of general population individuals without this disorder. However, risk estimates vary substantially across studies, and considerable uncertainty exists as to what mediates this elevated risk. Despite this uncertainty, current guidelines recommend that violence risk assessment should be conducted for all patients with schizophrenia. To determine the risk of violent crime among patients diagnosed as having schizophrenia and the role of substance abuse in mediating this risk. Longitudinal designs were used to link data from nationwide Swedish registers of hospital admissions and criminal convictions in 1973-2006. Risk of violent crime in patients after diagnosis of schizophrenia (n = 8003) was compared with that among general population controls (n = 80 025). Potential confounders (age, sex, income, and marital and immigrant status) and mediators (substance abuse comorbidity) were measured at baseline. To study familial confounding, we also investigated risk of violence among unaffected siblings (n = 8123) of patients with schizophrenia. Information on treatment was not available. Violent crime (any criminal conviction for homicide, assault, robbery, arson, any sexual offense, illegal threats, or intimidation). In patients with schizophrenia, 1054 (13.2%) had at least 1 violent offense compared with 4276 (5.3%) of general population controls (adjusted odds ratio [OR], 2.0; 95% confidence interval [CI], 1.8-2.2). The risk was mostly confined to patients with substance abuse comorbidity (of whom 27.6% committed an offense), yielding an increased risk of violent crime among such patients (adjusted OR, 4.4; 95% CI, 3.9-5.0), whereas the risk increase was small in schizophrenia patients without substance abuse comorbidity (8.5% of whom had at least 1 violent offense; adjusted OR, 1.2; 95% CI, 1.1-1.4; Pgenetic or early environmental) confounding of the

Running in the family? : structural brain abnormalities in first-degree relatives of patients with schizophrenia

NARCIS (Netherlands)

Boos, H.B.M.

2011-01-01

The studies conducted in this thesis explored brain structures in first-degree relatives of patients with schizophrenia. The meta-analysis that Boos and colleagues performed showed that relatives of patients with schizophrenia had smaller hippocampal volumes, smaller gray matter volumes and larger

Stratifying empiric risk of schizophrenia among first degree relatives using multiple predictors in two independent Indian samples.

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Bhatia, Triptish; Gettig, Elizabeth A; Gottesman, Irving I; Berliner, Jonathan; Mishra, N N; Nimgaonkar, Vishwajit L; Deshpande, Smita N

2016-12-01

Schizophrenia (SZ) has an estimated heritability of 64-88%, with the higher values based on twin studies. Conventionally, family history of psychosis is the best individual-level predictor of risk, but reliable risk estimates are unavailable for Indian populations. Genetic, environmental, and epigenetic factors are equally important and should be considered when predicting risk in 'at risk' individuals. To estimate risk based on an Indian schizophrenia participant's family history combined with selected demographic factors. To incorporate variables in addition to family history, and to stratify risk, we constructed a regression equation that included demographic variables in addition to family history. The equation was tested in two independent Indian samples: (i) an initial sample of SZ participants (N=128) with one sibling or offspring; (ii) a second, independent sample consisting of multiply affected families (N=138 families, with two or more sibs/offspring affected with SZ). The overall estimated risk was 4.31±0.27 (mean±standard deviation). There were 19 (14.8%) individuals in the high risk group, 75 (58.6%) in the moderate risk and 34 (26.6%) in the above average risk (in Sample A). In the validation sample, risks were distributed as: high (45%), moderate (38%) and above average (17%). Consistent risk estimates were obtained from both samples using the regression equation. Familial risk can be combined with demographic factors to estimate risk for SZ in India. If replicated, the proposed stratification of risk may be easier and more realistic for family members. Copyright © 2016. Published by Elsevier B.V.

Common variants conferring risk of schizophrenia

DEFF Research Database (Denmark)

Stefansson, Hreinn; Ophoff, Roel A; Steinberg, Stacy

2009-01-01

Schizophrenia is a complex disorder, caused by both genetic and environmental factors and their interactions. Research on pathogenesis has traditionally focused on neurotransmitter systems in the brain, particularly those involving dopamine. Schizophrenia has been considered a separate disease...... conform to classical nosological disease boundaries. Certain CNVs confer not only high relative risk of schizophrenia but also of other psychiatric disorders. The structural variations associated with schizophrenia can involve several genes and the phenotypic syndromes, or the 'genomic disorders', have.......2. Our findings implicating the MHC region are consistent with an immune component to schizophrenia risk, whereas the association with NRGN and TCF4 points to perturbation of pathways involved in brain development, memory and cognition....

Local and Widely Distributed EEG Activity in Schizophrenia With Prevalence of Negative Symptoms.

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Grin-Yatsenko, Vera A; Ponomarev, Valery A; Pronina, Marina V; Poliakov, Yury I; Plotnikova, Irina V; Kropotov, Juri D

2017-09-01

We evaluated EEG frequency abnormalities in resting state (eyes closed and eyes open) EEG in a group of chronic schizophrenia patients as compared with healthy subjects. The study included 3 methods of analysis of deviation of EEG characteristics: genuine EEG, current source density (CSD), and group independent component (gIC). All 3 methods have shown that the EEG in schizophrenia patients is characterized by enhanced low-frequency (delta and theta) and high-frequency (beta) activity in comparison with the control group. However, the spatial pattern of differences was dependent on the type of method used. Comparative analysis has shown that increased EEG power in schizophrenia patients apparently concerns both widely spatially distributed components and local components of signal. Furthermore, the observed differences in the delta and theta range can be described mainly by the local components, and those in the beta range mostly by spatially widely distributed ones. The possible nature of the widely distributed activity is discussed.

Autism and Schizophrenia in high functioning adults: Behavioral differences and overlap

NARCIS (Netherlands)

Spek, Annelies A; Wouters, Saskia G.M.

2011-01-01

Several recent studies have demonstrated a genetical overlap between autism and schizophrenia. However, at a behavioral level it remains unclear which features can validly distinguish adults with autism from an adult schizophrenia group. To this end, the present study compared 21 individuals with

Theory of mind network activity is altered in subjects with familial liability for schizophrenia

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Mohnke, Sebastian; Erk, Susanne; Schnell, Knut; Romanczuk-Seiferth, Nina; Schmierer, Phöbe; Romund, Lydia; Garbusow, Maria; Wackerhagen, Carolin; Ripke, Stephan; Grimm, Oliver; Haller, Leila; Witt, Stephanie H.; Degenhardt, Franziska; Tost, Heike; Heinz, Andreas; Meyer-Lindenberg, Andreas; Walter, Henrik

2016-01-01

As evidenced by a multitude of studies, abnormalities in Theory of Mind (ToM) and its neural processing might constitute an intermediate phenotype of schizophrenia. If so, neural alterations during ToM should be observable in unaffected relatives of patients as well, since they share a considerable amount of genetic risk. While behaviorally, impaired ToM function is confirmed meta-analytically in relatives, evidence on aberrant function of the neural ToM network is sparse and inconclusive. The present study therefore aimed to further explore the neural correlates of ToM in relatives of schizophrenia. About 297 controls and 63 unaffected first-degree relatives of patients with schizophrenia performed a ToM task during functional magnetic resonance imaging. Consistent with the literature relatives exhibited decreased activity of the medial prefrontal cortex. Additionally, increased recruitment of the right middle temporal gyrus and posterior cingulate cortex was found, which was related to subclinical paranoid symptoms in relatives. These results further support decreased medial prefrontal activation during ToM as an intermediate phenotype of genetic risk for schizophrenia. Enhanced recruitment of posterior ToM areas in relatives might indicate inefficiency mechanisms in the presence of genetic risk. PMID:26341902

Genetic Relationships Between Schizophrenia, Bipolar Disorder, and Schizoaffective Disorder

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Cardno, Alastair G.

2014-01-01

There is substantial evidence for partial overlap of genetic influences on schizophrenia and bipolar disorder, with family, twin, and adoption studies showing a genetic correlation between the disorders of around 0.6. Results of genome-wide association studies are consistent with commonly occurring genetic risk variants, contributing to both the shared and nonshared aspects, while studies of large, rare chromosomal structural variants, particularly copy number variants, show a stronger influence on schizophrenia than bipolar disorder to date. Schizoaffective disorder has been less investigated but shows substantial familial overlap with both schizophrenia and bipolar disorder. A twin analysis is consistent with genetic influences on schizoaffective episodes being entirely shared with genetic influences on schizophrenic and manic episodes, while association studies suggest the possibility of some relatively specific genetic influences on broadly defined schizoaffective disorder, bipolar subtype. Further insights into genetic relationships between these disorders are expected as studies continue to increase in sample size and in technical and analytical sophistication, information on phenotypes beyond clinical diagnoses are increasingly incorporated, and approaches such as next-generation sequencing identify additional types of genetic risk variant. PMID:24567502

Influence of psycho-social factors on the emergence of depression and suicidal risk in patients with schizophrenia.

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Pješčić, Katarina Dokić; Nenadović, Milutin M; Jašović-Gašić, Miroslava; Trajković, Goran; Kostić, Mirjana; Ristić-Dimitrijević, Radmila

2014-09-01

The aim of this study was to investigate the influence of certain psychosocial factors - insight, psycho-education, family and social support, loneliness and social isolation - on the appearance of depression and suicidal risk in schizophrenia. This was a cross-sectional study that comprised hospitalized patients with schizophrenia in the initial remission phase. The assessment of depression and suicidal risk was made by applying a semi-structured psychiatric interview that included scrutinized factors (insight, psycho-education, family and social support, loneliness and social isolation), Positive and Negative Syndrome Scale (PANSS), and Calgary Depression Scale for Schizophrenia (CDSS). On the basis of the assessment results, the sample was divided into two groups: Group of patients with depression and suicidal risk in schizophrenia (N = 53) and Control group (N = 159) of patients with schizophrenia without depression and suicidal risk. In the Group of patients with depression and suicidal risk, compared with the Control group, there was significantly higher frequency of insight in the mental status (χ² = 31.736, p risk in schizophrenia. This study shows that considered psycho-social factors - insight in the mental status, lack of psycho-education, as well as social isolation - could be predictors for appearance of depression and suicidal risk in schizophrenia.

Caregiver Expressed Emotion and Psychiatric Symptoms in African-Americans with Schizophrenia: An Attempt to Understand the Paradoxical Relationship.

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Gurak, Kayla; Weisman de Mamani, Amy

2017-06-01

Expressed emotion (EE) is a family environmental construct that assesses how much criticism, hostility, and/or emotional over-involvement a family member expresses about a patient (Hooley, Annual Review of Clinical Psychology, 2007, 3, 329). Having high levels of EE within the family environment has generally been associated with poorer patient outcomes for schizophrenia and a range of other disorders. Paradoxically, for African-American patients, high-EE may be associated with a better symptom course (Rosenfarb, Bellack, & Aziz, Journal of Abnormal Psychology, 2006, 115, 112). However, this finding is in need of additional support and, if confirmed, clarification. In line with previous research, using a sample of 30 patients with schizophrenia and their primary caregivers, we hypothesized that having a caregiver classified as low-EE would be associated with greater patient symptom severity. We also aimed to better understand why this pattern may exist by examining the content of interviews taken from the Five-Minute Speech Sample. Results supported study hypotheses. In line with Rosenfarb et al. (2006), having a low-EE caregiver was associated with greater symptom severity in African-American patients. A content analysis uncovered some interesting patterns that may help elucidate this finding. Results of this study suggest that attempts to lower high-EE in African Americans may, in fact, be counterproductive. © 2015 Family Process Institute.

Systematic Prioritization and Integrative Analysis of Copy Number Variations in Schizophrenia Reveal Key Schizophrenia Susceptibility Genes

Science.gov (United States)

Luo, Xiongjian; Huang, Liang; Han, Leng; Luo, Zhenwu; Hu, Fang; Tieu, Roger; Gan, Lin

2014-01-01

Schizophrenia is a common mental disorder with high heritability and strong genetic heterogeneity. Common disease-common variants hypothesis predicts that schizophrenia is attributable in part to common genetic variants. However, recent studies have clearly demonstrated that copy number variations (CNVs) also play pivotal roles in schizophrenia susceptibility and explain a proportion of missing heritability. Though numerous CNVs have been identified, many of the regions affected by CNVs show poor overlapping among different studies, and it is not known whether the genes disrupted by CNVs contribute to the risk of schizophrenia. By using cumulative scoring, we systematically prioritized the genes affected by CNVs in schizophrenia. We identified 8 top genes that are frequently disrupted by CNVs, including NRXN1, CHRNA7, BCL9, CYFIP1, GJA8, NDE1, SNAP29, and GJA5. Integration of genes affected by CNVs with known schizophrenia susceptibility genes (from previous genetic linkage and association studies) reveals that many genes disrupted by CNVs are also associated with schizophrenia. Further protein-protein interaction (PPI) analysis indicates that protein products of genes affected by CNVs frequently interact with known schizophrenia-associated proteins. Finally, systematic integration of CNVs prioritization data with genetic association and PPI data identifies key schizophrenia candidate genes. Our results provide a global overview of genes impacted by CNVs in schizophrenia and reveal a densely interconnected molecular network of de novo CNVs in schizophrenia. Though the prioritized top genes represent promising schizophrenia risk genes, further work with different prioritization methods and independent samples is needed to confirm these findings. Nevertheless, the identified key candidate genes may have important roles in the pathogenesis of schizophrenia, and further functional characterization of these genes may provide pivotal targets for future therapeutics and

Psychosocial and psychoeducational group program for main caregiver of mentally sick in early phase of schizophrenia

Directory of Open Access Journals (Sweden)

Estíbaliz Amaro Martín

2012-03-01

Full Text Available Deinstitutionalization processes in recent times have led to a new age in relations between family and mental health professionals. Care professionals were replaced, after the psychiatric reform, for care carried out by the family without the knowledge, information and skills to assume these functions. This is the situation of many families of patients with schizophrenia.Disabling features of schizophrenia usually cause depends on their families, who take care with the consequent impact on their lives. Psychosocial interventions assessing their work and want to build an alliance with them by giving them skills and coping mechanisms to reduce adverse family atmosphere, anticipate and solve problems and reduce the expressions of anger and guilt keeping appropiate expectations. However, these actions must be enforced by providing main caregivers with the skills that enable them to gain control, this is the main target of psychoeducational programs.Today there are many people in favour of such interventions in the early stages of schizophrenia. However, it is no clear how far development of these programs is supported by evidence of effectiveness. So it has proposed a psychosocial and psychoeducational program aimed at main caregivers of patients with schizophrenia in early stages. This program will be led by a psychiatric nurse in collaboration with other professionals in the interdisciplinary team; psychiatrist, clinical psychologist and social worker. It has developed clinical trial with a control group who will receive the gide for families, caregivers and people affected, "Cómo afrontar la esquizofrenia," and an experimental group will receive, in addition to the guide, the group intervention sessions.

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

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Jamali

2016-03-01

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

Schizophrenia: A Journey through Higher Education

Science.gov (United States)

Zeeuw, Diane

2015-01-01

Professor Diane Zeeuw describes her son's experience of being diagnosed with schizophrenia in early adulthood, and how despite the fact that he may never hold a job or raise a family, or even be able to live fully independently, he still has a deep and abiding love of learning. Most serious psychiatric disorders are first diagnosed between the…

Copy number variations of chromosome 16p13.1 region associated with schizophrenia

DEFF Research Database (Denmark)

Ingason, A; Rujescu, D; Cichon, S

2011-01-01

.007) and deletions in 0.12 % of cases and 0.04% of controls (P>0.05). The region can be divided into three intervals defined by flanking low copy repeats. Duplications spanning intervals I and II showed the most significant (P = 0.00010) association with schizophrenia. The age of onset in duplication and deletion...... carriers among cases ranged from 12 to 35 years, and the majority were males with a family history of psychiatric disorders. In a single Icelandic family, a duplication spanning intervals I and II was present in two cases of schizophrenia, and individual cases of alcoholism, attention deficit hyperactivity...

The nature and timing of social deficits in child and adolescent offspring of parents with schizophrenia: preliminary evidence for precursors of negative symptoms?

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Horton, Leslie E; Smith, Ashley A; Haas, Gretchen L

2014-10-01

Children with social dysfunction and a first-degree relative with schizophrenia are at elevated risk for schizophrenia; however, the nature of this dysfunction is unclear. It was hypothesized that familial high-risk (HR) children and adolescents (n=17) would have social skill deficits relative to healthy controls (HC; n=35). HR participants had a bimodal distribution of social skill scores (47% excellent; 53% poor). HR participants had worse social skills, assertion and empathy scores, suggesting possible developmental precursors to the social amotivation domain of negative symptoms. Characterizing HR children's social deficits could assist identification of those at risk for schizophrenia. Copyright © 2014 Elsevier B.V. All rights reserved.

REAL NECESSITIES OF A CONTRACEPTION ALGORITHM IN CASES OF WOMEN SUFFERING FROM SCHIZOPHRENIA. SPECIAL NEEDS FOR FAMILY PLANNING

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Madalina Ciuhodaru

2010-09-01

Full Text Available Schizophrenia has a devastating effect on patient lives all together with their families, changing dramatically the day by day life, affecting thinking, feelings, knowledge and modifying the patient’s ability to adapt to society – establishing “boundaries” and “stigma” cause of desasperation, confusion or other symptoms. Objectives: This study wanted to the established an algorithm that concerns contraceptive methods specifically made for schizophrenic female patients according to their needs and to reality in which they live. Material and method: the study included 6200 patients at reproductive age that had been hospitalized in Socola Psychiatric unit during 2005 - 2010 and have been investigated by inquiry about age, provenience, marital status, education, number of children, knowledge and attitudes towards methods of contraception failure. Results The majority of the ones that knew about the contraception were from the urban area, age 30-35 having medium education, in a relationship or married. Unfortunately the help providers tend to neglect this “delicate subject” the fertility of schizophrenic patients being a real problem not only for the health care specialist but also costing highly the social assistance, their families, and their own children. Conclusions. While the Royal College of Obstetricians from Great Britain affirms that as a criteria for medical eligibility in using contraception in female schizophrenic patients it can be used any method as there are no longer contraindications for each specific case and under a correct counseling the best way is to solve ethical problems offering those patients the right access to family planning

The relevance of recovery to carers of people who have schizophrenia

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Fox, Joanna Ruth

2013-01-01

Recovery is a new concept positing that people with schizophrenia can lead fulfilling, satisfying, and productive lives. Family carers often play a helpful but largely unacknowledged role in the support of service users with schizophrenia, and the nature of their contribution to and their role in recovery has hitherto not been investigated. This original PhD explores whether learning about the recovery approach through participation in a training intervention changes the way carers view recov...

Experience of stigma in the public life of relatives of people diagnosed with schizophrenia in the Republic of Belarus.

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Krupchanka, Dzmitry; Kruk, Nina; Sartorius, Norman; Davey, Silvia; Winkler, Petr; Murray, Joanna

2017-04-01

Mental health-related stigma affects people with mental disorders and their families. We aimed to investigate the experience of stigma among relatives of patients with schizophrenia in Belarus and formulate recommendations for anti-stigma interventions. We conducted and thematically analysed 20 interviews with relatives of people diagnosed with schizophrenia. Experience of discrimination, strategies to cope with it, and requests for interventions were examined. A number of themes related to the experience of stigma in the public life of relatives of people with schizophrenia were elicited in relation to: (1) mental health care (difficulties in contacting mental health professionals; in getting appropriate information; lack of alternatives to hospital treatment; absence of appropriate long-term care services); (2) employment of people living with schizophrenia and (3) contact with the police. Analysis of the strategies used to overcome difficulties revealed resignation and passive acceptance, self-reliance, and emotional containment during crises. Despite the passivity and scepticism in expressing needs, participants suggested a number of interventions that could reduce the burden of stigma. With respect to the public domain of life, substantial stigma and discrimination perceived by families of people living with schizophrenia in Belarus is associated with structural issues of the country's mental health care system. To reduce the stigma-related burden, action must be taken to: (1) educate and support families and (2) deal with structural issues, by reorganising mental health services to better meet the needs of the families of people diagnosed with schizophrenia, and by including them in decision making at all levels.

A functional Magnetic Resonance Imaging study of neurohemodynamic abnormalities during emotion processing in subjects at high risk for schizophrenia

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Venkatasubramanian, Ganesan; Puthumana, Dawn Thomas K.; Jayakumar, Peruvumba N.; Gangadhar, B. N.

2010-01-01

Background: Emotion processing abnormalities are considered among the core deficits in schizophrenia. Subjects at high risk (HR) for schizophrenia also show these deficits. Structural neuroimaging studies examining unaffected relatives at high risk for schizophrenia have demonstrated neuroanatomical abnormalities involving neo-cortical and sub-cortical brain regions related to emotion processing. The brain functional correlates of emotion processing in these HR subjects in the context of ecologically valid, real-life dynamic images using functional Magnetic Resonance Imaging (fMRI) has not been examined previously. Aim: To examine the neurohemodynamic abnormalities during emotion processing in unaffected subjects at high risk for schizophrenia in comparison with age-, sex-, handedness- and education-matched healthy controls, using fMRI. Materials and Methods: HR subjects for schizophrenia (n=17) and matched healthy controls (n=16) were examined. The emotion processing of fearful facial expression was examined using a culturally appropriate and valid tool for Indian subjects. The fMRI was performed in a 1.5-T scanner during an implicit emotion processing paradigm. The fMRI analyses were performed using the Statistical Parametric Mapping 2 (SPM2) software. Results: HR subjects had significantly reduced brain activations in left insula, left medial frontal gyrus, left inferior frontal gyrus, right cingulate gyrus, right precentral gyrus and right inferior parietal lobule. Hypothesis-driven region-of-interest analysis revealed hypoactivation of right amygdala in HR subjects. Conclusions: Study findings suggest that neurohemodynamic abnormalities involving limbic and frontal cortices could be potential indicators for increased vulnerability toward schizophrenia. The clinical utility of these novel findings in predicting the development of psychosis needs to be evaluated. PMID:21267363

Marriage and outcomes of people with schizophrenia in rural China: 14-year follow-up study.

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Ran, Mao-Sheng; Wong, Yin-Ling Irene; Yang, Shu-Yan; Ho, Petula S Y; Mao, Wen-Jun; Li, Jie; Chan, Cecilia Lai-Wan

2017-04-01

The influence of marriage on the long-term outcomes of schizophrenia is largely unknown. This study was to examine the impact of marriage on the 14-year outcomes and identify the correlates of marriage among persons with schizophrenia in rural community. All study participants with schizophrenia (n=510) were identified in 1994 in an epidemiological investigation of 123,572 people aged 15years and older and followed up in 2004 and 2008 in Xinjin County, Chengdu, China. The Patients Follow-up Schedule (PFS) was used in 2004 and 2008. The rate of follow-up in 2008 was 95.9%. Unmarried individuals in 1994 had higher rates of homelessness and suicide, and lower rate of survival in 2004 and 2008 than those married. In 14-year follow-up, unmarried individuals were more likely to be male, to have higher level of psychiatric symptoms and lower rate of full remission of illness, and to report lower level of work functioning, as well as with fewer family members and caregiver, and lower family economic status. The predictors of being married in 2008 included being married in 1994, shorter duration of illness, being female, and lower level of education. Being married is predictive of more favorable 14-year outcomes of persons with schizophrenia in the rural community. Given that marriage can be instrumental for enhancing family-based support and caregiving, as well as improving the community tenure of persons with schizophrenia, it is important to develop programs to enhance opportunity for persons with schizophrenia to get and stay married. Copyright © 2016 Elsevier B.V. All rights reserved.

Emotion recognition deficits as predictors of transition in individuals at clinical high risk for schizophrenia: a neurodevelopmental perspective.

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Corcoran, C M; Keilp, J G; Kayser, J; Klim, C; Butler, P D; Bruder, G E; Gur, R C; Javitt, D C

2015-10-01

Schizophrenia is characterized by profound and disabling deficits in the ability to recognize emotion in facial expression and tone of voice. Although these deficits are well documented in established schizophrenia using recently validated tasks, their predictive utility in at-risk populations has not been formally evaluated. The Penn Emotion Recognition and Discrimination tasks, and recently developed measures of auditory emotion recognition, were administered to 49 clinical high-risk subjects prospectively followed for 2 years for schizophrenia outcome, and 31 healthy controls, and a developmental cohort of 43 individuals aged 7-26 years. Deficit in emotion recognition in at-risk subjects was compared with deficit in established schizophrenia, and with normal neurocognitive growth curves from childhood to early adulthood. Deficits in emotion recognition significantly distinguished at-risk patients who transitioned to schizophrenia. By contrast, more general neurocognitive measures, such as attention vigilance or processing speed, were non-predictive. The best classification model for schizophrenia onset included both face emotion processing and negative symptoms, with accuracy of 96%, and area under the receiver-operating characteristic curve of 0.99. In a parallel developmental study, emotion recognition abilities were found to reach maturity prior to traditional age of risk for schizophrenia, suggesting they may serve as objective markers of early developmental insult. Profound deficits in emotion recognition exist in at-risk patients prior to schizophrenia onset. They may serve as an index of early developmental insult, and represent an effective target for early identification and remediation. Future studies investigating emotion recognition deficits at both mechanistic and predictive levels are strongly encouraged.

Spinocerebellar ataxia-10 with paranoid schizophrenia

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Bhavesh Trikamji

2015-01-01

Full Text Available Spino-cerebellar ataxia type 10 (SCA10 is an autosomal dominant disorder that is characterized by cerebellar ataxia, seizures and nystagmus with a fragmented pursuit. Schizophrenia has been reported with SCAs 1 and 2 yet in SCA 10, psychiatric manifestations are uncommon. We report a Hispanic family involving a father and his four children with SCA10 genetic mutation. Two of his children, a 20-year-old female and a 23-year-old male, presented with gradually progressive spino-cerebellar ataxia and paranoid schizophrenia. Neurological examination revealed ocular dysmetria, dysdiadokinesia, impaired finger-to-nose exam, gait ataxia and hyperreflexia in both the cases. Additionally, they had a history of psychosis with destructive behavior, depression and paranoid delusions with auditory hallucinations. Serology and CSF studies were unremarkable and MRI brain revealed cerebellar volume loss. Ultimately, a test for ATAXIN-10 mutation was positive thus confirming the diagnosis of SCA10 in father and his four children. We now endeavor to investigate the association between schizophrenia and SCA10.

Important components of a short-term family group programme. From the Danish National Multicenter Schizophrenia Project

DEFF Research Database (Denmark)

Buksti, Ann Staerk; Munkner, Runa; Gade, Inger Lise

2006-01-01

Clinicians from three psychiatric departments have established family groups as a specific intervention for the relatives of patients with first-episode psychosis. The intervention manual is combining the psychoeducational model with psychodynamic understanding and principles. The aim of this study...... was to identify the special elements of the programme that were the most important to the relatives. A questionnaire was developed for the participants of the groups in order to establish their satisfaction concerning 1) The actual knowledge received; 2) improvement in ability to cooperate with the therapeutic...... of 15 specific items. More than 95% of the relatives appreciated the gained knowledge about schizophrenia as well as the possibility of sharing thoughts and feelings with others. Two specific elements had the highest rating as important factors for the learning condition: 1) to listen to others...

A systematic review and meta-analysis of neurological soft signs in relatives of people with schizophrenia

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Neelam Kishen

2011-08-01

Full Text Available Abstract Background Neurological soft signs are subtle but observable impairments in motor and sensory functions that are not localized to a specific area of the brain. Neurological soft signs are common in schizophrenia. It has been established that soft signs meet two of five criteria for an endophenotype, namely: association with the illness, and state independence. This review investigated whether soft signs met a further criterion for an endophenotype, namely familial association. It was hypothesized that if familial association were present then neurological soft signs would be: (a more common in first-degree relatives of people with schizophrenia than in controls; and (b more common in people with schizophrenia than in their first-degree relatives. Method A systematic search identified potentially eligible studies in the EMBASE (1980-2011, OVID - MEDLINE (1950-2011 and PsycINFO (1806-2011 databases. Studies were included if they carried out a three-way comparison of levels of soft signs between people with schizophrenia, their first-degree relatives, and normal controls. Data were extracted independently by two reviewers and cross-checked by double entry. Results After screening 8678 abstracts, seven studies with 1553 participants were identified. Neurological soft signs were significantly more common in first-degree relatives of people with schizophrenia than in controls (pooled standardised mean difference (SMD 1.24, 95% confidence interval (c.i 0.59-1.89. Neurological soft signs were also significantly more common in people with schizophrenia than in their first-degree relatives (SMD 0.92, 95% c.i 0.64-1.20. Sensitivity analyses examining the effects of age and group blinding did not significantly alter the main findings. Conclusions Both hypotheses were confirmed, suggesting that the distribution of neurological soft signs in people with schizophrenia and their first-degree relatives is consistent with the endophenotype criterion of

Testing the association between the incidence of schizophrenia and social capital in an urban area.

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Kirkbride, J B; Boydell, J; Ploubidis, G B; Morgan, C; Dazzan, P; McKenzie, K; Murray, R M; Jones, P B

2008-08-01

Social capital has been considered aetiologically important in schizophrenia but the empirical evidence to support this hypothesis is absent. We tested whether social capital, measured at the neighbourhood level, was associated with the incidence of schizophrenia (ICD-10 F20). MethodWe administered a cross-sectional questionnaire on social capital to 5% of the adult population in 33 neighbourhoods (wards) in South London (n=16 459). The questionnaire contained items relating to two social capital constructs: social cohesion and trust (SC&T) and social disorganization (SocD). Schizophrenia incidence rates, estimated using data from the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study, provided the outcome. We used multi-level Poisson regression to test our hypothesis while controlling for individual- and neighbourhood-level characteristics. We identified 148 cases during 565 576 person-years at-risk. Twenty-six per cent of the variation in incidence rates was attributable to neighbourhood-level characteristics. Response from the social capital survey was 25.7%. The association between SC&T and schizophrenia was U-shaped. Compared with neighbourhoods with medial levels of SC&T, incidence rates were significantly higher in neighbourhoods with low [incidence rates ratio (IRR) 2.0, 95% confidence interval (CI) 1.2-3.3] and high (IRR 2.5, 95% CI 1.3-4.8) levels of SC&T, independent of age, sex, ethnicity, ethnic density, ethnic fragmentation and socio-economic deprivation. ConclusionNeighbourhood variation in SC&T was non-linearly associated with the incidence of schizophrenia within an urban area. Neighbourhoods with low SC&T may fail to mediate social stress whereas high SC&T neighbourhoods may have greater informal social control or may increase the risk of schizophrenia for residents excluded from accessing available social capital.

Brain structure in people at ultra-high risk of psychosis, patients with first-episode schizophrenia, and healthy controls: a VBM study.

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Nenadic, Igor; Dietzek, Maren; Schönfeld, Nils; Lorenz, Carsten; Gussew, Alexander; Reichenbach, Jürgen R; Sauer, Heinrich; Gaser, Christian; Smesny, Stefan

2015-02-01

Early intervention research in schizophrenia has suggested that brain structural alterations might be present in subjects at high risk of developing psychosis. The heterogeneity of regional effects of these changes, which is established in schizophrenia, however, has not been explored in prodromal or high-risk populations. We used high-resolution MRI and voxel-based morphometry (VBM8) to analyze grey matter differences in 43 ultra high-risk subjects for psychosis (meeting ARMS criteria, identified through CAARMS interviews), 24 antipsychotic-naïve first-episode schizophrenia patients and 49 healthy controls (groups matched for age and gender). Compared to healthy controls, resp., first-episode schizophrenia patients had reduced regional grey matter in left prefrontal, insula, right parietal and left temporal cortices, while the high-risk group showed reductions in right middle temporal and left anterior frontal cortices. When dividing the ultra-high-risk group in those with a genetic risk vs. those with attenuated psychotic symptoms, the former showed left anterior frontal, right caudate, as well as a smaller right hippocampus, and amygdala reduction, while the latter subgroup showed right middle temporal cortical reductions (each compared to healthy controls). Our findings in a clinical psychosis high-risk cohort demonstrate variability of brain structural changes according to subgroup and background of elevated risk, suggesting frontal and possibly also hippocampal/amygdala changes in individuals with genetic susceptibility. Heterogeneity of structural brain changes (as seen in schizophrenia) appears evident even at high-risk stage, prior to potential onset of psychosis. Copyright © 2014 Elsevier B.V. All rights reserved.

The relationship of antisocial personality disorder and history of conduct disorder with crime incidence in schizophrenia.

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Maghsoodloo, Safa; Ghodousi, Arash; Karimzadeh, Taghi

2012-06-01

Commission of crime and hostility and their forensic consequences in a patient with schizophrenia can worsen the patient's condition and disturb his family, society, and even the psychiatrist. Based on previous research, patients with schizophrenia are at a higher risk for crime. It is not clear whether this is due to the nature of schizophrenia, comorbidity of antisocial personality disorder, or the history of conduct disorder in childhood. In this study, we investigated this hypothesis. In this case-control study, 30 criminal and 30 non-criminal patients with schizophrenia, who had been referred by the court to the Forensic Medicine Center of Isfahan, were evaluated for antisocial personality disorder, history of conduct disorder, and psychopathy checklist-revise (PCL-R) score. Frequency distribution of antisocial personality disorder (73.3%), history of conduct disorder in childhood (86.7%), and score of PCL-R ≥25 (indicating high probability of hostility) in patients (40%) were significantly higher in criminal patients than in non-criminals (10%, 30% and 0%, respectively; P antisocial personality disorder, history of conduct disorder, and high score of PCL-R (≥25) in criminal schizophrenic patients may indicate that in order to control the hostility and for prevention of crime, besides treating acute symptoms of psychosis, patients might receive treatment and rehabilitation for comorbidities too.

Impaired conscious access and abnormal attentional amplification in schizophrenia

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L. Berkovitch

Full Text Available Previous research suggests that the conscious perception of a masked stimulus is impaired in schizophrenia, while unconscious bottom-up processing of the same stimulus, as assessed by subliminal priming, can be preserved. Here, we test this postulated dissociation between intact bottom-up and impaired top-down processing and evaluate its brain mechanisms using high-density recordings of event-related potentials. Sixteen patients with schizophrenia and sixteen controls were exposed to peripheral digits with various degrees of visibility, under conditions of either focused attention or distraction by another task. In the distraction condition, the brain activity evoked by masked digits was drastically reduced in both groups, but early bottom-up visual activation could still be detected and did not differ between patients and controls. By contrast, under focused top-down attention, a major impairment was observed: in patients, contrary to controls, the late non-linear ignition associated with the P3 component was reduced. Interestingly, the patients showed an essentially normal attentional amplification of the P1 and N2 components. These results suggest that some but not all top-down attentional amplification processes are impaired in schizophrenia, while bottom-up processing seems to be preserved. Keywords: Attention, Psychosis, Visual awareness, Masking, Top-down, Bottom-up

Factors Moderating the Relationship Between Childhood Trauma and Premorbid Adjustment in First-Episode Schizophrenia.

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Kilian, S; Burns, J K; Seedat, S; Asmal, L; Chiliza, B; Du Plessis, S; Olivier, M R; Kidd, M; Emsley, R

2017-01-01

Childhood trauma is a recognised risk factor for schizophrenia. It has been proposed that childhood trauma interferes with normal neurodevelopment, thereby establishing a biological vulnerability to schizophrenia. Poor premorbid adjustment is frequently a precursor to schizophrenia, and may be a manifestation of neurodevelopmental compromise. We investigated the relationship between childhood trauma and premorbid adjustment in 77 patients with first-episode schizophrenia spectrum disorders. We also investigated possible mediating roles for other selected risk factors in the relationship. We found several significant correlations between different trauma types and both social and academic premorbid adjustment from childhood to late adolescence. There were no significant moderating effects for family history of schizophrenia or family history of psychiatric disorder. History of obstetric complications, substance abuse and poor motor coordination weakened some of the associations between childhood trauma and premorbid adjustment, while poor sequencing of motor acts strengthened the association. Our results confirm previous studies indicating an association between childhood trauma and premorbid adjustment. Results indicate a general rather than specific association, apparent with different types of trauma, and affecting both social and academic components of premorbid adjustment across childhood, early and late adolescence. Further, our results suggest a complex interplay of various risk factors, supporting the notion of different pathways to psychosis.

Relationship of family caregiver burden with quality of care and psychopathology in a sample of Arab subjects with schizophrenia

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Zahid Muhammad A

2010-09-01

Full Text Available Abstract Background Although the burden experienced by families of people with schizophrenia has long been recognized as one of the most important consequences of the disorder, there are no reports from the Arab world. Following the example of the five - nation European (EPSILON study, we explored the following research question: How does the relationship between domains of caregiving (as in the Involvement Evaluation Questionnaire - IEQ-EU and caregiver psychic distress on the one hand, and caregiver's/patient's socio-demographics, clinical features and indices of quality of care, on the other hand, compare with the pattern in the literature? Method Consecutive family caregivers of outpatients with schizophrenia were interviewed with the IEQ-EU. Patients were interviewed with measures of needs for care, service satisfaction, quality of life (QOL and psychopathology. Results There were 121 caregivers (66.1% men, aged 39.8. The IEQ domain scores (total: 46.9; tension: 13.4; supervision: 7.9; worrying: 12.9; and urging: 16.4 were in the middle of the range for the EU data. In regression analyses, higher burden subscale scores were variously associated with caregiver lower level of education, patient's female gender and younger age, as well as patient's lower subjective QOL and needs for hospital care, and not involving the patient in outdoor activities. Disruptive behavior was the greatest determinant of global rating of burden. Conclusion Our results indicate that, despite differences in service set-up and culture, the IEQ-EU can be used in Kuwait as it has been used in the western world, to describe the pattern of scores on the dimensions of caregiving. Differences with the international data reflect peculiarities of culture and type of service. Despite generous national social welfare provisions, experience of burden was the norm and was significantly associated with patient's disruptive behavior. The results underscore the need for provision

GABAergic system impairment in the hippocampus and superior temporal gyrus of patients with paranoid schizophrenia: A post-mortem study.

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Steiner, Johann; Brisch, Ralf; Schiltz, Kolja; Dobrowolny, Henrik; Mawrin, Christian; Krzyżanowska, Marta; Bernstein, Hans-Gert; Jankowski, Zbigniew; Braun, Katharina; Schmitt, Andrea; Bogerts, Bernhard; Gos, Tomasz

2016-11-01

Glutamic acid decarboxylase (GAD) is a key enzyme in GABA synthesis and alterations in GABAergic neurotransmission related to glial abnormalities are thought to play a crucial role in the pathophysiology of schizophrenia. This study aimed to identify potential differences regarding the neuropil expression of GAD between paranoid and residual schizophrenia. GAD65/67 immunostained histological sections were evaluated by quantitative densitometric analysis of GAD-immunoreactive (ir) neuropil. Regions of interest were the hippocampal formation (CA1 field and dentate gyrus [DG]), superior temporal gyrus (STG), and laterodorsal thalamic nucleus (LD). Data from 16 post-mortem schizophrenia patient samples (10 paranoid and 6 residual schizophrenia cases) were compared with those from 16 matched controls. Overall, schizophrenia patients showed a lower GAD-ir neuropil density (P=0.014), particularly in the right CA1 (P=0.033). However, the diagnostic subgroups differed significantly (Pparanoid versus residual patients (P=0.036) and controls (Pparanoid versus residual schizophrenia cases (P=0.042). GAD-ir neuropil density correlated positively with antipsychotic dosage, particularly in CA1 (right: r=0.850, P=0.004; left: r=0.800, P=0.010). Our finding of decreased relative density of GAD-ir neuropil suggests hypofunction of the GABAergic system, particularly in hippocampal CA1 field and STG layer V of patients with paranoid schizophrenia. The finding that antipsychotic medication seems to counterbalance GABAergic hypofunction in schizophrenia patients suggests the possibility of exploring new treatment avenues which target this system. Copyright © 2016 Elsevier B.V. All rights reserved.

Autism and Schizophrenia in High Functioning Adults: Behavioral Differences and Overlap

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Spek, Annelies A.; Wouters, Saskia G. M.

2010-01-01

Several recent studies have demonstrated a genetical overlap between autism and schizophrenia. However, at a behavioral level it remains unclear which features can validly distinguish adults with autism from an adult schizophrenia group. To this end, the present study compared 21 individuals with the autistic disorder and 21 individuals with…

Life satisfaction and happiness among young adults with schizophrenia.

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

2016-08-30

People with schizophrenia often experience persistent symptoms and impairments in community functioning; however, despite this, many individuals with the illness report high levels of well-being. We explored the level of subjective well-being in a sample of relatively young outpatients with schizophrenia and matched healthy controls. Seventy-five outpatients with schizophrenia and 72 demographically matched healthy controls, aged 18-35 years, participated in the present study. Subjective well-being was defined as a combination of happiness and satisfaction with life, each of which were measured using validated instruments. Symptom severity, insight, and cognition were also evaluated. People with schizophrenia endorsed significantly lower levels of subjective well-being than healthy controls although, there was substantial overlap in scores, and many participants with schizophrenia endorsed a high level of well-being. Both depressive symptoms and motivational deficits demonstrated significant independent predictive value for determining level of well-being. At a group level, the mean level of happiness and life satisfaction was lower among people with schizophrenia than healthy comparison participants. However, despite this mean difference, there exists marked overlap in individual scores between those with and without schizophrenia, demonstrating that many young people with schizophrenia do, in fact, endorse high levels of subjective well-being. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Psychosocial Factors Contributing to Suicidal Ideation in Hospitalized Schizophrenia Patients in Korea

OpenAIRE

Kim, Sung-Wan; Kim, Su-Jung; Mun, Ji-Woong; Bae, Kyung-Yeol; Kim, Jae-Min; Kim, Seon-Young; Yang, Su-Jin; Shin, Il-Seon; Yoon, Jin-Sang

2010-01-01

Objective This study aimed to comprehensively evaluate psychosocial risk factors associated with suicidality in patients with schizophrenia in Korea. Methods The study sample consisted of 84 hospitalized patients with schizophrenia. Suicidal thoughts and a clear desire to be dead within 2 weeks were defined as a current suicidal ideation. Socio-demographic and clinical variables, including family history of completed suicides and psychiatric illnesses, were collected, and the Positive and Neg...

Effect of caregivers’ expressed emotion on the care burden and rehospitalization rate of schizophrenia

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Wang X

2017-09-01

Full Text Available Xia Wang,1 Qiongni Chen,2 Min Yang1 1Xiangya School of Nursing, 2Nursing Department, Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China Background: This study assessed the effect of expressed emotion (EE among caregivers of schizophrenia patients on their care burden and the illness rehospitalization rate. Subjects and methods: A total of 64 schizophrenia patients hospitalized for the first time and their key caregivers were recruited. The Chinese version of the Camberwell Family Interview (CFI-CV was used to evaluate the EE of the key caregivers. A family burden questionnaire was used to evaluate the care burden. The patients’ rehospitalization rate and medication compliance were evaluated by the self-designated criteria. The data collection was carried out at the first meeting in the hospital, at 6 months and 12 months after hospital discharge by using the same instruments. Results: The subjective stress burden and subjective demand burden scores were higher in caregivers before and after discharge with statistical difference between the various observation time points (P<0.05. Significant differences were observed in the rehospitalization rate between patients with high medication adherence and low medication adherence at 12 months (P<0.01 and between patients with high expressed emotion (HEE and low expressed emotion (LEE; P<0.05. The rehospitalization rate in patients with HEE caregivers was higher than that in those with LEE caregivers. The subjective stress burden scores were statistically significant between HEE and LEE caregivers (P<0.05.Conclusion: HEE is a predictor of rehospitalization rate in schizophrenic patients. The burdens of care scores are high in caregivers of schizophrenic patients. The caregivers with HEE have a high score in burden of care compared with those with LEE. Keywords: expressed emotion, care burden, schizophrenia, rehospitalization rate, caregivers

Co-aggregation of major psychiatric disorders in individuals with first-degree relatives with schizophrenia: a nationwide population-based study.

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Cheng, C-M; Chang, W-H; Chen, M-H; Tsai, C-F; Su, T-P; Li, C-T; Tsai, S-J; Hsu, J-W; Huang, K-L; Lin, W-C; Chen, T-J; Bai, Y-M

2017-11-07

A previous genetic study has suggested that schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) share common disease-associated genes. However, whether individuals with first-degree relatives (FDRs) with schizophrenia have a higher risk of these major psychiatric disorders requires further investigation. This study used Taiwan's National Health Insurance Research Database and identified 151 650 patients with schizophrenia and 227 967 individuals with FDRs with schizophrenia. The relative risks (RRs) of schizophrenia and other major psychiatric disorders were assessed in individuals with FDRs with schizophrenia. The individuals with FDRs with schizophrenia exhibited higher RRs (95% confidence interval) of major psychiatric disorders, namely schizophrenia (4.76, 4.65-4.88), bipolar disorder (3.23, 3.12-3.35), major depressive disorder (2.05, 2.00-2.10), ASD (2.55, 2.35-2.77) and ADHD (1.31, 1.25-1.37) than were found in the total population. Several sensitivity analyses were conducted to confirm these results. A dose-dependent relationship was observed between the risks of major psychiatric disorders and the numbers of FDRs with schizophrenia. The increased risks of major psychiatric disorders were consistent in different family relationships, namely among parents, offspring, siblings and twins. Our study supports the familial dose-dependent co-aggregation of schizophrenia, bipolar disorder, major depressive disorder, ASD and ADHD, and our results may prompt governmental public health departments and psychiatrists to focus on the mental health of individuals with FDRs with schizophrenia.Molecular Psychiatry advance online publication, 7 November 2017; doi:10.1038/mp.2017.217.

Beliefs about the cause of schizophrenia among caregivers in Midwestern Nigeria

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Osayi Igberase

2017-07-01

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

The Role of Inflammation in Schizophrenia

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Norbert eMüller

2015-10-01

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

Schizophrenia: A Systemic Disorder

Science.gov (United States)

Kirkpatrick, Brian; Miller, Brian; García-Rizo, Clemente; Fernandez-Egea, Emilio

2015-01-01

The concept of schizophrenia that is most widely taught is that it is a disorder in which psychotic symptoms are the main problem, and a dysregulation of dopamine signaling is the main feature of pathophysiology. However, this concept limits clinical assessment, the treatments offered to patients, research, and the development of therapeutics. A more appropriate conceptual model is that: 1) schizophrenia is not a psychotic disorder, but a disorder of essentially every brain function in which psychosis is present; 2) it is not a brain disease, but a disorder with impairments throughout the body; 3) for many patients, neuropsychiatric problems other than psychosis contribute more to impairment in function and quality of life than does psychosis; and, 4) some conditions that are considered to be comorbid are integral parts of the illness. In conclusion, students, patients, and family members should be taught this model, along with its implications for assessment, research, and therapeutics. PMID:23518782

Rethinking schizophrenia.

Science.gov (United States)

Insel, Thomas R

2010-11-11

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

Reliability of clinical ICD-10 schizophrenia diagnoses

DEFF Research Database (Denmark)

Jakobsen, Klaus D; Frederiksen, Julie N; Hansen, Thomas

2005-01-01

Concern has been expressed as to the reliability of clinical ICD-10 diagnosis of schizophrenia. This study was designed to assess the diagnostic reliability of the clinical ICD-10 diagnosis of schizophrenia in a random sample of Danish in- and outpatients with a history of psychosis. A sample...... value (87%) of ICD-10 schizophrenia and an overall good agreement between clinical and OPCRIT-derived diagnoses (kappa=0.60). An even higher positive predictive value was obtained when diagnoses were amalgamated into a diagnostic entity of schizophrenia-spectrum disorders (98%). Near perfect agreement...... was seen between OPCRIT-derived ICD-10 and DSM-IV diagnoses (kappa=0.87). Thus, this study demonstrates high reliability of the clinical diagnosis of schizophrenia and even more so of the diagnosis of schizophrenia-spectrum disorder....

Ontogenetic de novo copy number variations (CNVs as a source of genetic individuality: studies on two families with MZD twins for schizophrenia.

Directory of Open Access Journals (Sweden)

Sujit Maiti

2011-03-01

Full Text Available Genetic individuality is the foundation of personalized medicine, yet its determinants are currently poorly understood. One issue is the difference between monozygotic twins that are assumed identical and have been extensively used in genetic studies for decades. Here, we report genome-wide alterations in two nuclear families each with a pair of monozygotic twins discordant for schizophrenia evaluated by the Affymetrix 6.0 human SNP array. The data analysis includes characterization of copy number variations (CNVs and single nucleotide polymorphism (SNPs. The results have identified genomic differences between twin pairs and a set of new provisional schizophrenia genes. Samples were found to have between 35 and 65 CNVs per individual. The majority of CNVs (~80% represented gains. In addition, ~10% of the CNVs were de novo (not present in parents, of these, 30% arose during parental meiosis and 70% arose during developmental mitosis. We also observed SNPs in the twins that were absent from both parents. These constituted 0.12% of all SNPs seen in the twins. In 65% of cases these SNPs arose during meiosis compared to 35% during mitosis. The developmental mitotic origin of most CNVs that may lead to MZ twin discordance may also cause tissue differences within individuals during a single pregnancy and generate a high frequency of mosaics in the population. The results argue for enduring genome-wide changes during cellular transmission, often ignored in most genetic analyses.

Homer1a protein expression in schizophrenia, bipolar disorder, and major depression.

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Leber, Stefan L; Llenos, Ida C; Miller, Christine L; Dulay, Jeannette R; Haybaeck, Johannes; Weis, Serge

2017-10-01

In recent years, there was growing interest in postsynaptic density proteins in the central nervous system. Of the most important candidates of this specialized region are proteins belonging to the Homer protein family. This family of scaffolding proteins is suspected to participate in the pathogenesis of a variety of diseases. The present study aims to compare Homer1a expression in the hippocampus and cingulate gyrus of patients with major psychiatric disorders including schizophrenia, bipolar disorder and major depression. Immunohistochemistry was used to analyze changes of Homer1a protein expression in the hippocampal formation and the cingulate gyrus from the respective disease groups. Glial cells of the cingulate gyrus gray matter showed decreased Homer1a levels in bipolar disorder when compared to controls. The same results were seen when comparing cingulate gyrus gray matter glial cells in bipolar disorder with major depression. Stratum oriens glial cells of the hippocampus showed decreased Homer1a levels in bipolar disorder when compared to controls and major depression. Stratum lacunosum glial cells showed decreased Homer1a levels in bipolar disorder when compared to major depression. In stratum oriens interneurons Homer1a levels were increased in all disease groups when compared to controls. Stratum lucidum axons showed decreased Homer1a levels in bipolar disorder when compared to controls. Our data demonstrate altered Homer1a levels in specific brain regions and cell types of patients suffering from schizophrenia, bipolar disorder and major depression. These findings support the role of Homer proteins as interesting candidates in neuropsychiatric pathophysiology and treatment.

Consortium on the Genetics of Schizophrenia (COGS) assessment of endophenotypes for schizophrenia: an introduction to this Special Issue of Schizophrenia Research.

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Swerdlow, Neal R; Gur, Raquel E; Braff, David L

2015-04-01

The COGS is a multi-site NIMH-sponsored investigation of the genetic basis of 12 primary and multiple secondary quantitative endophenotypes in schizophrenia. Since 2003, COGS has completed studies using a family-based ascertainment strategy (COGS-1), and a case-control ascertainment strategy (COGS-2) (cumulative "n">4000). COGS-1 family study confirmed robust deficits in, and heritability of, these endophenotypes in schizophrenia, and provided evidence for a coherent genetic architecture underlying the risk for neurocognitive and neurophysiological deficits in this disorder. COGS-2 case-control findings, many reported herein, establish a foundation for fine genomic mapping and other analyses of these endophenotypes and risk genes for SZ. Several reports in this Special Issue compare findings of endophenotype deficits generated by fundamentally different COGS-1 vs. COGS-2 ascertainment strategies. Despite the expectation that family-based and case-control designs would establish demographically and potentially biologically distinct patient cohorts, findings generally revealed comparable patterns of endophenotype deficits across studies. The COGS-2 case-control design facilitated the accrual of a larger "n", permitting detailed analyses of factors moderating endophenotype performance. Some COGS-2 endophenotypes not assessed in COGS-1 are also reported, as is a new factor analytic strategy for identifying shared vs. unique factors among the COGS endophenotypes which can be used to develop composite variables with distinct genetic signatures. The path to date of COGS-1 endophenotype and genetic findings, followed by replication and extension in COGS-2, establishes benchmarks for endophenotype deficits in SZ and their moderation by specific factors, and clear expectations for informative findings from upcoming COGS-2 genetic analyses. Published by Elsevier B.V.

Minor physical anomalies and schizophrenia spectrum disorders: a prospective investigation

DEFF Research Database (Denmark)

Schiffman, Jason; Ekstrøm, Morten; LaBrie, Joseph

2002-01-01

at high risk. RESULTS: Individuals with a high number of minor physical anomalies developed schizophrenia spectrum disorders significantly more often than they developed a no mental illness outcome. Further, individuals with a high number of minor physical anomalies tended to develop schizophrenia......OBJECTIVE: The authors prospectively assessed the relationship between minor physical anomalies identified in childhood and adult psychiatric outcome. METHOD: In 1972, minor physical anomalies were measured in a group of 265 Danish children ages 11-13. The examination was part of a larger study...... investigating early signs of schizophrenia spectrum disorders. Many of the subjects had a parent with schizophrenia, leaving them at high risk for developing a schizophrenia spectrum disorder. In 1991, adult psychiatric outcome data were obtained for 91.3% (N=242) of the original subjects, including 81 who were...

Construction of Short-length High-rates Ldpc Codes Using Difference Families

OpenAIRE

Deny Hamdani; Ery Safrianti

2007-01-01

Low-density parity-check (LDPC) code is linear-block error-correcting code defined by sparse parity-check matrix. It isdecoded using the massage-passing algorithm, and in many cases, capable of outperforming turbo code. This paperpresents a class of low-density parity-check (LDPC) codes showing good performance with low encoding complexity.The code is constructed using difference families from combinatorial design. The resulting code, which is designed tohave short code length and high code r...

Use of the word schizophrenia in Portuguese newspapers.

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Rodrigues-Silva, Nuno; Falcão de Almeida, Telma; Araújo, Filipa; Molodynski, Andrew; Venâncio, Ângela; Bouça, Jorge

2017-10-01

Stigmatizing references to schizophrenia have a negative impact on self-esteem, deter treatment seeking and diminish the effectiveness of treatment. To analyze the reporting of schizophrenia in Portuguese newspapers. We analyzed five high circulation Portuguese newspapers between 2007 and 2013. We selected all news containing the word "esquizofrenia" (schizophrenia). Several variables were collected. About 1058 news items contained the word schizophrenia. Schizophrenia was mentioned metaphorically in 40% of the cases and in the context of Crime in 22%. When used in a Criminal context, schizophrenia was mostly attributed to people who were the perpetrators of the crime (93%). When used metaphorically, schizophrenia had a negative connotation in 90% of cases. We found an increasing reporting of schizophrenia in the criminal news and serious crimes. Our results suggest the media has an active role promoting stigma, as well as passively broadcasting and thus passing on prejudices.

Rethinking Schizophrenia

OpenAIRE

Insel, Thomas R.

2010-01-01

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

Schizophrenia.

Science.gov (United States)

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

2015-11-12

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

Quantitative analysis of low-density SNP data for parentage assignment and estimation of family contributions to pooled samples.

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Henshall, John M; Dierens, Leanne; Sellars, Melony J

2014-09-02

While much attention has focused on the development of high-density single nucleotide polymorphism (SNP) assays, the costs of developing and running low-density assays have fallen dramatically. This makes it feasible to develop and apply SNP assays for agricultural species beyond the major livestock species. Although low-cost low-density assays may not have the accuracy of the high-density assays widely used in human and livestock species, we show that when combined with statistical analysis approaches that use quantitative instead of discrete genotypes, their utility may be improved. The data used in this study are from a 63-SNP marker Sequenom® iPLEX Platinum panel for the Black Tiger shrimp, for which high-density SNP assays are not currently available. For quantitative genotypes that could be estimated, in 5% of cases the most likely genotype for an individual at a SNP had a probability of less than 0.99. Matrix formulations of maximum likelihood equations for parentage assignment were developed for the quantitative genotypes and also for discrete genotypes perturbed by an assumed error term. Assignment rates that were based on maximum likelihood with quantitative genotypes were similar to those based on maximum likelihood with perturbed genotypes but, for more than 50% of cases, the two methods resulted in individuals being assigned to different families. Treating genotypes as quantitative values allows the same analysis framework to be used for pooled samples of DNA from multiple individuals. Resulting correlations between allele frequency estimates from pooled DNA and individual samples were consistently greater than 0.90, and as high as 0.97 for some pools. Estimates of family contributions to the pools based on quantitative genotypes in pooled DNA had a correlation of 0.85 with estimates of contributions from DNA-derived pedigree. Even with low numbers of SNPs of variable quality, parentage testing and family assignment from pooled samples are

Remission and recovery in schizophrenia: practitioner and patient perspectives.

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

2008-01-01

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

Associations between renaming schizophrenia and stigma-related outcomes: A systematic review.

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Yamaguchi, Sosei; Mizuno, Masashi; Ojio, Yasutaka; Sawada, Utako; Matsunaga, Asami; Ando, Shuntaro; Koike, Shinsuke

2017-06-01

Renaming schizophrenia is a potential strategy to reduce the stigma attached to people with schizophrenia. However, the overall associations between renaming schizophrenia and stigma-related outcomes have not been fully elucidated. We conducted a systematic review of studies that empirically examined the outcomes between new or alternative terms and old or existing terms for schizophrenia. We searched for relevant articles in eight bibliographic databases, conducted a Google search, examined reference lists, and contacted relevant experts. We found a total of 2601 reference records, and 23 articles were included in this review. Overall, in countries where schizophrenia has been renamed, the name changes may be associated with improvements in adults' attitudes toward people with schizophrenia, and with increased diagnosis announcement. However, studies conducted in countries where schizophrenia has not been renamed report inconsistent findings. In addition, renaming may not influence portrayals of schizophrenia in the media. Most studies included in our review had a risk of bias in their methodology, and we employed a vote-counting method to synthesize study results; therefore, the impacts of renaming are still inconclusive. Future studies are needed to address the following issues: use of univariate descriptive statistics, adjustment for confounding variables, use of reliable measures, and employing a question that addresses the image of split or multiple personalities. Evidence is limited regarding the associations between renaming and stigma experienced by both people with schizophrenia and their families (e.g., perceived stigma, self-stigma, discrimination experience, and burden). Further research in these populations is needed to confirm the effects of renaming schizophrenia. © 2017 The Authors. Psychiatry and Clinical Neurosciences © 2017 Japanese Society of Psychiatry and Neurology.

Steeper discounting of delayed rewards in schizophrenia but not first-degree relatives.

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Yu, Linda Q; Lee, Sangil; Katchmar, Natalie; Satterthwaite, Theodore D; Kable, Joseph W; Wolf, Daniel H

2017-06-01

Excessive discounting of future rewards has been related to a variety of risky behaviors and adverse clinical conditions. Prior work examining delay discounting in schizophrenia suggests an elevated discount rate. However, it remains uncertain whether this reflects the disease process itself or an underlying genetic vulnerability, whether it is selective for delay discounting or reflects pervasive changes in decision-making, and whether it is driven by specific clinical dimensions such as cognitive impairment. Here we investigated delay discounting, as well as loss aversion and risk aversion, in three groups: schizophrenia (SZ), unaffected first-degree family members (FM), and controls without a family history of psychosis (NC). SZ had elevated discounting, without changes in loss aversion or risk aversion. Contrary to expectations, the FM group did not show an intermediate phenotype in discounting. Higher discount rates correlated with lower cognitive performance on verbal reasoning, but this did not explain elevated discount rates in SZ. Group differences were driven primarily by the non-smoking majority of the sample. This study provides further evidence for elevated discounting in schizophrenia, and demonstrates that steeper discounting is not necessarily associated with familial risk, cannot be wholly accounted for by cognitive deficits, and is not attributable to smoking-related impulsivity. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Effect of a psycho-educational intervention for family members on caregiver burdens and psychiatric symptoms in patients with schizophrenia in Shiraz, Iran

Science.gov (United States)

2012-01-01

Background This study explored the effectiveness of family psycho-education in reducing patients’ symptoms and on family caregiver burden. Methods Seventy Iranian outpatients with a diagnosis of schizophrenia disorder and their caregivers were randomly allocated to the experimental (n = 35) or control groups (n = 35). Patients in the experimental group received antipsychotic drug treatment and a psycho-educational program was arranged for their caregivers. The psycho-educational program consisted of ten 90-min sessions held during five weeks (two session in each week). Each caregiver attended 10 sessions (in five weeks) At baseline, immediately after intervention, and one month later. Validated tools were used to assess patients’ clinical status and caregiver burden. Results Compared with the control group, the case group showed significantly reduced symptom severity and caregiver burden both immediately after intervention and one month later. Conclusions These results suggest that even need based short-term psycho-educational intervention for family members of Iranian patients with schizophrenic disorder may improve the outcomes of patients and their families. Trial registration IRCT Number:138809122812 N1` PMID:22632135

Health promotion and schizophrenia: the year 2000 and beyond.

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O'Brien, S M

1998-01-01

The health promotion needs of persons with schizophrenia have not been emphasized as a result of historical stigma, the effort required to stabilize symptoms, the relapsing nature of the disease, and the helplessness felt by caregivers. Family members and individuals with schizophrenia experience shame, grief, guilt, fear, and isolation, all of which render them less able to be proactive. Health promotion strategies that change attitudes, build self-esteem, increase insight into the illness, modify behavior, provide sources of income and access to medical care, and support companionship are necessary while research efforts seek a cure for this historically misunderstood illness.

Impaired Social and Role Function in Ultra-High Risk for Psychosis and First-Episode Schizophrenia: Its Relations with Negative Symptoms.

Science.gov (United States)

Lee, So Jung; Kim, Kyung Ran; Lee, Su Young; An, Suk Kyoon

2017-09-01

Psychosocial dysfunction was a nettlesome problem of schizophrenia even in their prodromal phase as well as in their first-episode. In addition, its relations with psychopathology were not determined. The aim of the present study was to examine whether the social and role function impairment was found in ultra-high risk for psychosis (UHR) individuals as well as first-episode schizophrenia patients and to explore its relations with psychopathology. Thirty-seven normal controls, 63 UHR participants and 28 young, first-episode schizophrenia patients were recruited. Psychosocial functioning was examined by using Global function: Social and Role scale. Psychopathologies of positive, negative and depressive symptom were also measured. Social and role functioning in UHR were compromised at the equivalent level of those of first-episode schizophrenia patients. Multiple linear regression analysis revealed that social and role dysfunction was associated with negative symptoms in each UHR and first-episode schizophrenia group. These findings suggest that the significant impairment of social and role function may be appeared before the active psychosis onset at the level of extent to those of first-episode schizophrenia patients. The psychosocial intervention strategy especially targeting the negative symptoms should be developed and provided to individuals from their prepsychotic stage of schizophrenia.

Childhood residential mobility, schizophrenia, and bipolar disorder: a population-based study in Denmark.

Science.gov (United States)

Paksarian, Diana; Eaton, William W; Mortensen, Preben B; Pedersen, Carsten B

2015-03-01

Childhood adversity is gaining increasing attention as a plausible etiological factor in the development of psychotic disorders. Childhood residential mobility is a potential risk factor that has received little attention in this context. We used registry data to estimate associations of residential mobility with narrow and broad schizophrenia and bipolar disorder across the course of childhood among 1.1 million individuals born in Denmark 1971-1991 and followed from age 15 through 2010. We assessed effect modification by sex, family history of mental disorder, the presence of siblings close in age, and distance moved. In individual-year models adjusted for family history, urbanicity at birth, and parental age, mobility at all ages except the year of birth was associated with heightened risk of narrow and broad schizophrenia, and risk increased with age at moving and with the number of moves. Further adjustment for mobility at all ages 0-15 revealed associations mainly during the latter half of childhood, which were strongest during adolescence. Associations between mobility and bipolar disorder were fewer and weaker compared to schizophrenia. There was modest evidence of interaction with family history of psychiatric diagnosis, but little evidence for interaction by sex, the presence of closely-aged siblings, or distance moved. Schizophrenia associations did not appear attributable to increased mobility among adolescents with earlier onset. Mobility may increase risk for psychotic disorders, particularly schizophrenia. Children may be especially vulnerable during adolescence. Future research should investigate the importance of school changes and the potential for interaction with genetic risk. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

[Cognitive remediation and cognitive assistive technologies in schizophrenia].

Science.gov (United States)

Sablier, J; Stip, E; Franck, N

2009-04-01

Cognitive impairments are a core feature in schizophrenia. They impact several cognitive abilities but most importantly attention, memory and executive functions, consequently leading to great difficulties in everyday life. Most schizophrenia patients need assurance and require assistance and help from care workers, family members and friends. Family members taking care of a patient have additional daily work burden, and suffer psychological anguish and anxiety. Therefore, improving cognitive functions in schizophrenia patients is essential for the well-being of patients and their relatives. Reducing these deficits may decrease the economic burden to the health care system through lower numbers of hospital admissions and shorter hospitalisation periods, for example. Cognitive rehabilitation was developed to address the limited benefits of conventional treatments on cognitive deficits through the use of assistive technology as a means of enhancing memory and executive skills in schizophrenia patients. To provide clinicians with comprehensive knowledge on cognitive trainings, programs of remediation, and cognitive assistive technologies. Literature review. A search in the electronic databases (PubMed, EMBASE, Index Medicus) for recent articles in the last 10 years related to cognitive remediation published in any language using the words: cognitive and remediation or rehabilitation and schizophrenia, and a search for chapters in psychiatry and rehabilitation textbooks. We found 392 articles and 112 review paper mainly in English. First, we identified cognitive remediation programs that were beneficial to schizophrenia patients. Programs available in French (IPT, RECOS, and RehaCom) and others (CET, NET, CRT, NEAR, APT and CAT) were identified. In addition, since memory and executive function impairments could be present in people without schizophrenia, we reviewed inventories of cognitive assistive technologies proven to enhance cognitive skills in other populations

Inflammation and the Two-Hit Hypothesis of Schizophrenia

Science.gov (United States)

Feigenson, Keith A.; Kusnecov, Alex W.; Silverstein, Steven M.

2014-01-01

The high societal and individual cost of schizophrenia necessitates finding better, more effective treatment, diagnosis, and prevention strategies. One of the obstacles in this endeavor is the diverse set of etiologies that comprises schizophrenia. A substantial body of evidence has grown over the last few decades to suggest that schizophrenia is a heterogeneous syndrome with overlapping symptoms and etiologies. At the same time, an increasing number of clinical, epidemiological, and experimental studies have shown links between schizophrenia and inflammatory conditions. In this review, we analyze the literature on inflammation and schizophrenia, with a particular focus on comorbidity, biomarkers, and environmental insults. We then identify several mechanisms by which inflammation could influence the development of schizophrenia via the two-hit hypothesis. Lastly, we note the relevance of these findings to clinical applications in the diagnosis, prevention, and treatment of schizophrenia. PMID:24247023

Obstetric conditions and risk of first admission with schizophrenia: A Danish national register based study

DEFF Research Database (Denmark)

Byrne, Majella; Agerbo, Esben; Bennedsen, Birgit

2007-01-01

and 24, 826 individually matched controls. Adjusting for the other obstetric factors, family psychiatric history, and socio-economic and demographic factors, risk of schizophrenia was associated with maternal non-attendance at antenatal appointments (Incidence Rate Ratio (IRR) 2.08, 95% CI: 1.0, 4...... (IRR 2.15, 95% CI: 1.1, 4.4), and maternal sepsis of childbirth and the puerperium (IRR 2.91, 95% CI: 1.1, 7.9). There was no significant interaction between the obstetric factors and either sex or family psychiatric history. The data suggest a modest association between prematurity, indicators......-control study based on Danish longitudinal registers was conducted to investigate the risk of schizophrenia associated with exposure to a range of obstetric events. The sample included 1039 first admissions to, or contacts with Danish psychiatric services with an ICD-8 or ICD-10 diagnosis of schizophrenia...

Heritability of Neuropsychological Measures in Schizophrenia and Nonpsychiatric Populations: A Systematic Review and Meta-analysis.

Science.gov (United States)

Blokland, Gabriëlla A M; Mesholam-Gately, Raquelle I; Toulopoulou, Timothea; Del Re, Elisabetta C; Lam, Max; DeLisi, Lynn E; Donohoe, Gary; Walters, James T R; Seidman, Larry J; Petryshen, Tracey L

2017-07-01

Schizophrenia is characterized by neuropsychological deficits across many cognitive domains. Cognitive phenotypes with high heritability and genetic overlap with schizophrenia liability can help elucidate the mechanisms leading from genes to psychopathology. We performed a meta-analysis of 170 published twin and family heritability studies of >800 000 nonpsychiatric and schizophrenia subjects to accurately estimate heritability across many neuropsychological tests and cognitive domains. The proportion of total variance of each phenotype due to additive genetic effects (A), shared environment (C), and unshared environment and error (E), was calculated by averaging A, C, and E estimates across studies and weighting by sample size. Heritability ranged across phenotypes, likely due to differences in genetic and environmental effects, with the highest heritability for General Cognitive Ability (32%-67%), Verbal Ability (43%-72%), Visuospatial Ability (20%-80%), and Attention/Processing Speed (28%-74%), while the lowest heritability was observed for Executive Function (20%-40%). These results confirm that many cognitive phenotypes are under strong genetic influences. Heritability estimates were comparable in nonpsychiatric and schizophrenia samples, suggesting that environmental factors and illness-related moderators (eg, medication) do not substantially decrease heritability in schizophrenia samples, and that genetic studies in schizophrenia samples are informative for elucidating the genetic basis of cognitive deficits. Substantial genetic overlap between cognitive phenotypes and schizophrenia liability (average rg = -.58) in twin studies supports partially shared genetic etiology. It will be important to conduct comparative studies in well-powered samples to determine whether the same or different genes and genetic variants influence cognition in schizophrenia patients and the general population. © The Author 2016. Published by Oxford University Press on behalf of

Genetic analysis of long-lived families reveals novel variants influencing high density-lipoprotein cholesterol

DEFF Research Database (Denmark)

Feitosa, Mary F; Wojczynski, Mary K; Straka, Robert

2014-01-01

The plasma levels of high-density lipoprotein cholesterol (HDL) have an inverse relationship to the risks of atherosclerosis and cardiovascular disease (CVD), and have also been associated with longevity. We sought to identify novel loci for HDL that could potentially provide new insights...

Genome-wide association study of schizophrenia in Japanese population.

Directory of Open Access Journals (Sweden)

Kazuo Yamada

Full Text Available Schizophrenia is a devastating neuropsychiatric disorder with genetically complex traits. Genetic variants should explain a considerable portion of the risk for schizophrenia, and genome-wide association study (GWAS is a potentially powerful tool for identifying the risk variants that underlie the disease. Here, we report the results of a three-stage analysis of three independent cohorts consisting of a total of 2,535 samples from Japanese and Chinese populations for searching schizophrenia susceptibility genes using a GWAS approach. Firstly, we examined 115,770 single nucleotide polymorphisms (SNPs in 120 patient-parents trio samples from Japanese schizophrenia pedigrees. In stage II, we evaluated 1,632 SNPs (1,159 SNPs of p<0.01 and 473 SNPs of p<0.05 that located in previously reported linkage regions. The second sample consisted of 1,012 case-control samples of Japanese origin. The most significant p value was obtained for the SNP in the ELAVL2 [(embryonic lethal, abnormal vision, Drosophila-like 2] gene located on 9p21.3 (p = 0.00087. In stage III, we scrutinized the ELAVL2 gene by genotyping gene-centric tagSNPs in the third sample set of 293 family samples (1,163 individuals of Chinese descent and the SNP in the gene showed a nominal association with schizophrenia in Chinese population (p = 0.026. The current data in Asian population would be helpful for deciphering ethnic diversity of schizophrenia etiology.

Could cognitive vulnerability identify high-risk subjects for schizophrenia?

Science.gov (United States)

Sarfati, Yves; Hardy-Baylé, Marie-Christine

2002-12-08

This review puts into questions the possible role of cognitive vulnerability markers in prediction and prevention of schizophrenia. Until recently, none of the identified cognitive anomalies has been proved to be definitive. However, as new promising candidates are emerging (DS-CPT, CPT-IP, P suppression, Saccadic Eye Movements), the predictive value of these trait-type anomalies may be criticized regarding four issues, which are discussed: technical, metrological, theoretical, and clinical. As things stand, the existence of a cognitive vulnerability marker, which testify to a permanent pathological trait, does not constitute a sufficient factor to identify and treat subjects who are at risk for schizophrenia. Copyright 2002 Wiley-Liss, Inc.

Social worker involvement in identifying problems and needs of families with mentally ill members

Directory of Open Access Journals (Sweden)

Kovalčíková N.

2016-01-01

Full Text Available The aim of the current study was to explore the impact of schizophrenia on the life of the patient and his family, in particular, which problems people with schizophrenia and their families face. We applied a qualitative research strategy and method of semi-structured interview. Qualitative analysis of the data demonstrated barriers in the working and financial areas of life of people with schizophrenia. In addition, schizophrenia negatively affects social interactions of patients which lead to their social isolation which is also derived from barriers at work. Families with this kind of patient suffer mainly in the economic sphere of life with the necessity to leave the job and take care of an ill member. These families also suffer from isolation, restriction of social contacts, reduction of free-time activities, and many other problems included within the barriers in social interactions. Family members suffer psychological stress and they badly cope with the situation if the ill member is hospitalized. In addition, the family meets with the structural discrimination in the form of lack of information about the disease, lack of day care centres network and similar barriers in communication with physicians and the other professionals.

Recent developments in the genetics of schizophrenia.

Science.gov (United States)

Shastry, B S

1999-09-01

Schizophrenia, which is also called "split personality," is a complex and multifactorial mental disorder with variable clinical manifestations. It perhaps represents several diseases and occurs throughout the world. It is a more-prevalent disorder among homeless people and is clinically characterized by hallucinations and delusions. The pathophysiology of schizophrenia is not localized to a single region of the brain and the etiology of this illness is not understood. Because of its complex pattern of inheritance, genetic techniques are not readily applicable in identifying the genes responsible for this disorder. Family, twin, and adoption studies, however, provide strong but indirect support for genetic components in the etiology of schizophrenia. Extensive linkage analyses now suggest that susceptibility genes may be present on chromosomes 5q, 6p, 8p, 13q, 18p, and 22q. Identification and characterization of these and other genes, as well as non-genetic factors, is one of the greatest challenges in biomedicine. This may ultimately lead to the development of a new line of effective and safe drugs or treatments for its prevention or cure.

Reducing the Schizophrenia Stigma: A New Approach Based on Augmented Reality

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Silva, Rafael D. de C.; Albuquerque, Saulo G. C.; Muniz, Artur de V.; Filho, Pedro P. Rebouças; Ribeiro, Sidarta

2017-01-01

Schizophrenia is a chronic mental disease that usually manifests psychotic symptoms and affects an individual's functionality. The stigma related to this disease is a serious obstacle for an adequate approach to its treatment. Stigma can, for example, delay the start of treatment, and it creates difficulties in interpersonal and professional relationships. This work proposes a new tool based on augmented reality to reduce the stigma related to schizophrenia. The tool is capable of simulating the psychotic symptoms typical of schizophrenia and simulates sense perception changes in order to create an immersive experience capable of generating pathological experiences of a patient with schizophrenia. The integration into the proposed environment occurs through immersion glasses and an embedded camera. Audio and visual effects can also be applied in real time. To validate the proposed environment, medical students experienced the virtual environment and then answered three questionnaires to assess (i) stigmas related to schizophrenia, (ii) the efficiency and effectiveness of the tool, and, finally (iii) stigma after simulation. The analysis of the questionnaires showed that the proposed model is a robust tool and quite realistic and, thus, very promising in reducing stigma associated with schizophrenia by instilling in the observer a greater comprehension of any person during an schizophrenic outbreak, whether a patient or a family member. PMID:29317860

Self-management in Chinese people with schizophrenia and their caregivers: a qualitative study on facilitators and barriers.

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Zou, Haiou; Li, Zheng; Arthur, David; Wang, Hongxing

2014-08-01

The purpose of this study was to explore facilitators and barriers of self-management from the viewpoint of Chinese people with schizophrenia and their caregivers. A qualitative study using the individual interview method was used. Twenty-one people with schizophrenia and 14 caregivers were interviewed. Three facilitators were identified: family and peer support, positive relationships with health professionals, and positive attitudes towards self-management. Four barriers were identified: lack of knowledge and skills, financial constraint, social stigma, and uncoordinated mental health services. The findings from this study should help nurses to recognize the factors that influence self-management and provide direction for nurses and other health professionals involved in initiating and implementing family-based self-management programmes for people with schizophrenia. The findings also call for the development of antistigma programmes, which are needed to help reduce prejudice and discrimination towards individuals with schizophrenia in China. The study also provides information for health policy makers in China to help them make potential changes in mental health services, which can better meet the needs of Chinese people with schizophrenia. © 2013 Australian College of Mental Health Nurses Inc.

Caring Over the Lifespan: Experiences of Caring for a Sibling with Schizophrenia

OpenAIRE

Stillwell, Katherine

2016-01-01

Siblings can be seen as a huge resource in caring for adults with a diagnosis of schizophrenia: Many expect to take over the caring role of caring when their parents no longer can, and positive sibling relationships are related to better outcomes for adults with a diagnosis of schizophrenia (Smith, Greenberg and Seltzer, 2007). Despite these facts research into family carers has tended to neglect exploring sibling relationships until recently. Previous research has focused on the negative asp...

Advanced paternal age is a risk factor for schizophrenia in Iranians

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Mokri Bahareh

2011-04-01

Full Text Available Abstract Background Since 1958 many, but not all studies have demonstrated that paternal age is a risk factor for schizophrenia. There may be many different explanations for differences between studies, including study design, sample size, collection criteria, heterogeneity and the confounding effects of environmental factors that can for example perturb epigenetic programming and lead to an increase in disease risk. The small number of children in Western families makes risk comparisons between siblings born at different paternal ages difficult. In contrast, more Eastern families have children both at early and later periods of life. In the present study, a cross-sectional population study in an Iranian population was performed to compare frequency of schizophrenia in younger offspring (that is, older paternal age versus older offspring. Methods A total of 220 patients with the diagnosis of schizophrenia (cases from both psychiatric hospitals and private clinics and 220 individuals from other hospital wards (controls, matched for sex and age were recruited for this study. Patients with neurological problem, substance abuse, mental retardation and mood disorder were excluded from both groups. Results Birth rank comparisons revealed that 35% vs 24% of the cases vs the controls were in the third or upper birth rank (P = 0.01. Also, the mean age of fathers at birth in case group (30 ± 6.26 years was significantly more than the control group (26.45 ± 5.64 years; P = 0.0001. The age of 76 fathers at birth in case group was over 32 versus 33 fathers in control group. Individuals whose fathers' age was more than 32 (at birth were at higher risk (2.77 times for schizophrenia versus others (P P = 0.02. Logistic regression analysis suggests that maternal age is less likely to be involved in the higher risk of schizophrenia than advanced parental age. Discussion This study demonstrates a relationship between paternal age and schizophrenia in large

The relationship of antisocial personality disorder and history of conduct disorder with crime incidence in schizophrenia

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Safa Maghsoodloo

2012-01-01

Full Text Available Background: Commission of crime and hostility and their forensic consequences in a patient with schizophrenia can worsen the patient′s condition and disturb his family, society, and even the psychiatrist. Based on previous research, patients with schizophrenia are at a higher risk for crime. It is not clear whether this is due to the nature of schizophrenia, comorbidity of antisocial personality disorder, or the history of conduct disorder in childhood. In this study, we investigated this hypothesis. Materials and Methods: In this case-control study, 30 criminal and 30 non-criminal patients with schizophrenia, who had been referred by the court to the Forensic Medicine Center of Isfahan, were evaluated for antisocial personality disorder, history of conduct disorder, and psychopathy checklist-revise (PCL-R score. Results: Frequency distribution of antisocial personality disorder (73.3%, history of conduct disorder in childhood (86.7%, and score of PCL-R ≥25 (indicating high probability of hostility in patients (40% were significantly higher in criminal patients than in non-criminals (10%, 30% and 0%, respectively; P < 0.001. Conclusions: More prevalence of antisocial personality disorder, history of conduct disorder, and high score of PCL-R (≥25 in criminal schizophrenic patients may indicate that in order to control the hostility and for prevention of crime, besides treating acute symptoms of psychosis, patients might receive treatment and rehabilitation for comorbidities too.

A survey of an organization for families of patients with serious mental illness in The Netherlands

NARCIS (Netherlands)

Schene, A. H.; van Wijngaarden, B.

1995-01-01

Members of Ypsilon, a Dutch family organization for relatives of patients with schizophrenia or chronic psychosis, were surveyed to determine whether patients whose families were involved in the organization were representative of all patients with schizophrenia in the Netherlands and whether

Siblings' coping strategies and mental health services: a national study of siblings of persons with schizophrenia.

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Friedrich, Rose Marie; Lively, Sonja; Rubenstein, Linda M

2008-03-01

This study examined the helpfulness of coping strategies and the relative importance of mental health services in coping with schizophrenia from the perspective of siblings. This article presents selected survey data from a national study of 746 respondents that investigated the impact of schizophrenia on siblings' lives. The authors developed the Friedrich-Lively Instrument to Assess the Impact of Schizophrenia on Siblings (FLIISS), a closed-ended questionnaire that included questions about coping strategies and mental health services. Respondents identified services for the ill sibling, including symptom control, adequate housing, and long-term planning, as more important than direct services for themselves. The top-ranked coping strategies were education about schizophrenia, a supportive family, and seeing the ill sibling suffer less because symptoms were controlled. Understanding that families were not to blame for schizophrenia was the most helpful coping strategy for nearly three-fourths of siblings. Siblings had little contact with providers in the past; yet the majority of siblings wanted providers to be available to answer questions and clarify their role in future care. At the time of the study, respondents provided social support and helped with crises, but few coordinated the total care. Siblings identified multiple ways that providers can support and assist them in coping with the impact of schizophrenia. Education and support for siblings without schizophrenia and services for their ill siblings will become increasingly important for the well-being of siblings as they are faced with the responsibility of being the primary caregivers in the future.

[Epigenetics of schizophrenia: a review].

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Rivollier, F; Lotersztajn, L; Chaumette, B; Krebs, M-O; Kebir, O

2014-10-01

Schizophrenia is a frequent and disabling disease associated with heterogeneous psychiatric phenotypes. It emerges during childhood, adolescence or young adulthood and has dramatic consequences for the affected individuals, causing considerable familial and social burden, as well as increasing health expenses. Although some progress has been made in the understanding of their physiopathology, many questions remain unsolved, and the disease is still poorly understood. The prevailing hypothesis regarding psychotic disorders proposes that a combination of genetic and/or environmental factors, during critical periods of brain development increases the risk for these illnesses. Epigenetic regulations, such as DNA methylation, can mediate gene x environment interactions at the level of the genome and may provide a potential substrate to explain the variability in symptom severity and family heritability. Initially, epigenetics was used to design mitotic and meiotic changes in gene transcription that could not be attributed to genetic mutations. It referred later to changes in the epigenome not transmitted through the germline. Thus, epigenetics refers to a wide range of molecular mechanisms including DNA methylation of cytosine residues in CpG dinucleotides and post-translational histone modifications. These mechanisms alter the way the transcriptional factors bind the DNA, modulating its expression. Prenatal and postnatal environmental factors may affect these epigenetics factors, having responsability in long-term DNA transcription, and influencing the development of psychiatric disorders. The object of this review is to present the state of knowledge in epigenetics of schizophrenia, outlining the most recent findings in the matter. We did so using Pubmed, researching words such as 'epigenetics', 'epigenetic', 'schizophrenia', 'psychosis', 'psychiatric'. This review summarizes evidences mostly for two epigenetic mechanisms: DNA methylation and post

Factor structure and heritability of endophenotypes in schizophrenia: findings from the Consortium on the Genetics of Schizophrenia (COGS-1).

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Seidman, Larry J; Hellemann, Gerhard; Nuechterlein, Keith H; Greenwood, Tiffany A; Braff, David L; Cadenhead, Kristin S; Calkins, Monica E; Freedman, Robert; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Light, Gregory A; Olincy, Ann; Radant, Allen D; Siever, Larry J; Silverman, Jeremy M; Sprock, Joyce; Stone, William S; Sugar, Catherine; Swerdlow, Neal R; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Green, Michael F

2015-04-01

Although many endophenotypes for schizophrenia have been studied individually, few studies have examined the extent to which common neurocognitive and neurophysiological measures reflect shared versus unique endophenotypic factors. It may be possible to distill individual endophenotypes into composite measures that reflect dissociable, genetically informative elements. The first phase of the Consortium on the Genetics of Schizophrenia (COGS-1) is a multisite family study that collected neurocognitive and neurophysiological data between 2003 and 2008. For these analyses, participants included schizophrenia probands (n=83), their nonpsychotic siblings (n=151), and community comparison subjects (n=209) with complete data on a battery of 12 neurocognitive tests (assessing domains of working memory, declarative memory, vigilance, spatial ability, abstract reasoning, facial emotion processing, and motor speed) and 3 neurophysiological tasks reflecting inhibitory processing (P50 gating, prepulse inhibition and antisaccade tasks). Factor analyses were conducted on the measures for each subject group and across the entire sample. Heritability analyses of factors were performed using SOLAR. Analyses yielded 5 distinct factors: 1) Episodic Memory, 2) Working Memory, 3) Perceptual Vigilance, 4) Visual Abstraction, and 5) Inhibitory Processing. Neurophysiological measures had low associations with these factors. The factor structure of endophenotypes was largely comparable across probands, siblings and controls. Significant heritability estimates for the factors ranged from 22% (Episodic Memory) to 39% (Visual Abstraction). Neurocognitive measures reflect a meaningful amount of shared variance whereas the neurophysiological measures reflect largely unique contributions as endophenotypes for schizophrenia. Composite endophenotype measures may inform our neurobiological and genetic understanding of schizophrenia. Copyright © 2015 Elsevier B.V. All rights reserved.

Clustering by neurocognition for fine-mapping of the schizophrenia susceptibility loci on chromosome 6p

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Lin, Sheng-Hsiang; Liu, Chih-Min; Liu, Yu-Li; Fann, Cathy Shen-Jang; Hsiao, Po-Chang; Wu, Jer-Yuarn; Hung, Shuen-Iu; Chen, Chun-Houh; Wu, Han-Ming; Jou, Yuh-Shan; Liu, Shi K.; Hwang, Tzung J.; Hsieh, Ming H.; Chang, Chien-Ching; Yang, Wei-Chih; Lin, Jin-Jia; Chou, Frank Huang-Chih; Faraone, Stephen V.; Tsuang, Ming T.; Hwu, Hai-Gwo; Chen, Wei J.

2009-01-01

Chromosome 6p is one of the most commonly implicated regions in the genome-wide linkage scans of schizophrenia, whereas further association studies for markers in this region were inconsistent likely due to heterogeneity. This study aimed to identify more homogeneous subgroups of families for fine mapping on regions around markers D6S296 and D6S309 (both in 6p24.3) as well as D6S274 (in 6p22.3) by means of similarity in neurocognitive functioning. A total of 160 families of patients with schizophrenia comprising at least two affected siblings who had data for 8 neurocognitive test variables of the Continuous Performance Test (CPT) and the Wisconsin Card Sorting Test (WCST) were subjected to cluster analysis with data visualization using the test scores of both affected siblings. Family clusters derived were then used separately in family-based association tests for 64 single nucleotide polymorphisms covering the region of 6p24.3 and 6p22.3. Three clusters were derived from the family-based clustering, with deficit cluster 1 representing deficit on the CPT, deficit cluster 2 representing deficit on both the CPT and the WCST, and a third cluster of non-deficit. After adjustment using false discovery rate for multiple testing, SNP rs13873 and haplotype rs1225934-rs13873 on BMP6-TXNDC5 genes were significantly associated with schizophrenia for the deficit cluster 1 but not for the deficit cluster 2 or non-deficit cluster. Our results provide further evidence that the BMP6-TXNDC5 locus on 6p24.3 may play a role in the selective impairments on sustained attention of schizophrenia. PMID:19694819

Deficient prepulse inhibition in schizophrenia detected by the multi-site COGS.

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Swerdlow, Neal R; Light, Gregory A; Sprock, Joyce; Calkins, Monica E; Green, Michael F; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Lazzeroni, Laura C; Nuechterlein, Keith H; Radant, Allen D; Ray, Amrita; Seidman, Larry J; Siever, Larry J; Silverman, Jeremy M; Stone, William S; Sugar, Catherine A; Tsuang, Debby W; Tsuang, Ming T; Turetsky, Bruce I; Braff, David L

2014-02-01

Startle inhibition by weak prepulses (PPI) is studied to understand the biology of information processing in schizophrenia patients and healthy comparison subjects (HCS). The Consortium on the Genetics of Schizophrenia (COGS) identified associations between PPI and single nucleotide polymorphisms in schizophrenia probands and unaffected relatives, and linkage analyses extended evidence for the genetics of PPI deficits in schizophrenia in the COGS-1 family study. These findings are being extended in a 5-site "COGS-2" study of 1800 patients and 1200 unrelated HCS to facilitate genetic analyses. We describe a planned interim analysis of COGS-2 PPI data. Eyeblink startle was measured in carefully screened HCS and schizophrenia patients (n=1402). Planned analyses of PPI (60 ms intervals) assessed effects of diagnosis, sex and test site, PPI-modifying effects of medications and smoking, and relationships between PPI and neurocognitive measures. 884 subjects met strict inclusion criteria. ANOVA of PPI revealed significant effects of diagnosis (p=0.0005) and sex (pschizophrenia PPI differences were greatest among patients not taking 2nd generation antipsychotics, and were independent of smoking status. Modest but significant relationships were detected between PPI and performance in specific neurocognitive measures. The COGS-2 multi-site study detects schizophrenia-related PPI deficits reported in single-site studies, including patterns related to diagnosis, prepulse interval, sex, medication and other neurocognitive measures. Site differences were detected and explored. The target COGS-2 schizophrenia "endophenotype" of reduced PPI should prove valuable for identifying and confirming schizophrenia risk genes in future analyses. Copyright © 2013 Elsevier B.V. All rights reserved.

Parents' Criticisms and Attributions about Their Adult Children with High Functioning Autism or Schizophrenia

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Wasserman, Stephanie; Weisman de Mamani, Amy; Mundy, Peter

2010-01-01

The current study examined the criticism component of expressed emotion (EE) and attributions in parents of adults diagnosed with schizophrenia/schizoaffective disorder (S/SA) or high functioning autism/Asperger's. Consistent with study hypotheses, parents of adults diagnosed with autism/Asperger's disorder exhibited lower levels of high…

An Update on the Epidemiology of Schizophrenia with a Special Reference to Clinically Important Risk Factors

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El-Missiry, Ahmed; Aboraya, Ahmed Sayed; Manseur, Hader; Manchester, Johnna; France, Cheryl; Border, Katherine

2011-01-01

Schizophrenia is a chronic mental illness which poses a tremendous burden on the families, caregivers and the society. The purpose of this paper is to provide an updated review of the epidemiology of schizophrenia with a special attention to the clinically important risk factors such as drug abuse, hormonal factors and the new advances in genetic…

Attitudes and burden in relatives of patients with schizophrenia in a middle income country

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Richards-Araya David

2011-09-01

Full Text Available Abstract Background Most studies of family attitudes and burden have been conducted in developed countries. Thus it is important to test the generalizability of this research in other contexts where social conditions and extended family involvement may be different. The aim of this study was to assess the relationship between the attitudes of caregivers and the burden they experience in such a context, namely Arica, a town located in the northernmost region of Chile, close to the border with Peru and Bolivia. Methods We assessed attitudes towards schizophrenia (including affective, cognitive and behavioural components and burden (including subjective distress, rejection and competence in 41 main caregivers of patients with schizophrenia, all of whom were users of Public Mental Health Services in Arica. Results Attitude measures differed significantly according to socio-demographic variables, with parents (mainly mothers exhibiting a more negative attitude towards the environment than the rest of the family (t = 4.04; p = 0.000.This was also the case for caregivers with a low educational level (t = 3.27; p 2 = .104, F = 4,55; p = .039. Conclusions Similar to finding developed countries, the current study revealed a positive and significant relationship between the attitudes of caregivers and their burden. These findings emphasize the need to support the families of patients with schizophrenia in this social context.

[The perceived burden of care and its correlates in schizophrenia].

Science.gov (United States)

Gülseren, Leyla; Cam, Birmay; Karakoç, Berna; Yiğit, Tamer; Danacı, Ayşen Esen; Cubukçuoğlu, Zeynep; Taş, Cumhur; Gülseren, Seref; Mete, Levent

2010-01-01

The present study aimed to investigate the perceived level of burden of care and its correlates in family members of schizophrenia patients. The study included 239 schizophrenic patients that were followed-up at the psychiatric outpatient clinics of Izmir Ataturk Education and Research Hospital, and Celal Bayar University Medical School, and 239 of their primary caregivers. Patients were assessed using the Positive and Negative Syndrome Scale (PANNS), Global Assessment of Functioning Scale (GAF), Social Functioning Scale (SFS), Brief Cognitive State Examination (BCE), and UKU Side Effect Rating Scale. Their primary caregivers were assessed using the Perceived Family Burden Scale (PFBS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Caregiver PFBS scores ere correlated with male patients, female caregivers, inadequate social support, economic difficulty, the presence of chronic physical disorder in the caregivers, patient violence toward the caregivers, total duration of illness, the number of patient hospitalizations, PANNS total and subscale scores, and SFS, BDI, and BAI scores. Perceived burden of care was predicted by the severity of the patients' positive symptoms, SFS independence/competence and interpersonal functioning subscale scores, and caregivers' anxiety and depression levels. In order to decrease the burden of care in schizophrenia we recommend effective management of patient symptoms, enhancement of patient social functioning, interventions that target caregivers with high levels anxiety and depression, and social support provided by healthcare professionals.

Minor physical anomalies and schizophrenia spectrum disorders: a prospective investigation

DEFF Research Database (Denmark)

Schiffman, Jason; Ekstrøm, Morten; LaBrie, Joseph

2002-01-01

at high risk. RESULTS: Individuals with a high number of minor physical anomalies developed schizophrenia spectrum disorders significantly more often than they developed a no mental illness outcome. Further, individuals with a high number of minor physical anomalies tended to develop schizophrenia......OBJECTIVE: The authors prospectively assessed the relationship between minor physical anomalies identified in childhood and adult psychiatric outcome. METHOD: In 1972, minor physical anomalies were measured in a group of 265 Danish children ages 11-13. The examination was part of a larger study...... spectrum disorders more often than other psychopathology. Among individuals at genetic high risk, higher numbers of minor physical anomalies may interact with pre-existing vulnerabilities for schizophrenia to increase the likelihood of a schizophrenia spectrum disorder outcome. CONCLUSIONS: Minor physical...

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

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I-Ming Chen

2015-06-01

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

A comprehensive family-based replication study of schizophrenia genes

DEFF Research Database (Denmark)

Aberg, Karolina A; Liu, Youfang; Bukszár, Jozsef

2013-01-01

 768 control subjects from 6 databases and, after quality control 6298 individuals (including 3286 cases) from 1811 nuclear families. MAIN OUTCOMES AND MEASURES Case-control status for SCZ. RESULTS Replication results showed a highly significant enrichment of SNPs with small P values. Of the SNPs...... in an independent family-based replication study that, after quality control, consisted of 8107 SNPs. SETTING Linkage meta-analysis, brain transcriptome meta-analysis, candidate gene database, OMIM, relevant mouse studies, and expression quantitative trait locus databases. PATIENTS We included 11 185 cases and 10...

Glucoregulation in normal weight schizophrenia patients treated by first generation antipsychotics

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Marić Nađa

2008-01-01

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

Patient compliance with drug therapy in schizophrenia. Economic and clinical issues.

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Lindström, E; Bingefors, K

2000-08-01

The effectiveness of drug treatment in clinical practice is considerably lower than the efficacy shown in controlled studies. The lower effectiveness in practice presumably leads to lower cost effectiveness of drug treatment in real-life situations compared with that demonstrated by studies based on results from controlled trials. Improved cost effectiveness in routine clinical practice would be a significant advantage in the treatment of schizophrenia, one of the most costly diseases in society. The aetiology of schizophrenia is unknown, and there is no cure. The main aims of therapy with antipsychotic medication include the effective relief of symptoms without the introduction of adverse effects or serious adverse events, improved quality of life, cost effectiveness and a positive long term outcome. The older classical antipsychotic drugs do not always meet these requirements because of their well-known limitations, such as a lack of response in a subgroup of individuals with schizophrenia and intolerable adverse effects. There has long been a need for new antipsychotics that can ameliorate more symptoms and have no or few adverse effects. Some of the recently introduced antipsychotics have been shown to be more effective in certain clinical situations and to have a more favourable adverse effect profile than the classical antipsychotics. A major factor contributing to the lower effectiveness of drug treatment is noncompliance, which may be very high in schizophrenia. There are several factors influencing compliance, including drug type and formulation, patient, disease status, physician, health care system, community care and family. There have been very few studies of compliance improvement strategies in schizophrenia or, indeed, in medicine in general. Current methods are relatively complex and there are differing opinions on their effectiveness. There are several ways to increase compliance in schizophrenia--the evidence is strongest for psychoeducative

Do hypertension and diuretic treatment in pregnancy increase the risk of schizophrenia in offspring?

DEFF Research Database (Denmark)

Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

2003-01-01

treatment during pregnancy. RESULTS: In a risk set of 7,866 individuals, 84 cases of schizophrenia were found (1.1% prevalence). Logistic multiple regression analysis identified the following independent risk factors: maternal hypertension (odds ratio=1.69 [95% CI=1.02-2.80]), diuretic treatment...... neurodevelopment and increase the risk of schizophrenia in offspring. METHOD: Using data from the Copenhagen Perinatal Cohort of individuals born between 1959 and 1961, the authors studied the relationship of maternal hypertension and diuretic treatment during pregnancy with the risk of schizophrenia (ICD-8 code...... 295) in the offspring. Prenatal medical information was linked to the Danish National Psychiatric Register. The effects of maternal hypertension and diuretic treatment were adjusted for the maternal history of schizophrenia, social status of the family breadwinner, mother's age, and concomitant drug...

Mutated Genes in Schizophrenia Map to Brain Networks

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... Matters NIH Research Matters August 12, 2013 Mutated Genes in Schizophrenia Map to Brain Networks Schizophrenia networks ... have a high number of spontaneous mutations in genes that form a network in the front region ...

Smoking in Schizophrenia: an Updated Review.

Science.gov (United States)

Šagud, Marina; Vuksan-Ćusa, Bjanka; Jakšić, Nenad; Mihaljević-Peleš, Alma; Rojnić Kuzman, Martina; Pivac, Nela

2018-06-01

Patients with schizophrenia continue to have the highest rate of both smoking and heavy nicotine dependence. The interaction between smoking and schizophrenia is complex. There is evidence of the shared genetic background. Recent preclinical and clinical research has further investigated self-medication hypothesis, given that nicotine might alleviate cortical dysfunction. While prior research indicated some favorable effects of smoking on cognitive performance, particulatly on attention/vigilance, recent studies did not confirm those findings. Lower severity of negative symptoms in smokers was not confirmed across studies. Cigarette smoking decreases clozapine and olanzapine concentrations. There is no consistent evidence of favorable effects of nicotine on symptoms in schizophrenia, but the evidence of detrimental effects of smoking on general health is highly consistent. Smoking cessation should be a priority in patients with schizophrenia.

Is There an Association between Advanced Paternal Age and Endophenotype Deficit Levels in Schizophrenia?

Science.gov (United States)

Tsuang, Debby; Esterberg, Michelle; Braff, David; Calkins, Monica; Cadenhead, Kristin; Dobie, Dorcas; Freedman, Robert; Green, Michael F.; Greenwood, Tiffany; Gur, Raquel; Gur, Ruben; Horan, William; Lazzeroni, Laura C.; Light, Gregory A.; Millard, Steven P.; Olincy, Ann; Nuechterlein, Keith; Seidman, Larry; Siever, Larry; Silverman, Jeremy; Stone, William; Sprock, Joyce; Sugar, Catherine; Swerdlow, Neal; Tsuang, Ming; Turetsky, Bruce; Radant, Allen

2014-01-01

The children of older fathers have increased risks of developing schizophrenia spectrum disorders, and among those who develop these disorders, those with older fathers present with more severe clinical symptoms. However, the influence of advanced paternal age on other important domains related to schizophrenia, such as quantitative endophenotype deficit levels, remains unknown. This study investigated the associations between paternal age and level of endophenotypic impairment in a well-characterized family-based sample from the Consortium on the Genetics of Schizophrenia (COGS). All families included at least one affected subject and one unaffected sibling. Subjects met criteria for schizophrenia (probands; n = 293) or were unaffected first-degree siblings of those probands (n = 382). Paternal age at the time of subjects’ birth was documented. Subjects completed a comprehensive clinical assessment and a battery of tests that measured 16 endophenotypes. After controlling for covariates, potential paternal age–endophenotype associations were analyzed using one model that included probands alone and a second model that included both probands and unaffected siblings. Endophenotype deficits in the Identical Pairs version of the 4-digit Continuous Performance Test and in the Penn Computerized Neurocognitive Battery verbal memory test showed significant associations with paternal age. However, after correcting for multiple comparisons, no endophenotype was significantly associated with paternal age. These findings suggest that factors other than advanced paternal age at birth may account for endophenotypic deficit levels in schizophrenia. PMID:24523888

Is there an association between advanced paternal age and endophenotype deficit levels in schizophrenia?

Science.gov (United States)

Tsuang, Debby; Esterberg, Michelle; Braff, David; Calkins, Monica; Cadenhead, Kristin; Dobie, Dorcas; Freedman, Robert; Green, Michael F; Greenwood, Tiffany; Gur, Raquel; Gur, Ruben; Horan, William; Lazzeroni, Laura C; Light, Gregory A; Millard, Steven P; Olincy, Ann; Nuechterlein, Keith; Seidman, Larry; Siever, Larry; Silverman, Jeremy; Stone, William; Sprock, Joyce; Sugar, Catherine; Swerdlow, Neal; Tsuang, Ming; Turetsky, Bruce; Radant, Allen

2014-01-01

The children of older fathers have increased risks of developing schizophrenia spectrum disorders, and among those who develop these disorders, those with older fathers present with more severe clinical symptoms. However, the influence of advanced paternal age on other important domains related to schizophrenia, such as quantitative endophenotype deficit levels, remains unknown. This study investigated the associations between paternal age and level of endophenotypic impairment in a well-characterized family-based sample from the Consortium on the Genetics of Schizophrenia (COGS). All families included at least one affected subject and one unaffected sibling. Subjects met criteria for schizophrenia (probands; n = 293) or were unaffected first-degree siblings of those probands (n = 382). Paternal age at the time of subjects' birth was documented. Subjects completed a comprehensive clinical assessment and a battery of tests that measured 16 endophenotypes. After controlling for covariates, potential paternal age-endophenotype associations were analyzed using one model that included probands alone and a second model that included both probands and unaffected siblings. Endophenotype deficits in the Identical Pairs version of the 4-digit Continuous Performance Test and in the Penn Computerized Neurocognitive Battery verbal memory test showed significant associations with paternal age. However, after correcting for multiple comparisons, no endophenotype was significantly associated with paternal age. These findings suggest that factors other than advanced paternal age at birth may account for endophenotypic deficit levels in schizophrenia.

Is there an association between advanced paternal age and endophenotype deficit levels in schizophrenia?

Directory of Open Access Journals (Sweden)

Debby Tsuang

Full Text Available The children of older fathers have increased risks of developing schizophrenia spectrum disorders, and among those who develop these disorders, those with older fathers present with more severe clinical symptoms. However, the influence of advanced paternal age on other important domains related to schizophrenia, such as quantitative endophenotype deficit levels, remains unknown. This study investigated the associations between paternal age and level of endophenotypic impairment in a well-characterized family-based sample from the Consortium on the Genetics of Schizophrenia (COGS. All families included at least one affected subject and one unaffected sibling. Subjects met criteria for schizophrenia (probands; n = 293 or were unaffected first-degree siblings of those probands (n = 382. Paternal age at the time of subjects' birth was documented. Subjects completed a comprehensive clinical assessment and a battery of tests that measured 16 endophenotypes. After controlling for covariates, potential paternal age-endophenotype associations were analyzed using one model that included probands alone and a second model that included both probands and unaffected siblings. Endophenotype deficits in the Identical Pairs version of the 4-digit Continuous Performance Test and in the Penn Computerized Neurocognitive Battery verbal memory test showed significant associations with paternal age. However, after correcting for multiple comparisons, no endophenotype was significantly associated with paternal age. These findings suggest that factors other than advanced paternal age at birth may account for endophenotypic deficit levels in schizophrenia.

心理干预对改善精神分裂症患者家属心理状况的效果分析%The analysis of psychological intervention to improve psychological status in families of patients with schizophrenia

Institute of Scientific and Technical Information of China (English)

刘光凤; 曹禺; 王旸

2009-01-01

目的 探讨心理干预对改善精神分裂症患者家属心理状况的效果.方法 采用症状自评量表(SCL-90)、焦虑自评量表(SAS)和抑郁自评量表(SDS)对229名精神分裂症患者家属进行调查,并对其进行为期4周的心理干预.结果 精神分裂症患者家属的SCL-90各因子、SAS和SDS的评分均显著高于全国常模(P<0.05),心理干预后,患者家属的SCL-90各因子、SAS和SDS的评分较干预前有显著性降低(P<0.05).结论 精神分裂症患者家属的心理问题状况较为严重,而心理干预可有效改善患者家属的心理状况.%Objective To explore the effects of psychological intervention on psychological status in families of patients with schizophrenia. Methods A total of 229 families of patients with schizophrenia were assessed with Symptom Checklist-90(SCL-90), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS)with psychological intervention for 4 weeks. Results The factor scores of SCL-90,total scores of SAS and SDS in families of patients with schizophrenia were significantly higher than those in national normals,and signifi-cantly decreased after intervention. Conclusion There are serious psychological problems in families of patients with schizophrenia,psychological intervention could improve their psychological status.

Cognitive behaviour therapy for schizophrenia

OpenAIRE

Addington, Jean; Lecomte, Tania

2012-01-01

Schizophrenia is one of the major and potentially severe mental illnesses. Even with best practices, there are limitations to the effectiveness of treatments that include medications for this disorder. Relapse rates are high and often those with the illness remain symptomatic and functionally impaired. All the evidence suggests that individuals with schizophrenia do best with a combination of pharmacological and psychosocial intervention. One psychosocial treatment that has received much atte...

[Theory of mind in schizophrenia spectrum disorders].

Science.gov (United States)

Bora, Emre

2009-01-01

To review studies that investigated theory of mind (ToM) deficits in schizophrenia spectrum disorders. After a thorough literature search, 71 studies were included in this review. Data regarding the relationship between ToM, and other cognitive skills, symptoms, and the impact of the state of illness were reviewed. ToM instruments used in schizophrenia spectrum disorders have some major psychometric limitations; however, previous research was still able to provide some important findings regarding mentalizing impairments in schizophrenia. While ToM deficits are more pronounced in the acute phase of illness, it seems to persist during periods of remission. There is also evidence of ToM deficits in the healthy relatives of schizophrenics, patients with delusional disorder and bipolar disorder (BD), and individuals with high schizotypy scores. ToM dysfunction might be secondary to other cognitive deficits in patients with schizophrenia that have a good prognosis, asymptomatic schizophrenia, delusional disorder, and BD. Other cognitive deficits do not seem to explain ToM dysfunction in patients with psychosis and severe negative symptoms. These findings support the contribution of impairment in both domain-general and domain-specific mechanisms to ToM deficits in schizophrenia spectrum disorders. ToM deficits may be important for understanding poor social functioning and poor insight in psychotic disorders. While ToM is influenced by state variables, it might be an endophenotype of schizophrenia; however, ToM is likely to be an indicator of other frontal lobe-related endophenotypes. Longitudinal studies conducted with high-risk individuals are particularly important.

[Intervention of Schizophrenia From the Community Model].

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Taborda Zapata, Eliana María; Montoya González, Laura Elisa; Gómez Sierra, Natalia María; Arteaga Morales, Laura María; Correa Rico, Oscar Andrés

2016-01-01

Schizophrenia is a complex disease for which pharmacological management is an insufficient therapeutic measure to ensure adaptation to the community and restoring the quality of life of the patient, with a multidimensional management and community interventions being necessary. Case report. This case report illustrates a multidisciplinary treatment response, based on a community care model for mental health from Envigado, Colombia. The management of schizophrenia requires multimodal interventions that include community screening, psychoeducation of individuals, their families and society, addressing different areas of operation that allow adaptation of the subject to his social environment. A integrated intervention that can be provided on a Community scale, with the implementation of policies that allow it to be applied. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Accelerated Brain Aging in Schizophrenia: A Longitudinal Pattern Recognition Study.

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Schnack, Hugo G; van Haren, Neeltje E M; Nieuwenhuis, Mireille; Hulshoff Pol, Hilleke E; Cahn, Wiepke; Kahn, René S

2016-06-01

Despite the multitude of longitudinal neuroimaging studies that have been published, a basic question on the progressive brain loss in schizophrenia remains unaddressed: Does it reflect accelerated aging of the brain, or is it caused by a fundamentally different process? The authors used support vector regression, a supervised machine learning technique, to address this question. In a longitudinal sample of 341 schizophrenia patients and 386 healthy subjects with one or more structural MRI scans (1,197 in total), machine learning algorithms were used to build models to predict the age of the brain and the presence of schizophrenia ("schizophrenia score"), based on the gray matter density maps. Age at baseline ranged from 16 to 67 years, and follow-up scans were acquired between 1 and 13 years after the baseline scan. Differences between brain age and chronological age ("brain age gap") and between schizophrenia score and healthy reference score ("schizophrenia gap") were calculated. Accelerated brain aging was calculated from changes in brain age gap between two consecutive measurements. The age prediction model was validated in an independent sample. In schizophrenia patients, brain age was significantly greater than chronological age at baseline (+3.36 years) and progressively increased during follow-up (+1.24 years in addition to the baseline gap). The acceleration of brain aging was not constant: it decreased from 2.5 years/year just after illness onset to about the normal rate (1 year/year) approximately 5 years after illness onset. The schizophrenia gap also increased during follow-up, but more pronounced variability in brain abnormalities at follow-up rendered this increase nonsignificant. The progressive brain loss in schizophrenia appears to reflect two different processes: one relatively homogeneous, reflecting accelerated aging of the brain and related to various measures of outcome, and a more variable one, possibly reflecting individual variation and

Reducing the Schizophrenia Stigma: A New Approach Based on Augmented Reality

Directory of Open Access Journals (Sweden)

Rafael D. de C. Silva

2017-01-01

Full Text Available Schizophrenia is a chronic mental disease that usually manifests psychotic symptoms and affects an individual’s functionality. The stigma related to this disease is a serious obstacle for an adequate approach to its treatment. Stigma can, for example, delay the start of treatment, and it creates difficulties in interpersonal and professional relationships. This work proposes a new tool based on augmented reality to reduce the stigma related to schizophrenia. The tool is capable of simulating the psychotic symptoms typical of schizophrenia and simulates sense perception changes in order to create an immersive experience capable of generating pathological experiences of a patient with schizophrenia. The integration into the proposed environment occurs through immersion glasses and an embedded camera. Audio and visual effects can also be applied in real time. To validate the proposed environment, medical students experienced the virtual environment and then answered three questionnaires to assess (i stigmas related to schizophrenia, (ii the efficiency and effectiveness of the tool, and, finally (iii stigma after simulation. The analysis of the questionnaires showed that the proposed model is a robust tool and quite realistic and, thus, very promising in reducing stigma associated with schizophrenia by instilling in the observer a greater comprehension of any person during an schizophrenic outbreak, whether a patient or a family member.

Does Schizophrenia in Offspring Increase the Risk of Developing Alzheimer's Dementia

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Christopher Rohde

2016-08-01

Full Text Available Background/Aims: Prior studies have consistently found a higher risk of dementia in individuals with schizophrenia, but whether this is due to a common etiology between the disorders remains obscure. We wanted to elucidate this association by investigating whether schizophrenia in offspring increases the risk of Alzheimer's dementia. Methods: All individuals born between 1930 and 1953 were identified through national registers and followed from their 50th birthday until the date of Alzheimer's dementia, death or end of the study. Regressions were performed to evaluate the association between offspring with schizophrenia and Alzheimer's dementia. Results: Individuals with offspring with schizophrenia did not have an increased risk of Alzheimer's dementia [incidence rate ratio (IRR, 0.97; 95% CI, 0.88-1.07] compared to individuals with offspring without psychiatric contact. This finding remained stable when evaluating early-onset (IRR, 1.10; 95% CI, 0.91-1.31 and late-onset Alzheimer's dementia (IRR, 0.92; 95% CI, 0.88-1.07. Similar findings were made for vascular and unspecified dementia. Conclusion: The finding of no familial coaggregation between schizophrenia and Alzheimer's dementia may suggest that no common etiology between the disorders exists. This may indicate that the excess risk of dementia in individuals with schizophrenia is a by-product of the higher rates of somatic comorbidity and adverse health risk factors among these individuals.

Systemic inflammation and intelligence in early adulthood and subsequent risk of schizophrenia and other non-affective psychoses: a longitudinal cohort and co-relative study.

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Kappelmann, Nils; Khandaker, Golam M; Dal, Henrik; Stochl, Jan; Kosidou, Kyriaki; Jones, Peter B; Dalman, Christina; Karlsson, Håkan

2018-04-06

Schizophrenia is associated with impaired neurodevelopment as indexed by lower premorbid IQ. We examined associations between erythrocyte sedimentation rate (ESR), a marker of low-grade systemic inflammation, IQ, and subsequent schizophrenia and other non-affective psychoses (ONAP) to elucidate the role of neurodevelopment and inflammation in the pathogenesis of psychosis. Population-based data on ESR and IQ from 638 213 Swedish men assessed during military conscription between 1969 and 1983 were linked to National Hospital Discharge Register for hospitalisation with schizophrenia and ONAP. The associations of ESR with IQ (cross-sectional) and psychoses (longitudinal) were investigated using linear and Cox-regression. The co-relative analysis was used to examine effects of shared familial confounding. We examined mediation and moderation of effect between ESR and IQ on psychosis risk. Baseline IQ was associated with subsequent risk of schizophrenia (adjusted HR per 1-point increase in IQ = 0.961; 95% confidence interval (CI) 0.960-0.963) and ONAP (adjusted HR = 0.973; 95% CI 0.971-0.975). Higher ESR was associated with lower IQ in a dose-response fashion. High ESR was associated with increased risk for schizophrenia (adjusted HR = 1.14; 95% CI 1.01-1.28) and decreased risk for ONAP (adjusted HR = 0.85; 95% CI 0.74-0.96), although these effects were specific to one ESR band (7-10 mm/hr). Familial confounding explained ESR-IQ but not ESR-psychoses associations. IQ partly mediated the ESR-psychosis relationships. Lower IQ is associated with low-grade systemic inflammation and with an increased risk of schizophrenia and ONAP in adulthood. Low-grade inflammation may influence schizophrenia risk by affecting neurodevelopment. Future studies should explore the differential effects of inflammation on different types of psychosis.

Risk and protective factors for relapse among individuals with schizophrenia: a qualitative study in Dar es Salaam, Tanzania.

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Sariah, Adellah E; Outwater, Anne H; Malima, Khadija I Y

2014-08-30

Relapse in people with schizophrenia is a major challenge for mental health service providers in Tanzania and other countries. Approximately 10% of people with schizophrenia are re-admitted due to relapse at Muhimbili National Hospital (MNH) Psychiatric Unit each month. Relapse brings about negative effects and it results in a huge burden to patients, their families, the mental health sector and the country's economy. So far no study has been done to address relapse in Tanzania. The purpose of the study was to explore perspectives on risk and protective factors influencing relapse of people with schizophrenia and their caregivers attending Muhimbili National Hospital Psychiatric Out-patient Department, Dar es Salaam, Tanzania. A qualitative study was conducted, involving in-depth interviews of seven people with schizophrenia who are out-patients and their seven family caregivers at MNH. Purposive sampling procedure was used to select participants for the study. Audio recorded in-depth interviews in Swahili language were conducted with all study participants. The recorded information was transcribed and analyzed using NVivo 9 computer assisted qualitative data analysis software. Personal risk and protective factors for relapse, environmental risk and protective factors for relapse and suggestions to reduce relapse were the main themes that emerged from this study. People with schizophrenia and their caregivers (all of whom were relatives) perceived non adherence to antipsychotic medication as a leading risk factor of relapse; other risks included poor family support, stressful life events and substance use. Family support, adherence to antipsychotic medication, employment and religion were viewed as protective factors. Participants suggested strengthening mental health psycho-education sessions and community home visits conducted by mental health nurses to help reduce relapse. Other suggestions included strengthening the nurse-patient therapeutic relationship in

SCHIZOPHRENIA: A REVIEW

OpenAIRE

Parle Milind; Sharma Kailash

2013-01-01

Schizophrenia continues to be a mysterious disease fascinating the minds of psychiatrists, pharmacologists and neuroscientists all over the world for more than a century. The crucial welfare of the millions afflicted with schizophrenia is at stake. The cause of schizophrenia is not yet identified. However, it appears from the available reports that schizophrenia results from genetic, occupational and environmental risk factors, which act independently or combine synergistically to develop sch...

The Genetics of Endophenotypes of Neurofunction to Understand Schizophrenia (GENUS) consortium: A collaborative cognitive and neuroimaging genetics project.

Science.gov (United States)

Blokland, Gabriëlla A M; Del Re, Elisabetta C; Mesholam-Gately, Raquelle I; Jovicich, Jorge; Trampush, Joey W; Keshavan, Matcheri S; DeLisi, Lynn E; Walters, James T R; Turner, Jessica A; Malhotra, Anil K; Lencz, Todd; Shenton, Martha E; Voineskos, Aristotle N; Rujescu, Dan; Giegling, Ina; Kahn, René S; Roffman, Joshua L; Holt, Daphne J; Ehrlich, Stefan; Kikinis, Zora; Dazzan, Paola; Murray, Robin M; Di Forti, Marta; Lee, Jimmy; Sim, Kang; Lam, Max; Wolthusen, Rick P F; de Zwarte, Sonja M C; Walton, Esther; Cosgrove, Donna; Kelly, Sinead; Maleki, Nasim; Osiecki, Lisa; Picchioni, Marco M; Bramon, Elvira; Russo, Manuela; David, Anthony S; Mondelli, Valeria; Reinders, Antje A T S; Falcone, M Aurora; Hartmann, Annette M; Konte, Bettina; Morris, Derek W; Gill, Michael; Corvin, Aiden P; Cahn, Wiepke; Ho, New Fei; Liu, Jian Jun; Keefe, Richard S E; Gollub, Randy L; Manoach, Dara S; Calhoun, Vince D; Schulz, S Charles; Sponheim, Scott R; Goff, Donald C; Buka, Stephen L; Cherkerzian, Sara; Thermenos, Heidi W; Kubicki, Marek; Nestor, Paul G; Dickie, Erin W; Vassos, Evangelos; Ciufolini, Simone; Reis Marques, Tiago; Crossley, Nicolas A; Purcell, Shaun M; Smoller, Jordan W; van Haren, Neeltje E M; Toulopoulou, Timothea; Donohoe, Gary; Goldstein, Jill M; Seidman, Larry J; McCarley, Robert W; Petryshen, Tracey L

2018-05-01

Schizophrenia has a large genetic component, and the pathways from genes to illness manifestation are beginning to be identified. The Genetics of Endophenotypes of Neurofunction to Understand Schizophrenia (GENUS) Consortium aims to clarify the role of genetic variation in brain abnormalities underlying schizophrenia. This article describes the GENUS Consortium sample collection. We identified existing samples collected for schizophrenia studies consisting of patients, controls, and/or individuals at familial high-risk (FHR) for schizophrenia. Samples had single nucleotide polymorphism (SNP) array data or genomic DNA, clinical and demographic data, and neuropsychological and/or brain magnetic resonance imaging (MRI) data. Data were subjected to quality control procedures at a central site. Sixteen research groups contributed data from 5199 psychosis patients, 4877 controls, and 725 FHR individuals. All participants have relevant demographic data and all patients have relevant clinical data. The sex ratio is 56.5% male and 43.5% female. Significant differences exist between diagnostic groups for premorbid and current IQ (both pneuropsychological tests are available for 92% of participants, and 30% have structural MRI scans (half also have diffusion-weighted MRI scans). SNP data are available for 76% of participants. The ancestry composition is 70% European, 20% East Asian, 7% African, and 3% other. The Consortium is investigating the genetic contribution to brain phenotypes in a schizophrenia sample collection of >10,000 participants. The breadth of data across clinical, genetic, neuropsychological, and MRI modalities provides an important opportunity for elucidating the genetic basis of neural processes underlying schizophrenia. Copyright © 2017 Elsevier B.V. All rights reserved.

Systems-level analysis of risk genes reveals the modular nature of schizophrenia.

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Liu, Jiewei; Li, Ming; Luo, Xiong-Jian; Su, Bing

2018-05-19

Schizophrenia (SCZ) is a complex mental disorder with high heritability. Genetic studies (especially recent genome-wide association studies) have identified many risk genes for schizophrenia. However, the physical interactions among the proteins encoded by schizophrenia risk genes remain elusive and it is not known whether the identified risk genes converge on common molecular networks or pathways. Here we systematically investigated the network characteristics of schizophrenia risk genes using the high-confidence protein-protein interactions (PPI) from the human interactome. We found that schizophrenia risk genes encode a densely interconnected PPI network (P = 4.15 × 10 -31 ). Compared with the background genes, the schizophrenia risk genes in the interactome have significantly higher degree (P = 5.39 × 10 -11 ), closeness centrality (P = 7.56 × 10 -11 ), betweeness centrality (P = 1.29 × 10 -11 ), clustering coefficient (P = 2.22 × 10 -2 ), and shorter average shortest path length (P = 7.56 × 10 -11 ). Based on the densely interconnected PPI network, we identified 48 hub genes and 4 modules formed by highly interconnected schizophrenia genes. We showed that the proteins encoded by schizophrenia hub genes have significantly more direct physical interactions. Gene ontology (GO) analysis revealed that cell adhesion, cell cycle, immune system response, and GABR-receptor complex categories were enriched in the modules formed by highly interconnected schizophrenia risk genes. Our study reveals that schizophrenia risk genes encode a densely interconnected molecular network and demonstrates the modular nature of schizophrenia. Copyright © 2018 Elsevier B.V. All rights reserved.

Fine mapping of ZNF804A and genome-wide significant evidence for its involvement in schizophrenia and bipolar disorder.

LENUS (Irish Health Repository)

Williams, H J

2011-04-01

A recent genome-wide association study (GWAS) reported evidence for association between rs1344706 within ZNF804A (encoding zinc-finger protein 804A) and schizophrenia (P=1.61 × 10(-7)), and stronger evidence when the phenotype was broadened to include bipolar disorder (P=9.96 × 10(-9)). In this study we provide additional evidence for association through meta-analysis of a larger data set (schizophrenia\\/schizoaffective disorder N=18 945, schizophrenia plus bipolar disorder N=21 274 and controls N=38 675). We also sought to better localize the association signal using a combination of de novo polymorphism discovery in exons, pooled de novo polymorphism discovery spanning the genomic sequence of the locus and high-density linkage disequilibrium (LD) mapping. The meta-analysis provided evidence for association between rs1344706 that surpasses widely accepted benchmarks of significance by several orders of magnitude for both schizophrenia (P=2.5 × 10(-11), odds ratio (OR) 1.10, 95% confidence interval 1.07-1.14) and schizophrenia and bipolar disorder combined (P=4.1 × 10(-13), OR 1.11, 95% confidence interval 1.07-1.14). After de novo polymorphism discovery and detailed association analysis, rs1344706 remained the most strongly associated marker in the gene. The allelic association at the ZNF804A locus is now one of the most compelling in schizophrenia to date, and supports the accumulating data suggesting overlapping genetic risk between schizophrenia and bipolar disorder.

Resting-state theta-band connectivity and verbal memory in schizophrenia and in the high-risk state.

Science.gov (United States)

Andreou, Christina; Leicht, Gregor; Nolte, Guido; Polomac, Nenad; Moritz, Steffen; Karow, Anne; Hanganu-Opatz, Ileana L; Engel, Andreas K; Mulert, Christoph

2015-02-01

Disturbed functional connectivity is assumed to underlie neurocognitive deficits in patients with schizophrenia. As neurocognitive deficits are already present in the high-risk state, identification of the neural networks involved in this core feature of schizophrenia is essential to our understanding of the disorder. Resting-state studies enable such investigations, while at the same time avoiding the known confounder of impaired task performance in patients. The aim of the present study was to investigate EEG resting-state connectivity in high-risk individuals (HR) compared to first episode patients with schizophrenia (SZ) and to healthy controls (HC), and its association with cognitive deficits. 64-channel resting-state EEG recordings (eyes closed) were obtained for 28 HR, 19 stable SZ, and 23 HC, matched for age, education, and parental education. The imaginary coherence-based multivariate interaction measure (MIM) was used as a measure of connectivity across 80 cortical regions and six frequency bands. Mean connectivity at each region was compared across groups using the non-parametric randomization approach. Additionally, the network-based statistic was applied to identify affected networks in patients. SZ displayed increased theta-band resting-state MIM connectivity across midline, sensorimotor, orbitofrontal regions and the left temporoparietal junction. HR displayed intermediate theta-band connectivity patterns that did not differ from either SZ or HC. Mean theta-band connectivity within the above network partially mediated verbal memory deficits in SZ and HR. Aberrant theta-band connectivity may represent a trait characteristic of schizophrenia associated with neurocognitive deficits. As such, it might constitute a promising target for novel treatment applications. Copyright © 2014 Elsevier B.V. All rights reserved.

Importing low-density ideas to high-density revitalisation

DEFF Research Database (Denmark)

Arnholtz, Jens; Ibsen, Christian Lyhne; Ibsen, Flemming

2016-01-01

Why did union officials from a high-union-density country like Denmark choose to import an organising strategy from low-density countries such as the US and the UK? Drawing on in-depth interviews with key union officials and internal documents, the authors of this article argue two key points. Fi...

Postmortem evidence of cerebral inflammation in schizophrenia: a systematic review.

Science.gov (United States)

Trépanier, M O; Hopperton, K E; Mizrahi, R; Mechawar, N; Bazinet, R P

2016-08-01

Schizophrenia is a psychiatric disorder which has a lifetime prevalence of ~1%. Multiple candidate mechanisms have been proposed in the pathogenesis of schizophrenia. One such mechanism is the involvement of neuroinflammation. Clinical studies, including neuroimaging, peripheral biomarkers and randomized control trials, have suggested the presence of neuroinflammation in schizophrenia. Many studies have also measured markers of neuroinflammation in postmortem brain samples from schizophrenia patients. The objective of this study was to conduct a systematic search of the literature on neuroinflammation in postmortem brains of schizophrenia patients indexed in MEDLINE, Embase and PsycINFO. Databases were searched up until 20th March 2016 for articles published on postmortem brains in schizophrenia evaluating microglia, astrocytes, glia, cytokines, the arachidonic cascade, substance P and other markers of neuroinflammation. Two independent reviewers extracted the data. Out of 5385 articles yielded by the search, 119 articles were identified that measured neuroinflammatory markers in schizophrenic postmortem brains. Glial fibrillary acidic protein expression was elevated, lower or unchanged in 6, 6 and 21 studies, respectively, and similar results were obtained for glial cell densities. On the other hand, microglial markers were increased, lower or unchanged in schizophrenia in 11, 3 and 8 studies, respectively. Results were variable across all other markers, but SERPINA3 and IFITM were consistently increased in 4 and 5 studies, respectively. Despite the variability, some studies evaluating neuroinflammation in postmortem brains in schizophrenia suggest an increase in microglial activity and other markers such as SERPINA3 and IFITM. Variability across studies is partially explained by multiple factors including brain region evaluated, source of the brain, diagnosis, age at time of death, age of onset and the presence of suicide victims in the cohort.

Conceptualizations of illness among relatives of patients diagnosed with schizophrenia.

Science.gov (United States)

Villares, Cecília C; Redko, Cristina P; Mari, Jair J

2017-06-01

Family concepts of a relative's illness are an important part of the coping process and reveal the cultural construction of the experience of illness. As part of a qualitative study conducted in the Schizophrenia Outpatient Clinic of the Department of Psychiatry, Escola Paulista de Medicina - UNIFESP, 14 relatives of eight outpatients diagnosed with schizophrenia were interviewed and invited to talk freely about their ideas and feelings concerning their relative's problem. Qualitative analysis was used to identify categories of illness representations. Three main categories were discussed, including Problema de Nervoso, Problema na Cabeça and Problema Espiritual (Problem of the Nerves, Problem in the Head and Spiritual Problem). The authors present evidence of these categories as cultural constructions, and discuss the relevance of popular notions of illness to the understanding of the course and outcome of schizophrenia, and the planning of culturally meaningful interventions.

SOCIODEMOGRAPHIC PROFILE OF SCHIZOPHRENIA WITH AND WITHOUT OBSESSIVE COMPULSIVE SYMPTOMS

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Adavalath Druhin

2017-12-01

Full Text Available BACKGROUND Schizophrenia is a complex neurobehavioural disorder affecting about 1% of the general population. Schizophrenia is characterised by disordered cognition including a “gain of function” in psychotic symptoms and “loss of function” in specific cognitive functions such as working and declarative memory, but without the progressive dementia that characterises classical neurodegenerative disorder. The primary aim of the study was to compare the profile of patients diagnosed with schizophrenia with and without obsessive compulsive symptoms. MATERIALS AND METHODS This was a cross-sectional study. Consecutive patients in the age group of 18-59 years diagnosed to have schizophrenia with at least 2 years of duration of illness consulting in outpatient department of psychiatry and inpatients admitted in psychiatry ward at a tertiary care centre at northern Kerala were included. Clinical status of the patient was assessed using Structured Clinical Interview for DSM - IV - TR (SCID I, the Positive and Negative Symptom Scale (PANSS and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS severity and symptom checklist. YBOCS ≥16 was labelled as OCD. Sociodemographic profile of the patients will be collected using specially designed pro forma. Data analysis was done using software “R” (Chi-square and t test. RESULTS A total of 73 participants formed the study sample. The schizophrenia with OCS were better educated were more likely to come from a semi-urban background had alcohol dependence and longer duration of untreated illness than the group with schizophrenia alone. Though, there was increased frequency of paranoid subtype in the study sample, schizophrenia patients with OCD/OCS had majority of undifferentiated subtype. There is no difference in gender, family type, marital status, occupation, religion or socioeconomic status. CONCLUSION Schizophrenia patients with OCS/OCD and without OCS/OCD have comparable clinical profile with few

The New York High-Risk Project: social and general intelligence in children at risk for schizophrenia.

Science.gov (United States)

Ott, S L; Spinelli, S; Rock, D; Roberts, S; Amminger, G P; Erlenmeyer-Kimling, L

1998-05-04

Social deficits, as well as low performance on intelligence tests, are known early symptoms of schizophrenia. We studied whether impairment of social intelligence can be detected before the outbreak of the disorder. In the New York High-Risk Project, children at risk for schizophrenia (HRSz) or affective disorder (HRAff) and a normal control group (NC) were studied over the past 26 years. The children are now in mid-adulthood, with known psychiatric outcomes. Developmental and clinical data from childhood can now be related to adulthood diagnoses. We compared mean WISC (or WISC-R) and WAIS (or WAIS-R) scores from childhood and adolescence, and change of IQ, between the risk groups, as well as between the adulthood outcomes. We were specifically interested in the development of social intelligence (the Picture Arrangement and Comprehension subtests). We used logistic regression analyses to generate a model predicting adulthood schizophrenia. IQ at age 9,7 was lower in children with HRSz than with HRAff. Adulthood schizophrenia, compared with major depressive disorder and no psychiatric diagnosis could not be related conclusively to low IQ. This may be a result of the study design, since children with IQ below 70 or behavioral problems were not eligible as study subjects. There was no evidence of lower scores or more decline in social intelligence related to age or group membership (risk or outcome). Subtest-Scatter, a nondirectional measure of the differences between all subtests and Vocabulary, reflecting a lesser difference between crystallized and fluid intelligence, was identified as a significant predictor of adulthood schizophrenia, in the whole group as well as in the HRSz group alone.

Cross-cultural adaptation and validation of the Greek version of the Family Questionnaire for assessing expressed emotion.

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Koutra, Katerina; Economou, Marina; Triliva, Sofia; Roumeliotaki, Theano; Lionis, Christos; Vgontzas, Alexandros N

2014-05-01

Expressed emotion (EE) has proved to be an established factor in short-term relapse in schizophrenia. The aim of the present study was to examine the psychometric properties of the Greek version of the Family Questionnaire (FQ), a brief self-report questionnaire measuring the EE status of relatives of patients with schizophrenia in terms of criticism (CC) and emotional overinvolvement (EOI). The translated and adapted 20-item FQ was administered to 176 family caregivers of patients with schizophrenia and bipolar disorder. Caregivers' burden (Family Burden Scale) and psychological distress (General Health Questionnaire-28) were also evaluated. The findings indicated that the Greek version displays a two-factor structure with two subscales of EE-CC and EOI-with 10 items each, similarly to the original version. The convergent validity of the subscales was highly supported by correlations with caregivers' burden and psychological distress. The Cronbach's α coefficient measuring internal consistency for the two scales were 0.90 for CC and 0.82 for EOI. The test-retest correlation coefficients measuring reproducibility were 0.99 and 0.98 for CC and EOI, respectively. The Greek version of the FQ appears to be a valid and reliable instrument to be used in both research and clinical assessment of family EE. Copyright © 2014 Elsevier Inc. All rights reserved.

First episode schizophrenia

African Journals Online (AJOL)

with schizophrenia present clinically with psychotic, negative and cognitive ... changes in their emotions, cognition or behaviour which may indicate a ... contribute 80% to the risk of schizophrenia developing. A number of .... Positive symptoms ... Depression ... treatment of first episode schizophrenia is of critical importance.

Family history density of substance use problems among undergraduate college students: Associations with heavy alcohol use and alcohol use disorder.

Science.gov (United States)

Powers, Gregory; Berger, Lisa; Fuhrmann, Daniel; Fendrich, Michael

2017-08-01

A family history of alcoholism has been found associated with problematic alcohol use among college students, but less research has examined the effects of family history density of substance use problems in this population. This study examined the prevalence of family history density of substance use problems and its associations with heavy alcohol use, negative alcohol consequences, and alcohol use disorder in a college sample. Based on a secondary analysis of a probability sample, data were analyzed from 606 undergraduate students. Family history density of substance use problems included both first and second degree biological relatives. Heavy alcohol use was the total number of days in which participants drank five/four or more drinks for men/women, negative alcohol consequences were derived from items commonly asked in college student surveys, and an alcohol use disorder was defined as meeting diagnostic criteria for alcohol abuse or dependence. Point prevalence estimated rates of family history density of substance use problems, and negative binomial, ANCOVA, and logistic regression models examined associations between family history density and the alcohol variables while adjusting for sociodemographic variables. Family history density of substance use problems was not significantly associated with total days of heavy alcohol use. Having a second degree, a first degree, or both a first and second degree relative(s) with a substance use problem, however, was significantly associated with experiencing negative alcohol consequences. In addition, having both a first and second degree relative(s) with a substance use problem significantly increased the odds of having an alcohol use disorder. Family history density of substance use problems may play a role in experiencing negative alcohol consequences and in having an alcohol use disorder among undergraduate college students and may be an important risk factor to assess by college health professionals. Copyright

Associating schizophrenia, long non-coding RNAs and neurostructural dynamics

Science.gov (United States)

Merelo, Veronica; Durand, Dante; Lescallette, Adam R.; Vrana, Kent E.; Hong, L. Elliot; Faghihi, Mohammad Ali; Bellon, Alfredo

2015-01-01

Several lines of evidence indicate that schizophrenia has a strong genetic component. But the exact nature and functional role of this genetic component in the pathophysiology of this mental illness remains a mystery. Long non-coding RNAs (lncRNAs) are a recently discovered family of molecules that regulate gene transcription through a variety of means. Consequently, lncRNAs could help us bring together apparent unrelated findings in schizophrenia; namely, genomic deficiencies on one side and neuroimaging, as well as postmortem results on the other. In fact, the most consistent finding in schizophrenia is decreased brain size together with enlarged ventricles. This anomaly appears to originate from shorter and less ramified dendrites and axons. But a decrease in neuronal arborizations cannot explain the complex pathophysiology of this psychotic disorder; however, dynamic changes in neuronal structure present throughout life could. It is well recognized that the structure of developing neurons is extremely plastic. This structural plasticity was thought to stop with brain development. However, breakthrough discoveries have shown that neuronal structure retains some degree of plasticity throughout life. What the neuroscientific field is still trying to understand is how these dynamic changes are regulated and lncRNAs represent promising candidates to fill this knowledge gap. Here, we present evidence that associates specific lncRNAs with schizophrenia. We then discuss the potential role of lncRNAs in neurostructural dynamics. Finally, we explain how dynamic neurostructural modifications present throughout life could, in theory, reconcile apparent unrelated findings in schizophrenia. PMID:26483630

[Psychosocial Interventions in Acute and Maintenance Treatment of Adult Patients Diagnosed With Schizophrenia].

Science.gov (United States)

Ahunca Velásquez, Luisa Fernanda; García Valencia, Jenny; Bohórquez Peñaranda, Adriana Patricia; Gómez-Restrepo, Carlos; Jaramillo González, Luis Eduardo; Palacio Acosta, Carlos

2014-01-01

To determine the effectiveness of the psychosocial strategies designed to improve the outcomes in adults with schizophrenia in both, acute and stable phase of the disorder. This evidence is used to propose recommendation in the guidelines of integral attention for the diagnosis, treatment and psychosocial rehabilitation of adults with schizophrenia. A guideline for clinical practice was developed using the methodological framework of the Ministerio de la Protección Social to collect evidence and grading recommendations. A search, evaluation and synthesis of evidence were carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The psychoeducation and family intervention showed higher efficacy, compared with the usual treatment, to prevent relapses and hospital readmissions, to reduce family burden and to improve adherence to treatment. The social skill training was effective to improve symptoms, social functioning and quality of life. However, the quality of evidence was low. There was not enough evidence about the efficacy of occupational therapy, but considering patients preferences and its wide clinical utilization, the GDG suggested its inclusion. Psychoeducation, family intervention and social skill training are recommended to be offered for the treatment of schizophrenia. Furthermore, occupational therapy is suggested for inpatients and outpatients with the disorder. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Group and site differences on the California Verbal Learning Test in persons with schizophrenia and their first-degree relatives: findings from the Consortium on the Genetics of Schizophrenia (COGS).

Science.gov (United States)

Stone, William S; Giuliano, Anthony J; Tsuang, Ming T; Braff, David L; Cadenhead, Kristin S; Calkins, Monica E; Dobie, Dorcas J; Faraone, Stephen V; Freedman, Robert; Green, Michael F; Greenwood, Tiffany A; Gur, Raquel E; Gur, Ruben C; Light, Gregory A; Mintz, Jim; Nuechterlein, Keith H; Olincy, Ann; Radant, Allen D; Roe, Andrea H; Schork, Nicholas J; Siever, Larry J; Silverman, Jeremy M; Swerdlow, Neal R; Thomas, Alison R; Tsuang, Debby W; Turetsky, Bruce I; Seidman, Larry J

2011-05-01

Genetic studies of schizophrenia focus increasingly on putative endophenotypes because their genetic etiology may be simpler than clinical diagnosis. The Consortium on the Genetics of Schizophrenia (COGS), a multisite family study, aims to identify the genetic basis of several endophenotypes including verbal declarative memory (VDM), a neurocognitive function that shows robust impairment in schizophrenia. We present data on one type of measure of VDM, the California Verbal Learning Test, Second Edition (CVLT-II), in schizophrenia probands (n=305), their full biological siblings (n=449) and parents (n=232), and in community comparison subjects (CCS; n=509) across seven sites. Probands performed more poorly on each of five CVLT-II measures compared to related sibling and parent groups and CCS. Siblings and parents performed significantly worse than CCS on one measure (Discriminability), but with smaller effect sizes and less impairment than observed previously. The results raise questions about the homogeneity of VDM as an endophenotype, about methodological issues related to sampling, and about psychometric issues that impact the utility of the CVLT for detecting VDM deficits in nonpsychotic relatives of persons with schizophrenia. Copyright © 2011 Elsevier B.V. All rights reserved.

Social problem-solving in high-functioning schizophrenia: specific deficits in sending skills.

Science.gov (United States)

Vaskinn, Anja; Sundet, Kjetil; Hultman, Christina M; Friis, Svein; Andreassen, Ole A

2009-02-28

This study examined social problem-solving performance in high-functioning schizophrenia (n=26) and its relation to neurocognition. Ten healthy controls were used as a comparison group. Social problem-solving was assessed with the Assessment of Interpersonal Problem Solving Skills (AIPSS) method. The schizophrenia group was outperformed by healthy controls on all AIPSS measures, reaching statistical significance for sending skills. Exploration of the internal relationship between different aspects of social problem-solving showed that identification of an interpersonal problem (a receiving skill) was not correlated with formulating solutions to the problem (processing skills) or successfully role-playing solutions (interpersonal sending skills). Non-verbal performance in the role-play (an interpersonal sending skill) was not significantly correlated with identification of an interpersonal problem or the generation of solutions. This suggests a dissociation of social problem-solving processes. Social problem-solving was significantly associated with psychomotor speed, verbal learning, semantic fluency and cognitive flexibility. Clinical implications are that remediation of social problem-solving skills should focus on role-playing (nonverbal) interpersonal behaviors, rather than on verbally analyzing an interpersonal problem and clarifying alternative solutions.

Endogenous and Antipsychotic-Related Risks for Diabetes Mellitus in Young People With Schizophrenia: A Danish Population-Based Cohort Study.

Science.gov (United States)

Rajkumar, Anto P; Horsdal, Henriette Thisted; Wimberley, Theresa; Cohen, Dan; Mors, Ole; Børglum, Anders D; Gasse, Christiane

2017-07-01

Diabetes mellitus contributes to excessive cardiovascular deaths and reduced life expectancy in schizophrenia. This population-based cohort study investigated the endogenous risk for diabetes in antipsychotic-naive schizophrenia and evaluated the risks added by starting antipsychotic treatment in people with schizophrenia. The study followed all people born in Denmark on or after Jan. 1, 1977, until Jan. 1, 2013 (N=2,736,510). The Danish Psychiatric Central Research Register ascertained schizophrenia diagnoses. The Danish National Prescription Registry provided data on prescriptions of antipsychotics. Diabetes was ascertained from the Danish National Patient Register and Danish National Prescription Registry. The authors estimated the endogenous and antipsychotic-related risks for diabetes by using Cox proportional hazards regression models, while accounting for potential confounders. Of the cohort members, 14,118 (0.52%) developed diabetes, and 8,945 (0.33%) developed schizophrenia during follow-up (49,582,279 person-years). The adjusted hazard ratio for diabetes was 3.07 (95% confidence interval [CI], 1.71-5.41) in antipsychotic-naive schizophrenia compared with the general population. The risk for diabetes after starting antipsychotic treatment was significantly higher (adjusted hazard ratio, 3.64; 95% CI, 1.95-6.82) than the risk in antipsychotic-naive schizophrenia, after adjustment for family history of diabetes and other potential confounders. First-line treatment with either first-generation antipsychotics (adjusted hazard ratio, 3.06; 95% CI, 1.32-7.05) or second-generation antipsychotics (adjusted hazard ratio, 3.44; 95% CI, 1.73-6.83) increased the risk for diabetes without a statistically significant difference. Appropriate sensitivity analyses limited to type 2 diabetes corroborated these results. Schizophrenia confers a high endogenous risk for diabetes, and the risk is further increased by both first-generation and second-generation antipsychotics

Association of the 3′ Region of COMT with Schizophrenia in Taiwan

Directory of Open Access Journals (Sweden)

Yi-Ling Chien

2009-04-01

Conclusion: The SNP rs165599, which has been mapped to the 3′-UTR region of the COMT gene, was significantly associated with schizophrenia in our family study, and possibly associated with the age of onset, delusion/hallucination symptom dimension, and CPT performance. Therefore, COMT may contribute to the genetic risk for schizophrenia not through the Val108/158 Met polymorphism, but through other variants that are situated 3′ to this region, in the Taiwanese population. Nevertheless, the true associated functional variants in our subjects remain to be elucidated.

High Energy Density Laboratory Astrophysics

CERN Document Server

Lebedev, Sergey V

2007-01-01

During the past decade, research teams around the world have developed astrophysics-relevant research utilizing high energy-density facilities such as intense lasers and z-pinches. Every two years, at the International conference on High Energy Density Laboratory Astrophysics, scientists interested in this emerging field discuss the progress in topics covering: - Stellar evolution, stellar envelopes, opacities, radiation transport - Planetary Interiors, high-pressure EOS, dense plasma atomic physics - Supernovae, gamma-ray bursts, exploding systems, strong shocks, turbulent mixing - Supernova remnants, shock processing, radiative shocks - Astrophysical jets, high-Mach-number flows, magnetized radiative jets, magnetic reconnection - Compact object accretion disks, x-ray photoionized plasmas - Ultrastrong fields, particle acceleration, collisionless shocks. These proceedings cover many of the invited and contributed papers presented at the 6th International Conference on High Energy Density Laboratory Astrophys...